Transforming through moral injury: Visitor encounters with difficult heritage

Holocaust museums around the world are distinctive in their emphasis on educational missions premised on the idea of “never again”, a deep belief that increasing public awareness of the history and contemporary significance of the Holocaust – the mass murder of six million European Jews by the Nazi regime during World War Two – can prevent the future recurrence of such events. In the Australian context, tens of thousands of school students visit Holocaust museums every year to participate in learning programs designed to impart powerful historical and moral lessons about the Holocaust, its antecedent conditions, and its ongoing relevance. The aspirations attached to these programs and the scale at which they are delivered stand in stark contrast to the lack of empirical evidence to support their efficacy. This research protocol describes an extensive four-year research study designed to evaluate the presumed linear relationship between Holocaust education programs and ethical, moral, and affective learning that leads to durable attitudinal and behavioural change. Funded through the Australian Research Council’s Linkage Projects scheme, the study will assess the impact of Holocaust museums’ education programs on high school students from diverse demographics, including the extent to which participation influences the views and actions of young people in relation to racial and identity-based discrimination. The research design is longitudinal and transdisciplinary, integrating qualitative, quantitative, and participatory techniques across three case studies. By strategically employing rapid ethnographic assessment procedures, archival research, analysis of museum representational practices, surveys, and visual research methods, we will examine both the educational intent behind Holocaust education programs and their actual impacts on a large sample of Australian Year 10 students. We expect the results of the research to be used by our project partners to develop Holocaust education programs that effectively engage students on cognitive and affective levels.

Employees frequently encounter situations at work that present moral or ethical dilemmas. Consequently, they may engage in immoral actions, witness moral violations, or fail to intervene when their coworkers behave immorally. Repeated exposure to such moral challenges can lead to moral injury--the damage to one's moral code and self-image resulting from witnessing, failing to prevent, or participating in what is perceived as an immoral act. Despite the potential for moral injury in workplace contexts, research has yet to adequately explore or measure this phenomenon. This dissertation addresses this gap by developing and validating the Moral Injury at Work Scale (MIWS). Across six studies, I confirm a three-factor model of moral injury, showing that the MIWS correlates meaningfully with theoretically relevant constructs (i.e., existing moral injury scales, guilt, shame, moral compass) and remains distinct from unrelated constructs (i.e., justice perceptions, experienced incivility, PTSD, depression, anxiety). The MIWS predicted high burnout and uniquely predicted positive outcomes such as job satisfaction and engagement. The MIWS did not provide incremental validity compared to existing moral injury scales. My results provide preliminary support for the MIWS, contribute to the growing nomological network of moral injury, and provide meaningful areas for future research. I discuss the theoretical and practical implications of these results.

This chapter provides an extended reading of Fyodor Dostoevsky's Crime and Punishment, which remains perhaps the most sustained, focused meditation on the psychological aftereffects of a criminal act in all of world literature. It both explores Raskolnikov's psychology through the moral injury lens and argues that in the figure of Sonya, Dostoevsky gives us a character who models some of the best practices contemporary researchers suggest for the treatment of moral injury. It shows that for Raskolnikov and Dostoevsky, crime is accompanied by a “disease” that looks quite similar to moral injury. Indeed, the chapter asserts that Dostoevsky is a canny observer of abnormal psychology and that Crime and Punishment offers an accurate prefiguration of the sketches of moral injury introduced in Chapter 1. But Dostoevsky's insights do not end there, as the chapter shows.

Frontline health-care workers experienced moral injury long before COVID-19, but the pandemic highlighted how pervasive and damaging this psychological harm can be. Moral injury occurs when individuals violate or witness violations of deeply held values and beliefs. We argue that a continuum exists between moral distress, moral injury, and burnout. Distinguishing these experiences highlights opportunities for intervention and moral repair, and may thwart progression to burnout.

This chapter discusses two twenty‐first‐century museum projects in India dedicated to the historical traumas of two different communities. The first of these, the Khalsa Heritage Complex, addresses the Sikh community and is a multimillion‐dollar project whose high‐tech displays are housed in spectacular “starchitecture.” The other, far more modest, project is sponsored by the Tibetan refugee community in their exile capital at Dharamsala. Though the two museums are vastly different in scale, architecture, and ambition, this chapter shows how both museums were inspired by Jewish Holocaust museums. But forms of Jewish Holocaust memorialization cannot simply be “cut” from one place and “pasted” in another, for local contexts and politics exert their own pushes and pulls on these projects. By comparing the differing fortunes of these two projects, this chapter discusses the circumstances in which a difficult memory becomes possible, or a difficult amnesia becomes a necessity.

