“It’s There and You’re Changed Forever”: Military Physicians’ Perceptions of Moral Injury

Moral injury implies a dissonance between personal ethics and systemic constraints. No research currently exists regarding moral injury in military physicians. The purpose of this qualitative study, therefore, was to examine military medical physicians’ perceptions of moral injury in order to understand how they define and experience this phenomenon. We used a qualitative phenomenological design to interview military physicians from a variety of specialties. We coded these interviews and organized these codes into categories, which were the themes of our study. These themes revealed our participants’ perceptions of moral injury: (1) inability to provide standard of care; (2) moral ambiguity of caring for foreign nationals; and (3) lasting impact. The participants described their experiences of being unable to provide adequate care for their patients due to the command hierarchy limiting their decision making or a lack of available resources. They also experienced moral ambiguity with humanitarian missions and treating enemy combatants. Overall, our study revealed that moral injury occurs in military physicians as they reconcile their morality with the scope of the military’s greater mission.