Coined by Jonathan Shay, a clinician who works with combat veterans, the term ‘moral injury’ refers to an injury that occurs when one’s moral beliefs are betrayed. Shay developed the term to capture the shame and guilt of veterans he saw in his clinical practice. Since then, debates about moral injury have centered around the ‘what’ (what kinds of actions count as morally injurious and why?) and the ‘who’ of moral injury (should moral injuries be restricted to the guilt and shame that I feel for what I do? Or is it possible to be morally injured by what I witness?). Clinicians universally acknowledge the challenge of treating moral injuries. I will argue that this is in part because there is an essential piece of the theoretical construct that has been left behind. Namely, when veterans are morally injured, they are not only haunted by what they have done (or failed to do) but also by the specter of a world without morals.
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