Shira Maguen, PhD and Brett Litz, PhD
What is moral injury?
Like psychological trauma, moral injury is a construct that describes extreme and unprecedented life experience including the harmful aftermath of exposure to such events. Events are considered morally injurious if they “transgress deeply held moral beliefs and expectations.” Thus, the key precondition for moral injury is an act of transgression which shatters moral and ethical expectations that are rooted in religious or spiritual beliefs, or culture-based, organizational, and group-based rules about fairness, the value of life, and so forth.
Moral injury in war
In the context of war, moral injuries may stem from direct participation in acts of combat, such as killing or harming others, or indirect acts, such as witnessing death or dying, failing to prevent immoral acts of others, or giving or receiving orders that are perceived as gross moral violations. The act may have been carried out by an individual or a group, through a decision made individually or as a response to orders given by leaders …
What is the aftermath of moral injury?
In terms of the aftermath of moral injuries, transgressive acts may result in highly aversive and haunting states of inner conflict and turmoil. Emotional responses may include:
- Shame, which stems from global self-attributions (for example “I am an evil terrible person; I am unforgivable”)
- Anxiety about possible consequences
- Anger about betrayal-based moral injuries
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