Considering Moral Injury

Anchor verses: 2 Samuel: 11 -12

We are generally taught from a young age the difference from right and wrong. How this is understood is not universal and can vary by culture. What is universal though that we generally feel some sort of empathy and compassion towards another person until it is conditioned out of us based on cultural norms. For example, no child comes into the world as a racist, but slowly learns this behavior through their cultural conditioning. At some point in this person’s life, they may return to those old feelings of empathy and put those racist feelings away, why? It is believed that we are not that kind of creature, our capacity for empathy transcends our cultural conditioning. Another fairly universal thought is that we should not kill people. In America and elsewhere in our world, we are observing a massive shift in consciousness where these long held beliefs of how we should treat others have been vastly eroded. It is felt that this is not new, I often point back to the late nineteenth century when we were seeing the same erosion. I believe two factors make this time we are living in more complicate – the dominance of AI generated media and toxic and ignorant mindset along with an erosion of theologically and rationally sound religious beliefs across the predominant Abrahamic religions that have largely dominated the narrative over the last thirty years.

What results for many is a moral injury and even a moral PTSD. In this post, I want to explore my thoughts on this.

Moral Injury Defined

Moral injury refers to the psychological harm that occurs when an individual experiences a betrayal of their moral beliefs, often in high-stakes situations like military combat or healthcare. It can lead to profound feelings of guilt, shame, and alienation, impacting one’s mental health and relationships.

When I was in college, preparing to become an officer in the Army, I studied the historic My Lai massacre, which occurred during the Vietnam War. On March 16, 1968, U.S. soldiers killed as many as 500 unarmed villagers in the hamlet of My Lai. This tragic event was a example in our training of how moral beliefs can be tested and, at times, tragically violated in high-stakes situations. Most recently, we have watched some of our military leaders challenge the current regime over decisions they are making regarding war. These leaders have faced steep consequences for their actions and this has demonstrated a significant shift in our thoughts about morality.

Recent events with our current regime has got me thinking about whether moral injury can be limited to military personnel and the deeper I dig, the more I believe that on a grander scale, we as civilians are not only dealing with moral injury but also moral burnout and moral post traumatic stress. In the next section, I want to demonstrate how everyone can experience moral injury.

Moral Injury is not Limited to Those who have Gone to War

Moral injury is not limited to military and law enforcement personnel. Also noted in my research are health care workers, educators and religious leaders. People in the general population can also be affected. Looking again at the definition of moral injury, I cam across these thoughts:

Moral injury refers to the profound psychological distress that can arise from being exposed to various situations involving acting, failing to act, or witnessing events that go against personal or collective core beliefs or expectations (e.g. Litz et al., 2009, Griffin et al, 2019; Ter Heide & Olff, 2023, Schnyder, 2024). Moral injury involves both an exposure to a potentially morally injurious event during which individuals experience or witness a transgression, as well as resulting symptoms of intense self-condemnation, spiritual struggles, and internal conflict regarding the moral implications of their actions. Experiencing moral injury carries significant emotional risks, as individuals may perceive their transgressions as irreparable, resulting in feelings of shame, guilt, despair, and loss of morale. Research suggests that moral injury is linked to cognitive, emotional, and behavioral changes, including social withdrawal, suicide behaviors, burnout, and psychiatric disorders such as depression and PTSD.

“Among the most impactful potentially morally injurious experiences (PMIEs) are those involving children, but betrayal trauma may be the most prevalent type of PMIE.” In this paper, the scope was still on the usual people we would expect, nurses and other health care professionals, refugees, etc.

It is felt that as our world has become in particularly post Christian and has moved into a type of Christianity that embraces beliefs contrary to any beliefs that would have been ever held by the historic Jesus and his followers, many people are feeling betrayed, especially with their view of God.

It is felt that betrayal trauma is one of the leading observations I have observed anecdotally as a clinician over the last several years. Long gone is the respect one once had about the morality of our politicians, ministers, doctors, scientists and teachers. In a world where we now trust no one, we now turn to questionable influences peddling outright false or dangerously questionable trends and ideas. Our faith has largely lost its influence among the younger population as demonstrated by a rise of the nones, dones and spiritual but not religious (See Ryan Burge’s voluminous work in this area).

Dealing with Moral Injury

At the heart of my being, I am a minister, trained in the Wesleyan tradition. Scripture is one of the core places I turn to for direction and when dealing with particularly challenging situations. Here, I want to reflect on Nathan’s response to David, who we observe engaging in very morally questionable behaviors. Our scripture offers this:

Then Nathan said to David, “You are the man! This is what the Lord, the God of Israel, says: ‘I anointed you king over Israel, and I delivered you from the hand of Saul. 8 I gave your master’s house to you, and your master’s wives into your arms. I gave you all Israel and Judah. And if all this had been too little, I would have given you even more. 9 Why did you despise the word of the Lord by doing what is evil in his eyes? You struck down Uriah the Hittite with the sword and took his wife to be your own. You killed him with the sword of the Ammonites. 10 Now, therefore, the sword will never depart from your house, because you despised me and took the wife of Uriah the Hittite to be your own.’

11 “This is what the Lord says: ‘Out of your own household I am going to bring calamity on you. Before your very eyes I will take your wives and give them to one who is close to you, and he will sleep with your wives in broad daylight. 12 You did it in secret, but I will do this thing in broad daylight before all Israel.’”

In Stoicism, virtue is considered the highest good and the only true measure of a well-lived life, encompassing qualities such as wisdom, courage, justice, and temperance. In Nathan, we get a model of how to handle feelings of betrayal and moral injury.

In Nathan’s approach, we observe the importance of confronting wrongdoing with honesty and integrity, rather than avoidance or denial. By addressing David directly, Nathan embodies the Stoic principle of justice—acting in accordance with what is morally right, even when it involves difficult conversations or risks personal safety. His courage to speak truth to power mirrors the Stoic ideal of bravery, while his wisdom in framing the confrontation in a way that encourages self-reflection rather than mere punishment highlights the value of discernment.

In both Stoicism and the biblical account, the response to moral injury or betrayal is not simply to condemn, but to seek restoration and understanding. Stoicism teaches that our reactions to events, rather than the events themselves, shape our moral character. Nathan’s method—offering a path toward repentance and healing—aligns with this philosophy. He does not allow David to evade responsibility, but also provides an opportunity for growth and transformation, underscoring the necessity of both accountability and compassion in addressing moral wounds.

Ultimately, when faced with moral injury or betrayal, the Stoic and scriptural approaches invite us to respond with courage, wisdom, and a desire for justice—not as a means to judge, but as a way to foster healing and restore integrity. This model encourages us, whether as individuals or leaders, to value virtue above all, to confront wrongdoing honestly, and to seek reconciliation wherever possible.

To close, we live a time where we have lost our moral bumpers. At our core, our humanity, we know that what we are seeing is wrong. May we have the courage of Nathan, Jesus, Ghandi, Martin and others to stand up to the wrongdoing. There will always be consequences, but change comes only when we speak up, when we say we have had enough, when we name the problems.