Being involved in events that injure or kill other people is incredibly distressing, and it happens far more frequently than many people realize. Car accidents are a common cause of accidental death or injury, but there are many others, too. Accidental shootings and drownings for example, and managers in high-risk occupations must sometimes make decisions that play a role in placing staff in harm’s way.

No matter how tangential your involvement and whether the accident was in any way your fault, these sorts of incidents can be very difficult to cope with. This tips sheet provides some information on common reactions you may experience after an incident that causes accidental death or injury, and some tips that may help.

Common reactions you may experience

When you are involved in events that harm or kill another person, you have participated in something—even though accidentally–that breaks your moral code and your sense of what is the “right and good” thing to do. In turn, this “moral injury” triggers a unique and powerful mixture of grief, guilt, shame, and trauma.

Immediately after the incident, many people report going into shock and feeling completely overwhelmed. You may “lose time” and not be able to remember later what happened during the accident or immediately afterwards. You also may be able to remember some details of the accident very clearly and unable to remember other details at all.

In the first few days or weeks after the accident, you may experience some of the following signs of major trauma:

  • Feeling numb, disconnected, and detached from the world around you or from yourself.
  • Sleep problems—having a hard time falling asleep, staying asleep, or staying awake. You may have nightmares.
  • Flashbacks, thoughts, images, and memories of the accident may dominate your thoughts.
  • A high general stress level, which can interfere with daily life and create physical problems such as an upset stomach.
  • Sadness, grief, guilt, and/or shame. This may feel constant or it may come in waves.
  • Fear, including fears you know to be irrational. You may want to avoid certain places, settings, activities, or situations. You may feel jumpy and startle easily. You may be “hyper-vigilant;” for instance, you might need to check and re-check to make sure something or somebody is safe.
  • Memory problems and difficulty concentrating.
  • Irritation—you may feel more impatient, have a “shorter fuse,” be quicker to anger.
  • Difficulty being loving and feeling connected to others.
  • A sense that you can never know happiness again, that you are a “bad” person, and that the world is a “bad” and unsafe place.

Over time and with support, these initial symptoms of trauma often go away. However, people who have caused accidental death or injury often report ongoing challenges related to:

  • Feeling like you have no right to be living, and wishing to change places.
  • Wanting to be punished, or to suffer yourself, because you feel like this can in some way make up for what has happened.
  • Feeling like something bad will happen to you or someone you love as a sort of cosmic payback or impending karmic justice.
  • Feeling guilt and shame every time you remember what happened.
  • Feeling like this has touched every part of your life, and that it cancels out or negates every good thing you have ever done.
  • Wanting to reach out to the victim’s family.
  • Feeling like you don’t deserve to be happy, or that bad things will happen if you relax and feel happy.
  • Anxiety or avoidance in the face of similar situations. For example, if it was a driving accident you may avoid driving (or avoid driving under similar conditions).

Things that can help

There is no one clear or simple path to healing after you have accidentally caused death or injury. Many people who have experienced this report facing three challenges:

  1. Coping with emotional distress
  2. Grappling with a sense of responsibility
  3. Finding a way to honor the experience and those who were harmed by seeking hope and growth and becoming better, stronger people.

Here are some things that may help you as you seek to come to terms with what has happened:

Know that you are not alone

It is not something that is often talked or written about, but there are many people every year who are involved in accidents or incidents that injure or kill somebody else. You are not the only one who has had this terrible experience. It may help to read about other people’s experiences online, or talk to others who have had similar experiences.

Find trusted people to talk to

Many people who have caused accidental death or injury find strength and solace from talking to trusted people about what happened and how they feel. These trusted people may be friends and family members, other people who have also caused accidental death and injury and who understand at a deep and personal level what you are going through, or a counselor.

Seek counseling

Speaking with a counselor can be particularly helpful. Many people in this situation don’t want to discuss the accident with people that they know because they don’t want to burden them or feel as if it may damage or change the relationship. There is some wisdom in this hesitance to share the story with other people. You need safety and understanding if you do not want to risk being further injured by people’s reactions. A counselor, on the other hand, can be a helpful, compassionate, wise, neutral source of support.

