Crisis Management

Yes, we did say that we wouldn’t be posting things weekly, but this was too important.



Yom Kippur 5782

Rabbi Meir Sendor

Some of us have been wrestling with serious issues of conscience that come to the fore during these ten days of repentance climaxing with Yom Kippur. The halakhot of Teshuvah give us a method for attaining kapparah, a cleansing of transgression before God: to regret our mistake, acknowledge it clearly through confession, apologize and make amends to anyone who was harmed, and resolve never to repeat it (Rambam, Hilkhot Tshuvah 1:1; 2:2, 9-11). But is this enough to resolve the more serious issues that continue to trouble us? And often it’s hard to effectively make amends – life limps on and opportunities are lost.

A recent article in The Atlantic analyzes experiences of healthcare workers during the ongoing pandemic. Every one of us owes a profound debt of gratitude to all the healthcare workers, especially nurses, who are risking their lives and their health to care for patients during this pandemic. They are heroes. Along with the physical dangers and challenges they face through long, grueling days, every day, are ethical challenges raised by being forced to make agonizing life-or-death decisions in patient care under great pressure. The author, Jonathan Moens, interviewed nurses and other healthcare workers who had to make hard choices with inadequate resources, such as triage decisions about which Covid patients should be put on scarce ventilators or given other life-saving therapies, or whether a family member should be allowed to be in the room with a highly contagious loved one who was dying. Many report being haunted by feelings that they have betrayed core ethical principles. (J. Moens, “On Top of Everything Else, the Pandemic Messed With Our Morals,” The Atlantic, June 8, 2021)

In his analysis, Moens invokes the concept of moral injury, coined by Dr. Jonathan Shay with regard to the experiences of war veterans who had to make difficult decisions under the stress of combat, decisions that they find it hard to live with. Dr. Shay defines moral injury as a “betrayal of what’s right, by someone who holds legitimate authority, in a high stakes situation (“Moral Injury,” Psychoanalytic Psychology, journal of the American Psychological Association, 2014, Vol. 31, No. 2).” Further research in this field has expanded the definition to anyone who feels they have made a wrong decision to act or not act in a stressful situation that led to serious harm and betrayed the moral code by which they live. The harm can be something the person did, or witnessed, or suffered themselves. Clinicians have noted that this sense of moral injury can result in persistent feelings of guilt, self-condemnation and depression. (Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). “Moral injury and moral repair in war veterans: A preliminary model and intervention strategy.” Clinical Psychology Review, 29, 695–706).

While healthcare workers and soldiers place themselves in dangerous situations to protect the lives of others and have to make choices under great pressure, even those of us who lead more sheltered lives can run up against tense situations in which we had to make a quick decision and feel afterwards we made the wrong one, one that violated our moral compass. A few years back, I was walking down a street in the center of Tzfat and passed a couple sitting in a parked car. The husband was loudly berating his wife in vicious, demeaning, soul-destroying terms. The wife was crying and trying to appease him by admitting he was right. The husband kept screaming at her. The car windows were mostly up, but I could hear them clearly. It was plainly a long-standing, abusive relationship. In my thirty-two years of work as Rabbi of a kehillah I had to deal with some terrible spouse abuse situations, and frankly, it was a learning curve. When I started out as a young rabbi, I had no awareness or understanding of the phenomenon, and did not provide help to a woman suffering abuse who had hinted at her troubles. Over the years, as I met with therapists and became aware of the syndrome and its telltale signs, I was able to step in more effectively, though even then I made some wrong moves that were not helpful and that I regret. But I can recognize an abusive relationship and this couple in the car were a textbook case. I did not know them, but I had seen the husband around so I knew they were from the neighborhood. I stood for a moment and debated knocking on the window on his side to signal to him I was witnessing his behavior, or knocking on her window and asking if she needed help. Then I thought that the situation was volatile and my interference at that moment could have unpredictable consequences, and I should try to approach them at another time. In the end, I walked on. I never did run into them again. I realized my decision was more about cowardice than about doing no harm, and that my awareness of the control-abuse syndrome and the need to confront it should have prepared me to step in effectively, but I didn’t. By getting involved, firmly but compassionately, I might have helped them both to acknowledge they needed help and worked to help them find it. I violated my moral principles by walking on. Now what?

Various suggestions have been offered to help those suffering a sense of moral injury to cope with their inner conflict. Therapists concur that troubling issues should be faced into as soon as possible and not left to fester. Support from family and friends with whom the person can confide their anguish is vital. It’s important to identify the values conflict as clearly as possible and acknowledge it – advice that echoes the halakhic requirements for teshuvah. One therapist suggests that helping the struggling person to develop a meaningful narrative that puts the person’s troubling decisions into a fuller context, including the complexity, pressure and stress of the situation, can be helpful.

But a crisis of conscience can also be an opportunity. Moens, the author of the article, cites Victoria Williamson, an ethics researcher at Oxford University and King’s College London, who notes that moral injury can also be an opening for “post-traumatic growth, whereby people’s sense of purpose is reinforced during adverse events.” Anne often says that our response to suffering should not rest content with praying to HaShem – we need to step up and take action ourselves. If we merely obsess over a crisis of conscience, we are just stuck in self-absorption. The most effective approach is to get moving, get beyond ourselves and act on our commitment to be helpful in this needy world. You made a mistake? Get up, dust yourself off, get moving and do better.

The pandemic has highlighted selfless heroes who have wrestled with complex challenges. It has also thrown an unflattering spotlight on the self-centeredness and selfishness and toxic tribalism of too many, here in Israel and in Jewish communities around the world, who continue to endanger others with irresponsible behavior. There are those who self-righteously refuse to adjust religious or social practices that might be okay in normal times but are lethally dangerous in the midst of these raging viruses. Desecrating Torah even further, some even engage in deceitful conduct to try to evade the legal consequences of their misbehavior. There are those who refuse to get vaccinated with vaccines proven safe and effective, for spurious reasons that mostly boil down protecting themselves from illusory harm at the expense of endangering the lives and health others with real harm. And often these self-centered behaviors go together. Anyone who has a healthy conscience and some sense of Torah ethics should be appalled by such irresponsibility, and appalled at themselves if they are indulging in it. It’s not too late to wake up, however painful the realization may be, and correct this conduct that is immoral by Torah standards and general human standards. Am Yisrael is a diverse nation, bless us, yet with that and because of that the unity of our nation is a cardinal principle of Torah: “all Israelites are responsible one for another (Gemara Shavuot 39a).” It’s high time that all of us, all Jews everywhere, start acting with a sense of responsibility for the life and health of every other Jew — and every other human being.

When the sense of moral injury is addressed in a healthy way it can actually be a spur to ethical and spiritual growth and a stronger sense of purpose in life. Rabbi Shimon ben Lakish in the Gemara Yuma (86b), dealing with Yom Kippur, says “great is Teshuvah, that transforms sins into merits.” May every one of us face whatever issues with which we are wrestling with honesty and courage, get beyond ourselves, and step forward with responsible action into this New Year of opportunities.

Please let us know if you have any suggestions or thoughts about this issue of how we can step up to take responsibility.

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