Moral injury: A contemporary perspective

Moral injury (MI) is a relatively new concept in the nascent stages of development. MI is a trauma-based phenomenon, distinct from Post Traumatic Stress Disorder (PTSD) as it is not a physiologically fear-based disorder, but often co-exists with PTSD. MI is primarily concerned with the transgression of deeply held moral beliefs and negative mental health sequelae. Recent significant global events are highlighting the need for a greater understanding of the concept of MI and the associated mental health consequences. Thus, this article provides a narrative review of the concept of MI. This article reviews the concept of MI including definitions of MI and associated concepts. The similarities and differences between MI and PTSD are considered. This article also examines MI within a military context and a civilian context, which is necessitated in the context of current events; namely the fall of Afghanistan and the current COVID-19 pandemic. The article also discusses the importance of MI in a treatment setting. Theory and research in the field of MI highlight the impact of MI on those who are exposed to potentially morally injurious events (PMIEs). This impact is evident in symptoms beyond the realm of PTSD. Further it is apparent that certain sectors of society are more at risk of being exposed to PMIEs and that MI may differ between military and civilian populations. As such research into MI in both populations is needed, especially within the context of current events.