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Moral Suffering
By Carl ToersBijns, former deputy warden, ASPC Eyman, Florence AZ
Published: 06/11/2018

Officer incident A little-known phenomenon called “Moral Distress” or “Moral Injury” is rarely talked about in an open circle of law enforcement officers, jailers, and correctional officers. Although it may play a major part in your life on duty or off duty, your mind disregards this factor, so you can focus on the job the best you can under the ever-present stressful circumstances. Without making a big deal about it, as a first responder, you suffer from traumatization and moral suffering without even recognizing it because of the role you play in being a first responder. Whatever you do and how well you perform your duty is based on your training, experiences and ethical or moral expectations.

Every critical incident you are involved in makes you that much better at what you can do but at the same time, you suffer another level or degree of damage to yourself. Even long after the critical incident has been resolved or you are told to stand down, you continue to execute, while at the same time dealing with the post-traumatic stress disorder inflicted upon you or exposed to you either in a primary stage or as a secondary exposure. Much of what you do is a matter of life or death and moral suffering impacts your well being long after you have endured a serious incident on your shift.

Whether you like to admit it or not, what you do or how you do it is all based on how much you care. The cost of caring too much weighs heavily on your shoulders and as it wears you down, fatigue sets in and attacks your immune system and your mind without you knowing it is happening. Your cognitive skills let you down that you are being attacked and because of this lack of awareness, it often takes you down to a point where you are dealing with what is called “compassion fatigue.”

Based on own personal perspective, it seems that compassion fatigue is cognitively related to the moral suffering experienced by first responders in the line of duty. Research shows that there are two types of moral suffering that leads to some level of traumatization – moral distress and moral injury. The role of these two factors leads to compassion fatigue and PTSD. Nobody is invincible, and it is foolish to think you are.

Moral distress was first talked about by first responder professionals who emphasized the challenging moral moments that law enforcement officers and correctional officers experience when they provide care to inmates or fellow officers. What was realized was the fact that these factors produced a series of painful feelings and psychological imbalance that takes place when first responders are made aware of a moral standard of care that dictates that a decently proper decision or a moral decision has to be made according to the needs without being able to make it, usually as a result, of various barriers including physical plant hurdles: institution policy, lack of time, lack of training, and sometimes political protocols.

It has also been suggested that moral distress refers to situations when first responder professionals fail to pursue the right course of action because of an error in judgment, wrong decision-making, wrong action plan, or the fact that the circumstances are beyond their action planning. Without a doubt, this shortcoming also has a level of guilt associated with it.

Unfortunately, it is argued that moral distress is more pervasive among first responders and medical professionals as they are the individuals who are expected to make decisions and judgments—that encompass moral components—during complex and often dangerous situations or incidents.

Complex decision-making as police, correctional officers, and medical staff are mandated by their role and oaths to maintain peace and order, safety and security and at the same time provide compassion to victims of crimes, violence or accidents. Their role is to save those who are in danger. From the very beginning, law enforcement officers and first responders are instilled with the prominent role dedication and expectation to perform with a high level of integrity, and even self-sacrifice ought to play in their conduct, with the objective in mind to save and support civilian victims and to complete their missions successfully.

It is sometimes commonly referred to as the “God’s Syndrome” and the pressure to uphold such an expectation is unsurmountable and unreal. Nevertheless, according to the circumstances they find themselves in, first responders are not always able to protect or support victims or arrest or detain and control violent criminals. However, when the first responder’s decision, action plans, or willingness to help those who are in danger and to provide aid is precluded or is not completed successfully, then officers may experience moral distress through no fault of their own.

Moral distress can be like a heavy weight on your shoulders that has been slowly building as you work in the criminal justice system. You may not even notice the developing distress until something snaps inside your head. Correctional officers need to monitor moral distress and seek morally satisfying solutions to the ethical dilemmas encountered in the day-to-day routine of the job. It is essential to take an awareness assessment and become aware where your moral compass sits.

The first step in solving moral distress is to identify it. Moral distress has been defined as knowing the right action to take but is constrained from taking it. However, among first responders, there are ethical dilemmas to consider where the best course of action is sometimes not the best for the victim. Thus, you may find yourself in conflict with what would be best for others; whether it is the public, the agency or organization, other officers etc. So, the internal set of circumstances of the first responder may conflict with the external world of the work environment. That is the reality we deal with daily. We do not work in a perfect world.

Moral distress is when you are involved or made aware of a critical incident that calls for a moral/ethical action and or a decision. To make it more complicated, you may be obstructed or blocked from taking or making that moral action or best possible decision. Lastly, you may experience negative feelings e.g. guilt or remorse or regret because that action was not taken. In the correctional world, there are many examples of obstructive factors that lead to moral distress.

They are based on cultural interactions, biases (intentional or unintentional) poor staffing patterns, lack of resources, lack of training or obstruction from officers or leadership that may lead to delays, or gaps in situational management tools.

Conscientious law enforcement staff or first responders absorb the stress of unethical or poorly executed performance.

Absorbing stress is a natural process. Every high-stress job has moral stress attached to it. Over time, this moral stress builds up and lays squarely on your shoulders every time you come to work. It affects your emotional, psychological and physical wellbeing. This extra weight has been defined as “moral residue” that is particularly intense when your personal and professional integrity is assailed repeated over a period of time and there is nothing you can do about it as it is a major part of your job.

Trying to identify what moral stress is can be most difficult. What some feel or express are moments of inner fear, feeling powerless, anxious or unhappy. It also has side effects that may be experienced as nausea or sick in your stomach kind of feeling and insomnia and headaches. It is certain these are feelings of discontent and could have been inflicted or be a result of the additional weight of dealing with long exposures of moral distress.

Persons experiencing moral distress can also feel embarrassed, humiliated or feel belittled or unimportant in morally distressing situations. It is common to experience a sense of isolation if you do not feel supported in talking about the morally injuring situations around you. Yet, talking to a supportive colleague is an important action to help identify and clarify moral distress. In most cases, you can resolve your own inner conflicts yourself, but some may need professional counseling to deal with the reality that it certainly exists in many instances where first responders are working in a stressful caregiving/caretaking servant position such as public safety or correctional services.

Reference materials used:
https://correctionalnurse.net/author/lorryschoenly/

Corrections.com author, Carl ToersBijns, (retired), has worked in corrections for over 25 yrs He held positions of a Correctional Officer I, II, III [Captain] Chief of Security Mental Health Treatment Center – Program Director – Associate Warden - Deputy Warden of Administration & Operations. Carl’s prison philosophy is all about the safety of the public, staff and inmates, "I believe my strongest quality is that I create strategies that are practical, functional and cost effective."

Other articles by ToersBijns:


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