title: Moral injury and moral repair in war veterans: a preliminary model and intervention strategy.
abstract: Throughout history, warriors have been confronted with moral and ethical challenges and modern unconventional and guerilla wars amplify these challenges. Potentially morally injurious events, such as perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations may be deleterious in the long-term, emotionally, psychologically, behaviorally, spiritually, and socially (what we label as moral injury). Although there has been some research on the consequences of unnecessary acts of violence in war zones, the lasting impact of morally injurious experience in war remains chiefly unaddressed. To stimulate a critical examination of moral injury, we review the available literature, define terms, and offer a working conceptual framework and a set of intervention strategies designed to repair moral injury.
authors.affiliation: National Center for PTSD, VA Boston Healthcare System, United States. brett.litz@va.gov
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
authors.forename: Nathan
authors.initials: N
authors.lastname: Stein
authors.forename: Eileen
authors.initials: E
authors.lastname: Delaney
authors.forename: Leslie
authors.initials: L
authors.lastname: Lebowitz
authors.forename: William P
authors.initials: WP
authors.lastname: Nash
authors.forename: Caroline
authors.initials: C
authors.lastname: Silva
authors.forename: Shira
authors.initials: S
authors.lastname: Maguen
mesh_terms: D004644:Emotions; D006801:Humans; D008889:Military Personnel / Q000523:psychology*; D008960:Models, Psychological; D028681:Moral Obligations; D009014:Morals; D014728:Veterans / Q000523:psychology*; D014754:Violence / Q000941:ethics / Q000523:psychology; D014857:Warfare / Q000941:ethics*