‘I don’t really know where I stand because I don’t know if I took something away from her’: moral injury in SouthAfrican speech–language therapists and audiologists due topatient death and dying

Abstract

Background: Speech–language therapists and audiologists (SLT&As) mayencounter difficulties when confronted with patient death and dying, whichmay conflict with their moral beliefs and result in moral injury. Furthermore,South African SLT&As practice in a country with a high mortality rate, whichmay add to the complexity of their experience. Moreover, they may be influ-enced by African philosophies promoting care, which might conflict with theirexperiences of patient death and dying.Aims: To explore the moral injury experienced by South African SLT&As inpatient death and dying, and how they overcame the injury.Methods & Procedures: This article forms part of a larger qualitative studythat explored SLT&As’ experiences of patient death and dying in South Africa.Thematic analysis was conducted on the transcripts of 25 episodic narrative inter-views conducted with South African SLT&As on their experiences of patientdeath and dying.Outcomes & Results: Findings suggest that South African SLT&As experiencedhelplessness, guilt and anger in patient death and dying. However, with sup-port from the allied team, engaging in self-reflection and religious practices, theyreported alleviation of moral injury. Conclusions & Implications: In order to mitigate moral injury in SouthAfrican SLT&As, they require professional education, self-care strategies, guide-lines and support from the teams in which they work and their supervisors.Research is needed that explores how SLT&As’ biographical characteristics andinteractions with significant others of dying and deceased patients, may result inmoral injury.