In highly stressful or traumatic situations, individuals may engage in, fail to prevent, or witness actions that conflict with their deeply held moral convictions. When someone takes an action that contradicts their beliefs, it is termed an act of commission, whereas failing to act in accordance with their beliefs is called an act of omission. People might also feel betrayed by leaders, those in authority, or their peers, leading to negative consequences. Moral injury is the psychological, behavioral, social, and sometimes spiritual distress that follows such events.
Moral injury arises when an individual feels that a moral transgression has occurred, whether through their own actions or the actions of others. Reactions to moral injury often include guilt, shame, disgust, and anger. Guilt involves feeling remorse over the morally injurious event (e.g., "I did something wrong"). Shame extends this feeling to one's self-identity (e.g., "I am a bad person because of what I did"). Disgust can be a reaction to remembering a wrongful act, and anger can stem from feelings of betrayal or loss. Another significant aspect of moral injury is difficulty with self-forgiveness, which can lead to self-destructive behaviors, such as believing one does not deserve success in personal or professional life.
Moral injury also typically affects an individual's spiritual beliefs. For example, someone suffering from moral injury may find it challenging to reconcile their faith and relationship with a Higher Power with the traumatic event they experienced, causing doubt about their previously held spiritual beliefs.
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