Editor’s Note: This is an explainer about moral injury, run today as part of the Ithaca Voice’s 10-part series “Hope for the Homefront.”
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Moral injury occurs when someone violates his or her own moral code or when someone they deeply trust does so. The National Center for PTSD defines moral injury as “An act of serious transgression that leads to serious inner conflict because the experience is at odds with core ethical and moral beliefs.”
The term is relatively new, and was first identified in psychologist Jonathan Shay’s 1994 book, Achilles in Vietnam.
While moral injury can be described simply as guilt for doing something unethical, the emotions involved are much more complex. In battle, soldiers may be be forced to shoot an approaching man in order to protect their comrades.
When, later, they discover that they have killed a civilian, father, or community leader, they realize that they have violated their own moral code. The action may have been justified in the moment, but as veterans look back, knowing more, they begin to regret what they did. This is one of many circumstances where moral injury can occur.
While the term formed in the early ‘90s, only recently has the medical community begun to specifically treat moral injury, instead of lumping it into other diagnoses, such as PTSD. The Huffington Post wrote in 2014 that only the San Diego Naval Medical Center has specifically designed treatment plans for moral injury, saying, “Several clinicians launched the program early in 2013 after realizing that many of their PTSD patients needed a different kind of help.”