Meador Keith G, Nieuwsma Jason A
Center for Biomedical Ethics and Society, Vanderbilt University, 2525 West End Avenue, Suite 400, Nashville, TN, 37203, USA.
Mental Health and Chaplaincy, VHA, Durham, NC, 27705, USA.
J Med Humanit. 2018 Mar;39(1):93-99. doi: 10.1007/s10912-017-9480-2.
Amidst the return of military personnel from post-9/11 conflicts, a construct describing the readjustment challenges of some has received increasing attention: moral injury. This term has been variably defined with mental health professionals more recently conceiving of it as a transgression of moral beliefs and expectations that are witnessed, perpetrated, or allowed by the individual. To the extent that morality is a system of conceptualizing right and wrong, individuals' moral systems are in large measure developmentally and socially derived and interpreted. Thus, in seeking to provide care and aid in reintegration for combat veterans, it is necessary to consider communities that have contributed to an individual's formation and that might have participated in the interpretation of his/her suffering. This can take many forms, but given that morality is often complexly intertwined with issues of religion, faith, and spirituality for many individuals, and recognizing that much of the current focus on moral injury is emanating out of healthcare contexts, we devote particular attention to how chaplains might be more intentionally engaged in healthcare systems such as the Veterans Health Administration to provide non-judgmental, person-centered, culturally-relevant care rooted in communities of practice to veterans with moral injury.
在9·11事件后的冲突中，军人陆续回国，一种描述部分军人重新适应挑战的概念受到了越来越多的关注：道德损伤。这个术语的定义各不相同，心理健康专业人员最近将其理解为个人目睹、实施或放任的对道德信念和期望的违背。由于道德是一个界定是非的概念体系，个人的道德体系在很大程度上是在发展过程中和社会环境中形成并被解读的。因此，在为退伍军人提供康复护理和援助时，有必要考虑那些对个人的形成有贡献、可能参与了对其痛苦解读的群体。这可以有多种形式，但鉴于对许多人来说，道德常常与宗教、信仰和精神性问题复杂地交织在一起，并且认识到当前对道德损伤的关注大多源自医疗保健背景，我们特别关注牧师如何能够更有意识地参与到诸如退伍军人健康管理局这样的医疗保健系统中，为患有道德损伤的退伍军人提供基于实践社区、不评判、以人为本且符合文化背景的护理。
