Chaplains, Covid, and the Moral Suffering of Healthcare Workers

Abstract

The early months of the Covid pandemic were a profoundly stressful experience for American healthcare workers, including chaplains working in hospitals and other healthcare settings. This D.Min. thesis paper begins with a personal reflection on the changes wrought by Covid at Vassar Brothers Medical Center, a mid-sized teaching hospital in the Hudson Valley. These changes involved medical, nursing, and chaplaincy practices, and brought considerable physical, emotional, and ethical distress to healthcare workers, not just at VBMC but across the world.

The thesis then reviews the international research literature and personal testimonies to examine how chaplains adapted to Covid restrictions. Chaplains across the world devoted more time to staff support than they did prior to Covid. Healthcare workers also reported unprecedented levels of moral suffering during the early months of the pandemic, “moral suffering” being an overarching idea that encompasses the distinct phenomena of moral distress and moral injury. The origins, definitions, applicability and overlap of moral distress and moral injury is discussed as background to a literature review of chaplain responses to moral suffering. Much of the research and innovation in addressing moral injury was developed by the military or in veteran’s institutions, and is not directly applicable to healthcare, as the source of the inner wounds is very different. Moral suffering should also be understood in the context of conventional medical ethics, which I believe can provoke distress from the inevitable failure to achieve narrowly defined ethically acceptable outcomes.

This paper proposes an alternative ethical approach, grounded in the ancient virtues, that may help healthcare workers develop what one ethicist calls “moral resilience,” or the capacity to retain one’s integrity in the face of competing and fast-moving moral demands. An approach to spiritual care informed by virtue ethics is proposed as a conceptual tool for chaplains in addressing the moral suffering of healthcare workers as they continue to struggle with diminished resources and chronic staffing shortages in the wake of the pandemic.