The Many Tentacles of Moral Injury

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While the term moral injury (MI) was originally envisioned to address the gap between PTSD and what Vietnam veterans were experiencing after returning from the war, our understanding of the phenomenon has grown (Shay, 2014). Due to recent scholarly work in the fields of servicewomen, healthcare, social work, and many others, we now know that moral injury can appear in many domains. The precursor of MI can be a wide variety of things, such as combat, sexual assault, having to choose who lives or dies in a healthcare setting, being forced to operate in a high stakes environment without needed resources, bullying, hazing, and all forms of injustice.

Given that moral injury refers to the trauma that occurs when one’s sense of moral rightness is violated, MI’s tentacles are everywhere and there is virtually no industry where one could not put together a viable research project on moral injury and gather important data. In other words, there is no human endeavor on this planet where moral injury does not have a chance of occurring.

Moral injury can not only do damage to those who are the direct victims of trauma, but it can affect others who are simply trying to help survivors. Chaplains, social workers, psychiatrists, nurses, physicians, and first responders of all kinds can suffer the consequences of moral injury through secondary trauma.

The tentacles of moral injury can spread even further. One could make the case that whole communities, even nations can be affected by MI. Might one draw the conclusion that non-white ethnic communities in many Western nations are suffering from moral injury due to perceived racial injustices?

MI damages the body, soul and mind. It can lead to long term health effects, psychosis, and even suicide. Many survivors cannot maintain meaningful relationships with others and are prone to substance abuse and homelessness.

MI is such a complex phenomenon that there is no universally agreed upon definition and scholars are still working to define the borders of moral injury. There is years worth of work to be done. One way that Moral Injury Support Network for Servicewomen, Inc. is attacking the problem is through the 2021 Comprehensive Moral Injury Conference (CMIC).

The 2021 CMIC, sponsored by Road Home Program and DoD inTransition, provided important information from researchers, thought leaders, and practitioners on the subject of moral injury in a wide range of domains and settings, including military and first responders, healthcare, women veterans, social justice, and chaplaincy. Presenters represent a variety of fields, including chaplaincy, psychology, medicine, community health, and others. The conference offered papers, workshops, and panels on assessment tools, interventions, and new research to deepen attendees’ understanding of moral injury and introduce ways of helping those suffering from moral injury.

When one begins to think deeply about moral injury and discuss it with others, it does not take long to realize that MI cuts across every discipline and is probably the source of most people’s deep pain. Because moral injury is so pervasive and the information is so important, we are offering access to the recordings, slides, and handouts from the conference. Many disciplines, including psychology, social work, chaplaincy, occupational and physical therapy, and counseling can benefit from the knowledge in the recordings.


Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182-191.

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