By the South door of York Minster sits a fine statue of the Emperor Constantine. His left hand rests on the pommel of his sword while the right is extended at leisure, hand relaxed. It is here that Constantine was proclaimed Emperor in 306 AD; leader of an empire in his mid-twenties.
Around the time of lockdown Constantine was given a surgical mask. I’ve no idea why, or by whom, but the addition reminded me of how power has been humbled by something so tiny. All the weaponry of the modern world is powerless in the face of this tide of sickness. The Prime Minister’s personal protection officers stood no chance of averting contagion and its consequences. Security gates, alarms and early warning systems, were useless when it came to Covid-19. While spending billions on sophisticated defences a virus has stolen into our lives and wreaked havoc. Tens of thousands dead; personal freedoms curtailed; economies heading into sharp decline with astonishing speed.
Even as we attempt to negotiate an exit from lockdown our capacity to return to anything like normality is in serious question. The threat of a second wave hovers over us and the NHS is on standby, prepared for its impact. We are both heaving a sigh of relief that the worst seems to be past, while feeling apprehensive about the consequences of more people being closer together.
Hidden in the worries about wellbeing and economic survival there is the risk of collective Moral Injury. This is a state of suffering distinct from PTSD and burnout, which reflects the implications of actions – or a lack of actions – in particular situations. Moral Injury as a distinct term is not yet twenty years old but offers a new way of understanding the impacts of behaviours which leave a deep sense of moral consequence. While initially developed in the context of military personnel it is a concept already recognised for its relevance in frontline health services. However, whatever moral pressures health systems were under before Covid-19, these have been magnified by the current crisis. As a fuller picture emerges, heath professionals are beginning to wonder what unintended consequences have followed a policy to send patients back into residential settings. This post-event dawning realisation is the stuff of Moral Injury.
Moral Injury is an evolving framework for the understanding of critical situations and their consequences for individuals. However, in the light of Covid-19 it is reasonable to ask whether this individual experience might take on a collective expression. If as a society we are shown to have given older people such limited priority in our planning and provision, what lasting consequences will there be for our national character? As I argued in a previous blog, there is a real question – when compared with other nations – as to whether the UK allowed a form of social amputation. James Childs, writing in March 2019, suggested that Moral Injury could have a kind of corporate manifestation:
When actions of government violate the ideals of our communal spirit, we as individual citizens, though not guilty, are nonetheless responsible for allowing our government to do such things and, therefore, share in that guilt as a community.Childs, J., 2019. Can a nation suffer moral injury?. Dialog, 58(1), pp.3-6.
There is a long way to go before we emerge on the other side of the acute crisis caused by Covid-19. Perhaps the lesson we need to draw from Moral Injury is the need to allow space for the possibility of corporate responsibility in the memorial events which will take place. To acknowledge that even when the last person infected with Covid-19 has emerged from isolation, there will be questions we must live with for a very long time to come. The tempting short-term option is to sweep it all under the carpet (‘what else could we have done?’) rather than address real questions of responsibility with openness and mutual compassion. The emerging evidence of Moral Injury requires us to consider the longterm emotional cost of our response to the virus and act now to mitigate its damaging aftermath. After all, a future which aspires to achieve wellbeing for all can never be built on a buried past.