MORAL INJURY AMONG MILITARY PROFESSIONALS: PSYCHOLOGICAL, SOCIAL, AND ETHICAL DIMENSIONS AND IMPLICATIONS FOR CRISIS INTERVENTION

Abstract

Moral injury refers to persistent distress that can follow experiences perceived to violate deeply held moral expectations. In military settings, potentially morally injurious events (PMIEs) may involve one's own action or omission, witnessing wrongdoing, or betrayal by a trusted authority. This study examines moral injury as a multidimensional phenomenon and considers its implications for crisis intervention. A systematically guided integrative review was conducted for literature published between 2009 and 2026, drawing on a reproducible military evidence synthesis and an update search; 18 core empirical studies were subjected to thematic synthesis and MMAT appraisal. Across the evidence, moral injury was associated with guilt, shame, self-condemnation, anger, loss of trust, disrupted identity and meaning, relational difficulties, and problems with reintegration. Social support, ethical leadership, organisational justice, purpose, and self-forgiveness emerged as potentially protective, although causal evidence remains limited and intervention findings are heterogeneous. The resulting framework positions crisis intervention as an initial stage of care that combines safety and stabilisation with assessment of moral meaning, responsibility, and betrayal, followed by appropriate relational, organisational, and specialist support. Moral injury is therefore best approached as a clinically relevant but non-diagnostic construct whose consequences extend beyond conventional post-traumatic symptom reduction.