Psychiatry as a vocation: Moral injury, COVID-19, and the phenomenology of clinical practice.

In this article, we focus on a particular kind of emotional impact of the pandemic, namely the phenomenology of the experience of moral injury in healthcare professionals. Drawing on Weber's reflections in his lecture Politics as a Vocation and data from the Experiences of Social Distancing during the COVID-19 Pandemic Survey, we analyse responses from healthcare professionals which show the experiences of burnout, sense of frustration and impotence, and how these affect clinicians' emotional state. We argue that this may relate to the ethical conflicts they experience when they are forced to make clinical decisions where there are no optimal outcomes, and how in turn that impacts on their own emotional state. We then further examine the notion of 'burnout' and the phenomenology of 'moral injury'. Our argument is that these experiences of moral injury across a range of clinicians during the pandemic may be more prevalent and long-standing in psychiatry and mental health than in other areas of healthcare, where ethically difficult decisions and resource constraints are common outside times of crisis. Hence, in these clinical arenas, moral injury and the phenomenology of emotional changes may be independent of the pandemic. The insights gained during the pandemic may provide wider insights into the challenges of developing services and training the workforce to provide appropriate mental health care.

The pandemic body: the lived body during the COVID-19 pandemic.

In this study, we conduct a detailed analysis of qualitative survey data focusing on adult populations in the UK, Japan and Mexico to address the following question: How has the COVID-19 pandemic changed people's lived experience of their bodies, other people's bodies and the world? We identify five themes: (i) fear and danger, (ii) bodily doubt and hypervigilance, (iii) risk and trust, (iv) adapting and enduring and (v) changes in perspective. We use two theoretical frameworks: first, Mary Douglas' anthropological work on purity, risk, danger and symbolism is applied to understand how social and cultural meanings attached to the body have changed during the pandemic. Second, we use the concept of bodily doubt developed by Havi Carel to interpret how people experience their bodies and other people's bodies differently during the pandemic. While we recognise the significant variation in people's embodied experience of the pandemic, our findings suggest there are commonalities that span different countries and cultures. Specifically, we look at responses to COVID-19 protective countermeasures such as national lockdowns and physical distancing which we suggest have reduced people's ability to put faith in their own bodies, trust other people and trust the political leadership. We conclude by proposing that the changes to our lived experience during the COVID-19 pandemic have prompted changes in perspective and a renewed focus on what people consider important in life from a social, moral, cultural and political point of view.

Corrigendum: The pandemic experience survey II: A second corpus of subjective reports of life under social restrictions during COVID-19 in the UK, Japan, and Mexico.

[This corrects the article DOI: 10.3389/fpubh.2022.913096.].