ABSTRACT
Moral injury is a multidimensional concept generally understood as transgressive actions to one's moral principles, causing moral dissonance and psychological/existential/spiritual distress in combat veterans. The pathway between moral injury and spiritual struggle needs closer examination. As the link between them solidifies, it will assist in integrating spiritual care and moral injury treatment. It will also help to increase moral injury's definitional clarity in the future. This article reviewed the concurrent predictors of moral injury and the mechanisms underlying moral injury and spiritual struggle. Spiritual struggle appeared to be a predictor of moral injury's occurrence. Potentially morally injurious events (PMIE) and other psychological symptoms like anxiety and posttraumatic stress disorder (PTSD) were also mediated by spiritual struggle. In addition, other factors like altruism and cognitive appraisal of one's actions were also examined. Lastly, this review included a qualitative study in spiritual care and an intervention study for morally injured veterans, revealing potentially effective healing modalities and limitations.
