Moral injury involves “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs” (Litz et al., 2009).
The effects of moral injury have been examined most extensively within military personnel. However, any person with deeply held moral beliefs who is committed to an organization is at risk of moral injury. Research in moral psychology shows that moral values form the core of personal identity: they make people “who they are.” Some people chose work that closely reflects who they are. In these cases, the professional and the personal are tied together with moral values, and professional pains are not only personal, but may also be moral injuries.
First responders including police and emergency medical professionals; lawyers, judges, academics, and journalists; politicians, policy-makers, and activists; social workers and therapists often pursue work motivated by a personal mission; accordingly the risk of moral injury for some of these occupations, including first responders and journalists is beginning to garner attention. Other people cannot or do not wish to take jobs that perfectly reflect their personal moral worldview. They can still be morally injured by perpetrating or bearing witness to moral transgressions in their workplace — take financial employees who may not have identified with their jobs but later come to condemn acts of fraud within their institutions as though they were personal betrayals. Regardless of what motivates one’s occupational choice, since identity is built on morality, and moral life often unfolds outside of one’s control at work, most everyone is at risk of moral injury.
When one’s identity is tied up with one’s profession, moral injury can be experienced as extremely destructive to the sense of self. Just as with military personnel, striking levels of depression and suicidality are reported across first responder occupations and academics at various training levels. Addressing moral injury calls for attention to prevention and treatment in organizations where it expected to be a risk, which are favored by communication about mental health and meaning at work, as well as real structural support for counseling and clinical treatment (benefits and scheduling). Further, research indicates that directly addressing stigma in obtaining mental health care can prevent harm to self and others, encouraging a positive loop that improves the workplace and addresses the dismal outcomes related to moral injury.
Moreover, people can take steps toward real institutional and personal change by transforming their moral injury into an instigator that enables them address a problematic system, or to make major life changes, such as pursuing more education or a new job. Finally, since it is known that the majority of people rely on moral values that include preventing harm to others and being impartial, people working in ethical organizations can be encouraged through institutional messaging from the top to lean on their inner moral compasses. Surrounded by maladaptive explicit and implicit signals promoting hyper-competitive professional trajectories and the risk of moral injury often just around the bend, such agency-promoting messaging is be welcome and healing.