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ABSTRACT
This article offers suggestions for categorizing combat-related moral injuries, highlights possible causes of these injuries in veterans, and touches upon broadly-conceived measures to prevent and repair them. The first part identifies three prevailing definitions – lost trust, guilt, and harm to one’s capacity for right action and moral virtue – and argues for an emphasis on the latter. In service of highlighting areas for future empirical research and clinical awareness, the second part outlines possible veteran-related causes associated with these three definitions, including unwarranted distrust of authorities, misapplying the theodicy problem to human acts, undue survivor’s guilt, wars that fail to meet ad bellum criteria, causing permissible collateral damage, and killing combatants without regret and for pleasure. The third part mentions strategies for preventing character harm, and then discusses the cognitive, rehabituative, and psychological aspects of moral repair.
Disclosure statement
No potential conflict of interest was reported by the author(s). This article reflects the author's views and not necessarily those of the U.S. Government.
Notes
2 See American Psychiatric Association (Citation2013), also known as DSM-5.
3 Complicating matters, PTSD and moral injury share symptoms (i.e., flashbacks and avoidance) and may be co-morbid. Further complicating matters, some analyses of combat trauma mistakenly portray PTSD—which is associated with causes other than fear—as moral injury; see, for example, Press Citation2018.
4 An often-cited definition is the following from Litz et al. (Citation2009, 700): “Perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations. This may entail participating in or witnessing inhumane or cruel acts, failing to prevent the immoral acts of others, as well as engaging in subtle acts or experiencing reactions that upon reflection, transgress a moral code … The event can be an act of wrongdoing, failing to prevent serious unethical behavior, or witnessing or learning about such an event.” See also Maguen and Litz Citation2012. Similarly, and referring to the above definition: “Moral injury is present when there has been (a) a betrayal of ‘what’s right’; (b) either by a person in legitimate authority (my definition), or by one’s self—‘I did it’ [ref to Litz et al. Citation2009]; (c) in a high stakes situation” (Shay Citation2014, 182).
5 See, for example, Shay Citation2014, 182–183, but also stipulated in the definition above from Litz et al. Citation2009.
6 For the sake of brevity, I also will not extensively treat spiritual and existential injuries that result from misperceptions of others’ wrongdoing.
7 This is emphasized by Litz et al. (Citation2009). In their discussions of the injurious symptoms of moral injury, these analyses cite dissonance and inner conflict as possible precursors to anxiety, guilt, and shame. This article will focus on guilt, on which the literature focuses the most attention.
8 See Levine Citation2018; 226. See also Meagher Citation2014. For an empirical study of reticence to killing, see David Grossman Citation1995.
9 For a nuanced treatment of the complex relationship between emotions and moral judgments, see Roberts Citation2015.
10 See Swift Citation1983 and Kopel Citation2015.
11 See Meagher Citation2014, as well as Wood Citation2016.
12 On this distinction, see Bernard Williams’ essay “Moral Luck,” in Williams Citation1981.
13 This article will assume certain relationships between an agent’s culpability/responsibility/blameworthiness for wrongdoing, lost virtue, and desert for punishment. In short, culpability is significant because it can undermine virtue and thus justify punitive harms that deter and/or reform the wrongdoer. Aristotle, in Book III of the Nicomachean Ethics, was the first Western thinker to explore these relationships, similarly asserting that only culpable acts—those done freely, and with knowledge of relevant norms and facts—are formative and punishable. In other words, punishment must be merited/deserved; good consequences do not justify punishing innocents.
14 Because regret—unwarranted or warranted—is not likely to be debilitating, this section will focus on remorse. That said, two points deserve to be mentioned. First, regret might require treatment, to include some of the atonement steps mentioned at the end of this piece. Second, experiencing regret when remorse is warranted is a serious moral problem; it demonstrates an inadequate appreciation of an act’s wrongness or an actor’s culpability.
15 See Roberts Citation2015, 29–30 (citing Seneca and Aquinas).
16 This train of thought is found in Kant’s Groundwork of the Metaphysic of Morals (Kant Citation1964).
17 For a seminal treatment of reactive attitudes, see Strawson Citation1962.
18 David Wood’s book on moral injury describes a West Point veteran and philosophy professor who uses this exact approach.
19 In the Nicomachean Ethics, Aristotle asserts that the acts of truly virtuous person “proceed from a firm and unchangeable character” (1105a); from W. D. Ross’ translation, available at https://people.bu.edu/wwildman/WeirdWildWeb/courses/wphil/readings/wphil_rdg09_nichomacheanethics_entire.htm.
20 On situationism, see Doris Citation1998.
21 Augustine, Contra Faustum, Book XXII, para. 74; in Reichberg, Syse, and Begby Citation2006, 73.
22 I am deviating from Aristotle’s conception of incontinence in some ways, especially inasmuch as my treatment concerns more than one’s disposition toward bodily pleasures.
23 As mentioned in a previous note, an inadequate appreciation of an act’s wrongness or an actor’s culpability can result in regret when remorse should be experienced. Cases where this ignorance is culpable might be regarded as worse than incontinence but better than emotionless viciousness.
24 See Sherman Citation2015, ch. 3.
25 See Luban Citation2016 and Dill Citation2020.
26 Discussed in On the Law of War, in Vitoria Citation1991, 307. On revisionism, see McMahan Citation2009.
27 If ad bellum criteria such as reasonable chance of success and overall proportionality should also be applied during conflicts, the fact that soldiers might possess more accurate pertinent information than their decisionmakers creates moral challenges that deserve more analysis.
28 Combat veterans insightfully insist that a distinction be made between sadistic pleasure and the pleasure experienced by fighting well.
29 See Augustine, City of God against the Pagans, book XIX, chap. 7; in Reichberg, Syse, and Begby Citation2006, 72. More research is needed on the relationship between these attitudes, emotions, and motives. One possibility: a disrespectful attitude undermines the possibility of feeling regret, and creates the possibility of taking pleasure in harm and being motivated by it.
30 For an elaboration of this position, see Eberle Citation2016, ch. 6.
31 See Robillard and Strawser Citation2016.
32 Rehabituation might harder than habituation, given that opposing emotions are ingrained.
33 David Luban, “Moral Injury and Atonement” [in this issue of Journal of Military Ethics].
34 For more recent treatments of rectificatory/restorative justice, see Swinburne Citation2009 and Radzik Citation2009.
Additional information
Notes on contributors
Edward Barrett
Edward Barrett is the Director of Research at the United States Naval Academy’s Stockdale Center for Ethical Leadership. An Air Force ROTC scholarship graduate of the University of Notre Dame, he completed a Ph.D. in political theory at the University of Chicago; is the author of Persons and Liberal Democracy: The Ethical and Political Thought of Karol Wojtyla/John Paul II and many edited volumes, journal articles and book chapters on military ethics issues; worked for two years as speechwriter to the Catholic Archbishop of Chicago, Francis Cardinal George; and served in the active duty and reserve Air Force as a pilot and strategic planner.