Moral injury in medical professionals during COVID-19

Moral injury has been documented across professions that involve high-stakes decision-making such as military service, emergency response, and healthcare. The COVID-19 pandemic particularly highlighted this phenomenon as a critical occupational hazard for healthcare workers, reflecting both personal suffering and broader systemic failures. This review explores moral injury among healthcare workers across three dimensions. First, it addresses individual factors such as clinical experience, gendered vulnerability, and self-accusation cycles. Second, it discusses institutional triggers, including duty-conscience conflicts, organizational trust erosion, and ethical triage under resource scarcity. Finally, it highlights protective factors, including being married, having a high level of education, well- being, and institutional support. The study finds that moral injury among healthcare workers during COVID-19 results from the interplay of individual vulnerabilities and systemic flaws. Future research should focus on integrating psychological support with healthcare reforms to prevent and alleviate moral injury.