Moral injury results from having to make difficult moral choices under extreme
conditions, experiencing morally anguishing events or duties, witnessing immoral
acts, or behaving in ways that profoundly challenge moral conscience and
identity and the values that support them. Moral injury is found in feelings of
survivor guilt, grief, shame, remorse, anger, despair, mistrust, and betrayal by
authorities. In its most severe forms, it can destroy moral identity and the
will to live. The struggle of combat veterans to return to civilian life can be
even more difficult than serving in war and last a lifetime.
While moral injury is an ancient wound of war that is documented in literature,
in modern times, moral injury has remained largely unaddressed or inadequately
addressed because it is confused with post-traumatic stress (PTSD is a
fear-victim reaction to trauma from damage to the fear suppression areas of the
brain). In addition, clinicians who treat PTSD are not trained in theology or
moral philosophy, and when veterans ask moral or religious questions, they are
usually referred to clergy. Finally, soldiers and veterans are more likely to
seek counseling from clergy than clinicians. Moral injury emerges from activity
in a healthy pre-frontal cortex, the executive function areas of the brain.
Near the end of 2009, Veterans Affairs clinicians offered this definition of
Moral injury is perpetrating, failing to prevent, bearing witness to, or
learning about acts that transgress deeply held moral beliefs and expectations.
This may entail participating in or witnessing inhumane or cruel actions,
failing to prevent the immoral acts of others, as well as engaging in subtle
acts or experiencing reactions that, upon reflection, transgress a moral code..
. Although there has been some research on the consequences of unnecessary acts
of violence in war zones, the lasting impact of morally injurious experience in
war remains chiefly unaddressed. (Brett Litz, et al. “Moral Injury and Moral
Repair in War Veterans: A Preliminary Model and Intervention Strategy.” Clinical
Psychology Review 29, no. 8 (2009): 695–706.)
Many warfighters who participate in combat suffer the loss of someone who is
loved, sometimes dearly. The attachments young warriors have for each other are
infused with an intensity that has few parallels in civilian life, coming closer
to the attachment a parent has for a child than the bonds of siblings or mere
friends'Hence, grief in war can be one of the most traumatic forms of grief.
(C.R. Figley and W. P. Nash, Combat Stress Injury
Theory, Research, and Management, Routledge 2007)