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The War Is Over but the Moral Pain Continues

Published online by Cambridge University Press:  10 March 2022

David Wood*
Texas, United States (
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Almost five million Americans volunteered to serve in the U.S. armed forces between 2001 and 2021 and returned home as discharged veterans. Among them, 30,177 men and women have taken their own lives, an awful toll that is more than five times the number of Americans killed in combat in our twenty-first century wars. As part of the roundtable, “Moral Injury, Trauma, and War,” this essay argues that the reasons are many, but one major factor may be the moral pain that many experience in wartime and the vast emptiness they often encounter when their military service ends. Our society has an obligation to the post–9/11 veterans to understand their experiences and truly welcome them back. The rising toll of veteran suicides suggests there is little time to lose.

Roundtable: Moral Injury, Trauma, and War
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Carnegie Council for Ethics in International Affairs

I heard recently from a friend about “a lot of bad stuff” happening inside a small circle of friends, Americans who had served in our longest wars. Since they had returned, twelve had taken their own lives; one spouse made it thirteen. None are listed in the Defense Department's casualty lists of those who sacrificed for our country.Footnote 1 But they figure heavily in the mounting cost of the conflict we began in Afghanistan twenty years ago. Many of us breathed sighs of relief as the final C-17 lifted off safely from Kabul airport in August, bearing the last American troops to depart from that war zone. For us the war is over. For many who fought and returned, the war continues.

Despite the bloody toll of U.S. combat troops who have died in Afghanistan and Iraq, more than five times as many U.S. active-duty military personnel and veterans have died of suicide since 2001, amounting to an awful toll of 30,177 deaths, according to a comprehensive accounting by Thomas Howard Suitt of Boston University.Footnote 2 By contrast, 5,474 Americans were killed in combat, according to the Defense Department.Footnote 3

The causes are many, of course, and in many cases it is not known what finally caused a person to see suicide as the only way to end their pain. But one major factor, largely unexplored until recently, is the moral pain many experience during military service and the vast emptiness they often find when their service ends.

Moral injury, in my experience, is the violation of our sense of what is right, a jagged disconnect from our understanding of who we are and what we and others ought to do and ought not to do. Experiences that are common in war—inflicting purposeful violence, witnessing the sudden violent maiming of a loved buddy, and the suffering of civilians—challenge and often shatter our understanding of the world as a good place where good things happen to us, the foundational beliefs we learn as infants. The broader losses of trust, faith, and innocence can have profound psychological, spiritual, social, and behavioral impacts.

I have heard moral injury expressed as a loss of moral bearings or loss of identity: In combat, what is right? This question came up frequently among grunts in Iraq and Afghanistan. I know a man who, as a marine, shot a child in a firefight. It was a justifiable kill: the child, perhaps ten or twelve years of age, was shooting at him and his fellow marines. Taking out a threat like that is the kind of thing that wins medals. But in the marine's mind, he killed a child, a deadly sin and a deep moral injury. What kind of person, he once asked me, kills a child? But when he returned home, people thanked him for his service.

The moral injury of war is not new, of course. Theologians, philosophers, and religious and secular leaders have wrestled with the morality of killing in war for centuries. Rather than looking away in silence as we have tended to do in more recent years, they acknowledged the moral damage of killing and searched for ways to cleanse the warrior after battle. The understanding that killing contaminates the killer has persisted stubbornly down through the ages. It is a constant theme in Greek tragedies. Samurai warriors used Zen meditation to assuage their fear and guilt over killing. The medieval church recognized that even killing under legally and morally justifiable circumstances demanded that the killers afterward cleanse themselves by making amends. Thus, if foot soldiers, archers, battle ax wielders, and mounted lancers survived after they were thrown into battle, they were sentenced to acts of penance. After the Battle of Hastings in 1066, a gathering of bishops ruled that “anyone who knows he killed a man in the great battle must do penance for one year for each man he killed.”Footnote 4

This may seem quaint and even backward. But the essential point is the recognition of the moral injury caused by killing and the damage this inflicts on the warrior. Other societies have gentler practices of forgiveness, cleansing, and healing their warriors after battle. No such rituals exist today in the U.S. military, or even in the Department of Veterans Affairs. If today's marine lance corporal or army staff sergeant feels the blow of a moral injury, he or she is left to deal with it personally.

Our wars of the twenty-first century have been exceptionally rich with opportunity for moral injury. The relatively small U.S. military force struggled to man wars in both Iraq and Afghanistan; as a result, soldiers and marines found themselves deploying over and over again, with shorter periods of anxious “recuperation” between bouts of combat. We are only now coming to see the enduring damage to service members and their families. For unlike past wars, a slight majority of those we sent were married, many with children.Footnote 5 Heading off for another deployment meant telling their families, “I'm going away for a year and I might not ever come back, because what I do over there is more important than being with you,” a moral blow to self and family. And once in combat, troops found the goal was unclear: Killing the enemy relentlessly until victory? Helping and protecting the civilian population from attack by insurgents? Troops often found themselves working under a dizzying set of regulations governing when they could shoot and at whom. “I know how to put a rocket through a window from two hundred fifty meters,” Marine Lance Corporal Chuck Newton told me, a few years after our tours in Afghanistan had ended.Footnote 6 I had gathered a few former marines from a battalion I had embedded with, and the reminiscences turned to the issue of killing. “And these guys,” Newton continued, “are telling me I'm going there to hand out MREs [military rations]? Something is not lining up. And we get there, we start killing people and our friends die.”