Due to the complex nature of correctional facilities, correctional health care professionals (CHPs) are at high risk of experiencing the harms of helping such as burnout, vicarious trauma, and post-traumatic stress disorder (PTSD). Although traditionally applied to military populations, the construct of moral injury has gained increasing application to health care and bears relevance to correctional health care. This qualitative study examines the prevalence of moral injury among CHPs while considering the moral dilemmas and ethical challenges of delivering care in a carceral environment. Employing an interpretative phenomenological analysis (IPA), 25 semi-structured interviews were conducted with a diverse sample of CHPs, selected through nonprobability, purposive sampling. Rigorous thematic analysis, guided by IPA principles, was used. The data revealed five key themes: moral injury is an occupational hazard for correctional health care workers; incidental versus cumulative moral injury; role of institutional betrayal; the intersectional relationship among moral injury, PTSD, and burnout; and the road to moral repair. These themes offer insights into the prevalence and effects of moral injury in correctional health care while offering solutions to navigating moral injury. These findings contribute to a deeper understanding of the complex ethical and psychological dynamics within correctional health care settings and explore implications for practice, policy, and future research.

Moral injury—emerging from actions, inactions, or witnessed events that transgress deeply held moral beliefs—remains an often overlooked yet profoundly consequential health condition. While initially described among military personnel, it now spans health care workers, first responders, educators, and countless others navigating ethically fraught environments. Unlike PTSD, moral injury’s core is spiritual, ethical, and emotional dissonance rather than fear. It manifests as shame, guilt, betrayal, and loss of meaning, undermining psychological well-being and professional longevity. Yet public health systems and workplaces rarely recognize or treat it with the seriousness it deserves. This opinion article argues that ignoring moral injury not only harms individuals but weakens institutions, erodes trust, and accelerates burnout. Addressing it requires cultural change, leadership accountability, trauma-informed practices, and integration of moral repair into mainstream health care. Moral injury is a public health problem hiding in plain sight, demanding urgent attention, empathy, and structural reform.

In recent years, social workers have paid increased attention to ethical issues. The profession's literature has burgeoned on topics such as ethical dilemmas in social work practice, ethical decision making, boundary issues and dual relationships, ethics-related risk management, and moral injury. This noteworthy trend builds on social work's rich and long-standing commitment to the development of core values and ethical standards evident throughout its history. Unlike allied human service and behavioral health professions, social work's ethics-related literature has not focused on the critically important issue of moral disengagement. Moral disengagement is typically defined as the process whereby individuals convince themselves that ethical standards do not apply to them. In social work, moral disengagement can lead to ethics violations and practitioner liability, particularly when social workers believe that they are not beholden to widely embraced ethical standards in the profession. The purpose of this article is to explore the nature of moral disengagement in social work, identify possible causes and consequences, and present meaningful strategies designed to prevent and respond to moral disengagement in the profession.

During life challenging times like the present COVID-19 pandemic, the health care worker (HCW) is faced with a number of questions of an existential nature. There is a sense of guilt, anguish, helplessness, uncertainty and powerlessness when one is fighting something on such a powerful scale with limited resources and no definite end in sight. There are circumstances when these feelings can overwhelm a person leading to demoralization and potentially a moral injury. Spiritual practices and advice may help to deal with moral paradoxes and ethical dilemmas when other secular supports are undermined or inaccessible. The Holy Indian Epic, the Bhagvad Gita has described the moral distress of the warrior Arjuna, during the battle of Kurukshetra and the advice given to him by the Lord Krishna the gist of which can be encapsulated in the form of the four Ds- Detachment, Duty, Doer-ship and Dhyana or meditation. In this article, the authors explore how these concepts may be useful aids to the HCW faced with moral and psychological distress.

Participedia is a collaborative, digital learning tool for the co-production of knowledge about new forms of citizen participation across the world ( www.participedia.net ). In this paper, we analyse using the platform as a learning resource for adult learners who are democracy practitioners and for undergraduate students. We examine Participedia’s role in advancing transformative civic and democratic learning, and situate our analysis in the current context of democracy and civic space under strain globally. We argue that this pedagogy is crucial in the face of democratic erosion, growing inequality, increased polarization and the rise of right-wing populism. We discuss how Participedia’s multiple channels for learner engagement (e.g., critical case study analysis, self-directed research, reflective writing, case study development based on lived experience, collaborative fellowships) support critical and reflective democratic practice. We show how the Participedia platform contributes to transformative learning outcomes, in particular around social action, active citizenship, participation and democracy.

A critical gap in the dark tourism literature concerns the possibility of social mobilization outcomes after taking part in dark tourism experiences. While a crucial driver behind the creation of museums focusing on war and genocide is to prevent their reoccurrence by socially mobilizing travelers, few studies look at whether travelers can become socially mobilized and take actions for human rights. We apply the Framing Theory of Social Action to investigate whether travelers employ framings in their discourse to reveal social mobilization outcomes after visiting exhibits at a Holocaust Museum. Travelers engage in photo-elicitation and in-depth interviews about their post-experience of visiting exhibits that are focusing on the Holocaust, women’s rights, and apartheid at Illinois Holocaust Museum & Education Center (IHMEC). Travelers suggest they engage in the main form of social mobilization outcomes: feeling empowered, pursuing remembrance and education, and identifying societal issues that warrant mobilization.

