The study of moral injury began with research and clinical work involving active U.S. Army personnel and veterans. Moral injury results from extraordinary, critical life events during which a person perpetrates, fails to prevent, or witnesses actions that “transgress deeply held moral beliefs and expectations.”¹ Consequently, exposure to morally injurious experiences can lead individuals to alter what they believe. For instance, such an event may cause persons to abandon their view of the world as a safe and benevolent place or of human beings as trustworthy.

Additionally, moral injury can occur in situations that, although not traumatic per se, may cause first responders to question their tactical decision-making or their ability to prevent what happened in the line of duty. For instance, inner conflict may arise when police officers must enforce a law that conflicts with their personal moral standards, such as when they arrest someone protesting for a cause they strongly favor or protect a person whom they consider morally repugnant.

Of course, officers can become traumatized in many ways by their on-duty actions. Research has shown that the most stressful scenarios associated with their duties occur when they seriously injure or kill someone.¹¹ In two other studies, officers reported that the most traumatizing experience they could imagine would involve making a mistake that led to the death of a colleague.¹²

Further, regarding cases where the traumatic event included the experience of a moral injury, research has found increased incidences of mental health issues, such as post-traumatic stress disorder (PTSD), substance abuse, and depression.¹³ For example, this may occur following a justifiable on-duty shooting of someone who the officer thought did not have evil intent, but, nonetheless, was confused, disoriented, and threatening.

Moral injury can compromise an officer’s performance in the line of duty. It leaves the individual struggling with feelings of rejection, guilt, shame, and emotional paralysis—all detrimental to mental functioning and job performance.¹⁴

One police veteran who served in a metropolitan city described an incident in which an officer pursued a suspect. During the chase, a train struck and killed the individual. The officer, considered one of the best in the department, experienced moral conflict to the point of considering himself responsible for the suspect’s death. Eventually, he committed suicide.¹⁵

Similar incidents of self-destructive behaviors due to exposure to morally injurious events have been recorded in the military literature.¹⁶

The impact also can extend outside of work. One Canadian police veteran described how his personal life became deeply affected by the moral injury that resulted from a situation in which he fatally shot someone.

It is this moral injury that sometimes feeds our anger the most. Everyone around you is treating you like a hero for having the courage to do what you had to do. Outwardly, you show appreciation for their supportive comments, but, inwardly, you feel emotionally broken.¹⁷

Recommendations

Based on available research and theory, the authors recommend several actions for preventing or combating moral injury’s impact on the health, well-being, and occupational performance of police officers.

Professional Help

Officers who identify any moral injury cues should seek assistance from peer support groups, as well as health professionals, familiar with the challenges of police work. Doing so will help them mitigate any cumulative effects of moral injury and associated future health complications.¹⁸

Police mental health professionals (e.g., psychologists, psychiatrists, and counselors) should partner with trainers and supervisors to educate officers about moral dilemmas that may arise during critical incidents and how the resultant moral injury can impact their health and well-being.

They also should train officers to identify moral injury cues exhibited by themselves or their colleagues. Also, these specialists can conduct assessments and screenings to identify personnel who have a higher risk of experiencing moral injury and monitor these officers in a caring, nonjudgmental, and nonstigmatizing way.

Such an approach would allow police departments to mentally equip their personnel to deal with these dilemmas, and it also would enable mental health professionals to further explore how morally injurious incidents occurring in the line of duty negatively impact officers’ health and well-being.

This method has aided survivors of terrorist attacks. For instance, crisis response teams have identified and assessed high-risk survivors and provided evidence-based interventions. Alternatively, crisis counseling and psychoeducation both have proven limited in effectiveness.¹⁹

In the medical field, some hospitals require employees to record any moral dilemmas they experience when working with patients to create a system wherein staff can receive recommendations and support from their peers. A similar system could be incorporated into police briefing and debriefing meetings.²⁰

Self-Care

Research focusing on military personnel and veterans has indicated that certain self-care actions appear to facilitate moral repair.

1) Make or seek amends. Some veterans prefer to become involved in service activities as volunteers or even write forgiveness letters tailored to their moral repair goals and needs.²¹

2) Engage in pleasant activities. Physical exercise, yoga, traveling, and other pleasurable pursuits can help divert officers’ minds. Studies have found activities such as exercises and hobbies effective in minimizing the negative impact of moral injury.²²

3) Communicate with spiritual healers or religious leaders. This can help officers suffering from moral injury to examine the importance of self-forgiveness and gratitude, restore a sense of purpose in life, and reestablish a relationship with a higher power or God.²³

Further Study

Researchers should collaborate with law enforcement organizations and conduct rigorous studies to improve the body of knowledge related to police moral injury, including its cues, symptoms, and association with potential physical and mental health issues among police officers. Consequently, this line of research may lead to the development of evidence-based interventions that can help protect officers against morally injurious experiences and support impacted personnel during their journey to moral repair.

Conclusion

Although the study of moral injury began within the context of active duty and veteran military personnel, many scholars have emphasized that police officers also likely experience its impact due to the high occurrence of morally injurious experiences in police work.

Law enforcement officials, clinicians, and policy makers should incorporate interventions designed to prevent and repair moral injury to support officers in maintaining their health, well-being, and high level of job performance. To this end, personnel should be encouraged to seek help from police health professionals if they identify any moral injury cues.

Thus, future research should focus extensively on how moral injury affects police officers’ health and job performance, as well as support the development of interventions for preventing and repairing moral injury.

Finally, when expanding the theory of moral injury from the military to civilian law enforcement, police administrators should conceptualize moral injury more broadly. It can result not only from exposure to severe forms of trauma but also from officers’ fairly routine encounters in which they experience inner conflicts with their strongly held values.