Moral Injuries: An APA Preview
Explore how hidden moral injury fuels clinician burnout, why betrayal and bystander guilt linger, and what psychiatry suggests for healing.
Psychiatry & Society
H. Steven Moffic, MD, gives a preview of one of the sessions he is involved in at the 2026 American Psychiatric Association (APA) Annual Meeting. This particular session is on moral injuries, or the violation of a mental health clinician’s personal values (not necessarily the ethical values).
The term moral injuries was coined in the 1990s by psychiatrist Jonathan Shay, and used to describe the profound psychological, ethical, and spiritual distress Vietnam veterans experienced when combat actions betrayed their core moral values.1
Ventilation of these injuries to a trusted confidante or family member seems to help reduce associated trauma or stress, according to Moffic.
At the same time, physicians are burning out an epidemic rate. This may lead to increased moral injuries, or rather concealed moral injuries.
Dr Moffic is an award-winning psychiatrist who specializes in the social, cultural, ethical, spiritual, and religious aspects of psychiatry, and since 2012 is in retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekdays column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He has been an advocate and activist for mental health issues related to climate instability, physical burnout, and xenophobia, among other social justice causes, serving on many related local and national community and professional Boards. He serves on the Editorial Board of Psychiatric Times.
Reference
1. The current state of understanding about moral injury. US Department of Veterans Affairs. Updated August 17, 2022. Accessed March 24, 2026.