To provide quality patient care, health professionals must be able to effectively communicate interpersonally and in team environments. While a lack of communication and conflict negotiation skills certainly can create obstacles to patient care, the organizational structures in which health professionals do their work also can obstruct communication or make it more difficult. Structurational divergence theory helps identify and explain the negative communication cycles that result when individuals must fulfill obligations from multiple competing systems, each with its own social rules. The structure of health care delivery systems also can result in structurational divergence, as health care workers must often navigate the space between their clinician priorities of improved patient health and the corporate priorities of greater efficiency and profit. This divergence creates tension for the clinician that can lead to burnout and moral injury, especially when the clinician feels forced to act outside the patient's best interests. Individual efforts to address moral injury are less likely to be successful than collective group action. However, medical education can take steps to prepare students with the knowledge and tools necessary to navigate competing role demands, systemic obstacles, and ethical dilemmas to ensure quality patient care.

Across the world, the ‘difficult heritage’ of discredited monuments has prompted pitched disputation. This article explores the fraught origins and fate of Leipzig's Karl Marx monument. From its unveiling in 1974, it was one of the East Bloc's most controversial landmarks, as it stood on the site of an intact Gothic church dynamited in May 1968 in the face of East Germany's largest mass protest between the 1953 Uprising and 1989 Revolution. Enthroned on Leipzig's central Karl Marx Square as an ideological triumph, the post-communist expulsion of Marx to a remote courtyard evolved out of a selective, contingent process, wherein asymmetrical power relations culminated in ‘events’ when the monument acquired an ideological charge. From a myriad of potential destinies, the decision to exile (rather than retain or destroy) Marx's effigy can only be deciphered by unpacking the layered symbolic messages players ascribed to the evolving aesthetics at its initial location before and after 1989. Informing disputes about landmarks from Ukraine to the American South, the rise and fall of Leipzig's Marx monument exemplifies how and why a metal object can become a lightning rod for controversy, as well as how its re-exhibition can facilitate discussions about trauma, guilt, and redemption.

Precision medicine seeks to tailor care such that patients receive individualized treatment based on their specific presentation, biology, and risk factors. Artificial intelligence, defined as the field of computational systems that perform tasks requiring human-like intelligence, such as prediction, pattern recognition, and decision-making, is revolutionizing precision medicine through enhanced diagnostic accuracy, optimized treatments, and improved health outcomes. However, the benefits of artificial intelligence can only be realized if clinicians understand the technology’s limitations and strengths, and if developers appreciate the clinical, systemic, and workflow contexts in which their tools were developed and will be introduced. Without this mutual understanding, risks include automation bias, exacerbations of existing healthcare inequities, breaches of patient privacy, and ethical dilemmas that may erode trust in healthcare systems. To address these challenges, the Temerty Centre for Artificial Intelligence Research and Education in Medicine at the University of Toronto has developed an interdisciplinary educational team and mandate. The mandate is organized into three guiding domains—principles, topics, and methods—that together provide a structured yet adaptable approach to artificial intelligence education. This commentary presents the rationale for this mandate and discusses its implications for precision medicine. Central to the mandate are commitments to formal, integrated training across disciplines, an emphasis on the ability to critically appraise artificial intelligence tools, and the delivery of interactive, evolving educational programs that are tailored to professional roles. As artificial intelligence continues to shape the landscape of healthcare, interdisciplinary and adaptive education will be critical to ensuring ethical artificial intelligence deployment and use, continued patient-centered care, and personalized medicine.

This article explores the emotional transformations of teachers since the pandemic, shifting from idealised passion for their profession to a more balanced, self-preserving approach to their work and mental well-being. Through four case studies of teachers from Hong Kong, Australia and France, this paper examines how teachers navigate emotional wisdom in response to trauma and burnout and how such wisdom informs their ability to recognise when to prioritise their mental health over job prospects. The idea of disillusioned transformation will be explored: when teachers who are initially invested in a set of ideals in their roles become disillusioned and disengaged, but through which find emotional balance and the resilience towards new sources of professional fulfilment. Central to transformative learning theory, this study highlights how trauma (moral injury, systemic trauma) and emotional wisdom contribute to teachers’ critical reflection and self-preservation. The article seeks to delineate the intersection between emotional wisdom, aesthetic emotions, and trauma recovery and to understand how teachers transform their professional identity in response to emotional distress, fostering a more sustainable and healthy approach to teaching.