ABSTRACT

Both the models of moral distress and of moral injury place an emphasis on various types of moral challenges that may violate the individual’s conscience, evoking moral emotions. Yet, there appears to be great conceptual confusion as regards both scholarly perspectives. The purpose of this article is to further elaborate on the qualitative content and conceptual demarcations of the theories of moral injury and moral distress. In the light of this theoretical elaboration, we propose an integrated moral distress and injury scale that provides a more holistic overview of these moral challenges. We suggest that the utility and applicability of the moral injury and moral distress theories may benefit from the integration of these concepts. A practical implication of our theoretical understanding is that processes of recovery, which involve moral dimensions, are complex. In line with this understanding, we advocate a holistic approach to health and well-being among military service members and Veterans.

摘要

道德困扰和道德伤害模型都强调各种可能挑战个人良心并引起道德情感的道德挑战。然而，关于两种学术观点，似乎都存在巨大的概念混乱。本文的目的是进一步阐述道德损害和道德困扰理论的质性内容和概念划分。根据这一理论上的阐述，我们提出了一个综合的道德困扰和伤害量表，它对这些道德挑战提供了更为全面的概述。我们认为，道德伤害和道德苦恼理论的实用性和适用性可能会受益于这些概念的整合。我们理论理解的实际含义是恢复过程，涉及道德层面，非常复杂。根据这种理解，我们提倡在兵役人员和退伍军人中采用全面的健康和福祉方法。