If you have caused accidental death or injury, it is strongly recommended that you seek out a good counselor to help you process the trauma, guilt, and responsibility. The IRC has an Employee Assistance and Resilience Program (EARP) that provides free counseling to all IRC staff members and their family. You can use this program to request no-cost, confidential counseling. And you should definitely seek help from a counselor or doctor if you feel suicidal, if you worry you cannot control your anger, and/or if your distress interferes significantly with your life (work, home life, relationships, mood, thinking, health, etc.) for more than one month.

Remind yourself that you will not always feel this way

Experiencing intense feelings of distress, guilt, and grief are normal after accidentally causing death or injury. However, you can find a path to peace over time. You will not always feel this bad (and nor do you deserve to, no matter what your role in the accident was).

Write a letter to the people affected

Write a letter to the people affected by the incident—both the person who was killed or injured and their loved ones. You may never send this letter—In fact, it’s best not to send a letter like this immediately after you’ve written it, before you’ve had a chance to reflect further. However, it can be very helpful to write such a letter, anyway, and tell them what is on your heart, even if you later decide never to send it.

Gently challenge feelings of guilt and shame

After an event like this it is common and normal to feel grief, guilt, and shame. However, over time these thoughts and feelings can take on a life of their own. They can continue to grow and intensify, until it can feel as if they dominate everything. Counseling can help with this, and you can also actively seek out counterbalancing thoughts and truths such as:

  • Accidents happen to everybody
  • You never intended for or wanted anybody to get hurt
  • Sometimes we can never figure out “why” something has happened
  • Feeling constantly guilty and unhappy will not change things

Do something that helps you release the burden

Try to find some way of helping yourself release the weight you feel related to what has happened. This is probably not something you can do just once, it will likely be something you have to try to do time and time again at different points in years to come. Some things that may help with this include prayer, meditations, affirmations, writing about it, participating in rituals of atonement and reconciliation, creating art, and performing acts of service for others.

Confront your level of responsibility

Some people who are involved in events that kill or injure others are neither reckless or negligent. They may just have been in the wrong place at the wrong time, or made decision that were “correct” according to policy but which had unintended consequences. Others have made serious mistakes such as driving drunk, careless inattention, or providing inappropriate advice or medical treatment. Confronting your level of responsibility for the accident is an important step in transforming trauma to growth. This can be a difficult, complicated process, and speaking to a good counselor can be very helpful.

Seek out meaningful rituals of atonement and reconciliation

Over time, consider seeking out some sort of ritual related to apology, atonement, and/or reconciliation. Different faith traditions and cultures from around the world have many related rituals and ceremonies. Participating in these sorts of rituals can help.

Do something good for others

Doing something good for others will not erase your feelings of sorrow or turn back the clock, but it can help you live more positively and purposefully in the aftermath of a tragedy that you bear some sense of responsibility for. So, look for something positive and symbolic to do in remembrance and acknowledgment. Something that benefits other people such as planting trees, volunteering, and supporting a cause.


There is no getting around it: causing accidental death and injury will change your life. It will always be a part of your story now, and something that you carry with you in some form.

While it may always be a part of your story, however, it does not have to become your entire story. This does not have to crowd out everything else. Remember that there is still room in your life and your story for feeling hopeful, content, and happy. This does not define you completely. There may not be any easy path to peace, but as you respond to this event it can push you towards new resolve, growth, and strength.

Many people who have accidentally caused injury or death report becoming more empathic. Some extricate themselves from unhappy situations at home or work. Some stop drinking or using drugs. Others dedicate themselves in new ways to service, creativity, or parenting.

You may feel that you don’t deserve that, but you will only increase the scope of the tragedy if you become an additional victim of the accident. So, remember, you are not betraying the person who you injured if you ask yourself what you can do to attempt to create something positive out of the tragedy.