Not all invisible wounds cause moral injury

Moral injury, and stakes-dependent invisibility commonly arise from system issues and can lead to profound emotional distress, including feelings of shame and betrayal, but both are often disregarded by institutions. Stakes-dependent invisibility highlights the lack of power, the lack of perceived recognition of one's contribution, and the lack of a voice, resulting in the failure to meet the individual's needs. The mechanism of harm behind moral injury, however, is distinctively different: moral injury goes much deeper, focusing on the internal psychological and ethical damage caused by powerlessness or by actions taken or experienced, which are in direct conflict with the person's own moral compass, violating their own conscience.

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Publication Details

Journal
BJA Open
Published
2026-06-18
DOI
https://doi.org/10.1016/j.bjao.2026.100574
Primary Topic
Psychology of Moral and Emotional Judgment
Type
article
Field-Weighted Citation Impact
0.00
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article

Not all invisible wounds cause moral injury

Britta Sylvia von Ungern-Sternberg, Karin Becke-Jakob, Aine Sommerfield
BJA Open
Psychology of Moral and Emotional Judgment
article

Not all invisible wounds cause moral injury

Britta Sylvia von Ungern-Sternberg, Karin Becke-Jakob, Aine Sommerfield
article en

Abstract

Moral injury, and stakes-dependent invisibility commonly arise from system issues and can lead to profound emotional distress, including feelings of shame and betrayal, but both are often disregarded by institutions. Stakes-dependent invisibility highlights the lack of power, the lack of perceived recognition of one's contribution, and the lack of a voice, resulting in the failure to meet the individual's needs. The mechanism of harm behind moral injury, however, is distinctively different: moral injury goes much deeper, focusing on the internal psychological and ethical damage caused by powerlessness or by actions taken or experienced, which are in direct conflict with the person's own moral compass, violating their own conscience.

BJA OpenVol. 19
The University of Western Australia (AU), Princess Margaret Hospital for Children (AU), Children's Cancer Institute Australia (AU), University Children’s Hospital Basel (CH)
Peace, Justice and strong institutions
Openalex Percentile: Top 5%
Psychology of Moral and Emotional Judgment
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