Revista de tratamiento y trastornos del estrés traumático

Unintentional Killing: A Neglected Trauma

Maryann J. Gray*

Each year, thousands of people unintentionally kill someone in car crashes, gun accidents, medical errors, and other accidents. COVID transmission is another form of unintentional killing. Many unintentional killers experience great anguish, but there is a dearth of research about the psychological effects of unintentional killing. This paper begins to fill the gap through a review of relevant literature. This paper defines unintentional killing as: (a) involvement in an incident that resulted in a fatality; (b) perceiving oneself as responsible for the fatality; and (c) having intended no harm. A distinction is drawn between causal responsibility, which does not indicate culpability, and moral responsibility, which indicates blameworthiness. Those who unintentionally kill are at risk for posttraumatic stress disorder, major depression, and other mental health problems. Four factors distinguish unintentional killing from other traumas, with implications for research and treatment. First, unintentionally causing a death often produces significant guilt and shame. Those who are morally responsible (i.e., blameworthy) may show signs of moral injury. Those who are considered blameless may experience non-moral or accident guilt. Second, the predominant cultural narrative for managing trauma – the journey from “victim” to “survivor” – is a poor fit for those who unintentionally kill. They are more like perpetrators rather than victims; and although they are survivors, this is not an indication of personal growth. A different language is needed. Third, those who grieve for or identify with the victim(s) may retalate against or ostracize the unintentional killer. Research in moral psychology suggests that emotionally stirring events such as unintentional killing can lead others to mistakenly assume intentionality or impose harsh judgments of blame. Fourth, there is a near-complete lack of resources for those who unintentionally kill. Future research should address the frequency of unintentional killing and characteristics of unintentional killers, psychological outcomes, and treatment.

Keywords

Unintentional killing; Moral injury; Trauma; Guilt; Blame; Intention; Responsibility; Accident; PTSD