This article uncovers how ethical challenges impact mental health in military and health care, suggesting a new model of moral injury.
To date, the interrelations between mental health and ethical challenges in frontline professions, such as the military, police and health care, have remained underexamined. This article addresses this gap by developing a contextual model of moral injury: psychosocial trauma resulting from morally significant experiences. This model is the result of grounded theory research with 50 expert interviews, 250 hours of participant observation and 170 interviews with former military and police personnel, iteratively analysed through an emerging multidisciplinary framework, including the concepts of moral injury, dirty work and recognition. The framework encompasses personal, situational, occupational, organisational, socio-political and technical dimensions. This study both contributes to a paradigm shift in understanding trauma and advances sociological research on the experience of frontline work. It expands the focus beyond individual pathology to include ethical and contextual dimensions of moral injury, providing comprehensive insight into the omnipresent and complex moral-psychological dimensions of frontline work.
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Molendijk et al. (2025) studied this question.
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