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“Ruptured selves: moral injury and wounded identity”

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Moral injury is the trauma caused by violations of deeply held values and beliefs. This paper draws on relational philosophical anthropologies to develop the connection between moral injury and moral identity and to offer implications for moral repair, focusing particularly on healthcare professionals. We expound on the notion of moral identity as the relational and narrative constitution of the self. Moral identity is formed and forged in the context of communities and narrative and is necessary for providing a moral horizon against which to act. We then explore the relationship between moral injury and damaged moral identities. We describe how moral injury ruptures one’s sense of self leading to moral disorientation. The article concludes with implications for moral repair. Since moral identity is relationally formed, moral repair is not primarily an individual task but requires the involvement of others to heal one’s identity. The repair of moral injury requires the transformation of a moral identity in community.

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  1. Some philosophical accounts have emphasized the objective effect on moral interactions with others, whether felt or not. (Wiinikka-Lydon 2019) Such moral injury also damages moral identity, as character is distorted by structures and systems. While such malformation is an important issue in which to attend, we find such a broad definition of moral injury to diminish the ability to give language to the experience of moral suffering felt by those forced to act against moral convictions. Our understanding of moral injuries is in line with Shay and Litz’s understanding of moral injury as a trauma arising from the violation of a moral norm.


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Correspondence to Lydia S. Dugdale.

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JMC and AJM receive salary support from the McDonald Agape Foundation, which has no financial or other interest in publication of this manuscript.

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Cahill, J.M., Moyse, A.J. & Dugdale, L.S. “Ruptured selves: moral injury and wounded identity”. Med Health Care and Philos 26, 225–231 (2023).

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