Abstract
The Arab world is currently flooded with wars of different kinds. Yet, amidst these wars, we continue to be inspired and assuaged by the presence of humanism, particularly exemplified by field physicians who defy the odds and decide to fight warfare via medicine, showing huge moral courage yet, often, victims of moral injury. In this chapter, we point to the strength that is moral courage and delve into the moral struggle that field physicians encounter as they attempt to enact that very courage and heal patients in the detrimental conditions of war. The ensuing moral struggle, otherwise known as moral distress leading to moral injury, is a tenacious struggle that places individuals at the disadvantage of what we term “moral handicap.” Henceforth, we highlight the process of injury and argue that it is not a term exclusive to veterans and soldiers but also an injury that extends to all moral agents participating in war. We tell the story of the virtuous physician whose help is much needed, and whose resultant moral injury is dual injury not only to herself, but to the welfare of underserved and helpless patients in war zones offering a lens to physicians aiding the sick in the ravaging wars of the Middle East and providing the reader with possible solutions to alleviate that moral injury (Lachman VD, MedSurg Nursing 25:121–125, 2016; Litz B, Stein N, Delaney E, Clin Psychol Rev 29:695–706, 2009).
Similar content being viewed by others
References
Archer A, Ridge M (2014) The heroism paradox: another paradox of supererogation. Philos Stud 172:1575–1592. https://doi.org/10.1007/s11098-014-0365-1
Aristotle (2009) The Nicomachean ethics. Translated by David Ross and edited by Lesley Brown L. Oxford University Press, Oxford
Buchanan RT (2016) The last senior pediatrician in Aleppo was killed in an airstrike on a Syrian hospital. BuzzFeed News. https://www.buzzfeednews.com/article/rosebuchanan/the-last-senior-pediatrician-in-aleppo-was-killed-in-an-airs. Accessed 8 Aug 2019
Camus A (1970) Lyrical and critical essays. Edited by Philip Thody and translated by Ellen Conroy Kennedy. Vintage (September 12, 1970)
Camus A (1992) The rebel. Translated by Anthony Bower. Vintage
Camus A (1995) The myth of Sisyphus, and other essays. Vintage Books, New York, pp 281–282
Currier JM, Holland JM, Drescher K, Foy D (2015) Initial psychometric evaluation of the Moral Injury Questionnaire – Military version. Clin Psychol Psychother 22(1):54–63
Drescher KD, Foy DW, Kelly C, Leshner A, Schutz K, Litz B (2011) An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology 17(1):8–13
Farnsworth J, Drescher K, Evans W, Walser R (2017) A functional approach to understanding and treating military-related moral injury. J Contextual Behav Sci 6:391–397. https://doi.org/10.1016/j.jcbs.2017.07.003
Flipse Vargas A, Hanson T, Kraus D, Drescher K, Foy D (2013) Moral injury themes in combat veterans’ narrative responses from the National Vietnam Veterans’ Readjustment Study. Traumatology 19(3):243–250
Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL (2004) Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 351(1):13–22
Lachman VD (2016) Moral resilience: managing and preventing moral distress and moral residue. Medsurg Nurs 25(2):121–125
Lamiani G, Borghi L, Argentero P (2016) When healthcare professionals cannot do the right thing: a systematic review of moral distress and its correlates. J Health Psychol 22:51–67. https://doi.org/10.1177/1359105315595120
Lee DA, Scragg P, Turner S (2001) The role of shame and guilt in traumatic events: a clinical model of shame-based and guilt-based PTSD. Br J Med Psychol 74:451–466
Litz B, Stein N, Delaney E et al (2009) Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev 29(8):695–706. https://doi.org/10.1016/j.cpr.2009.07.003
McCann L, Pearlman LA (1990) Psychological trauma and the adult survivor: theory, therapy, and transformation. Brunner/Mazel, Philadelphia
Murray J (2010) Moral courage in healthcare: acting ethically even in the presence of risk. Online J Issues Nurs. https://doi.org/10.3912/OJIN.Vol15No03Man02
Rushton C (2013) Principled moral outrage: an antidote to moral distress. AACN Adv Crit Care 24(1):82–89. https://doi.org/10.1097/nci.0b013e31827b7746
Talbot SG, Dean W (2018) Physicians aren’t ‘burning out.’ They’re suffering from moral injury. In: STAT. https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/. Accessed 9 Aug 2019
Urmson JO (1958) Saints and heroes. In: Melden a essays in moral philosophy. University of Washington Press
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this entry
Cite this entry
Arawi, T., El Halabi, S. (2020). Humanitarian Medicine and Moral Injury: An Inevitable Aftermath in Humanitarian Rebellion. In: Laher, I. (eds) Handbook of Healthcare in the Arab World. Springer, Cham. https://doi.org/10.1007/978-3-319-74365-3_199-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-74365-3_199-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74365-3
Online ISBN: 978-3-319-74365-3
eBook Packages: Springer Reference MedicineReference Module Medicine