Under these circumstances, it was practically impossible to escape moral injury. There was widespread unintentional and unavoidable harm caused to civilians and their property. Even the act of killing an enemy combatant can cause moral anguish, especially, warfighters say, if you look your victim in the eye before pulling the trigger. “I know why executioners wear a mask and why the condemned always faces away from the executioner,” Newton said. “Because the image of someone dying as you look him in the eye is nightmarish. It's something no one should ever do. Other than the nightmares about how I killed people and stuff, other than that there's really no adverse effect.” One of Newton's war buddies interrupted. “Wouldn't you say that's a pretty big adverse effect?” “Yeah,” Newton said, “as a member of the animal kingdom you probably shouldn't be killing your own species.”

Research by the V.A. psychologist Shira Maguen and colleagues has shown that those who kill in combat, even if fully justified, have a far greater chance later in life of developing significant psychological problems.Footnote 7

In many cases, moral injury is acutely painful because it involves people who are bound together by an unconditional devotion to each other: love, in civilian terms, is that driving force that leads a soldier to dive on a grenade to save his buddies. It begins as a boot camp rule: You are responsible for your buddy no matter what. Over time and under the pressure of war, that rule grows into a rock-hard determination to look after the guys in your squad or platoon. It provides the comfort of knowing they are looking after you, too. So, there is the collective guilt felt when a marine is downed by a sniper no one in the squad spotted in time; the shame and self-recrimination of the medic who could not save a fatally injured soldier; the agony of the staff sergeant medevaced home, feeling he abandoned his troops in the field. And the guilt and horror of lethal force gone wrong.

Jake Sexton was twenty years old, a kid from the crossroads hamlet of Farmland, Indiana, when he found himself in Iraq behind the barrel of a .50-caliber machine gun in the turret of a gun truck. It was his first combat deployment as a member of the Indiana National Guard. Even though the job of turret gunner was often given to the most junior soldier, the responsibility was huge: spotting and halting any suspected suicide bomber. Up in his turret, the gunner was the last line of defense, knowing the troops behind him were depending on him for their lives.

Jake's dad, Jeff Sexton, himself an army veteran, told me the rest of the story. Jake had spent eight months in Iraq. When he came back, he was quiet, but eventually he started opening up about his deployment. “He, ah, told me about this situation where he was manning the turret where they had this roadblock, and a car came up and didn't stop, and so he had to open fire on the car and when they went to investigate . . . it ended up being a family of four. No weapons. Just a miscommunication. And that really tore into him. He was the only one who fired, so there was no doubt he was the one that caused . . . you know, caused it.” Jeff paused, then went on. “Well, they had an investigation and said it was a clear-cut case of he had no choice. He said he didn't want to be back in that turret after that, and they took him off it. He was home almost a year and a half before I knew that happened.”

Had Jake Sexton served in World War II, he would have decompressed with his buddies on the long trip home by troopship. Soldiers coming home from Iraq and Afghanistan returned in a disorienting two or three days (as did Vietnam troops). Active-duty troops came home with their units, but the tens of thousands of National Guard soldiers came home to their individual towns or city neighborhoods, far from the guys they served with. Home to where no one really knew what the wars were like, where no one really understood the anxiety of sitting hour after hour in that gun truck turret knowing it was up to you to stop a suicide bomber. And then the terrible seconds as that car careened toward you and you had to decide, shoot or let it come, and the shame and guilt that enveloped you.

When Jake got home to Farmland, he had trouble sleeping and began drinking heavily. As his dad remembered it later, what was eating away at his son was “the senselessness of killing innocent people and then not knowing who you are fighting when it did happen.” One night Jake and his brothers and other friends went to the movies at Muncie Mall to see the horror-comedy Zombieland and settled in. After twenty minutes or so, Jake took out a handgun and shot himself in the temple. He died instantly. He was twenty-one.

When I spoke with Jeff recently, his son's death thirteen years earlier still hung heavily over our conversation. After some small talk, Jeff observed: “The suicide rate's going up.” He added: “It's a rough time for a lot of the families of the fallen.” For the Sexton family, moral injury endures.

Jake had in common with other returning veterans the experience of transitioning from combat into a civilian society that neither knows nor cares what they went through. I know so many soldiers and marines who could not wait to get home, to get out of the service—only to find that out of uniform, they had no one to talk to. No one with whom they shared that unconditional devotion. No one who could possibly understand the experience of war. How could Jake Sexton admit to his civilian buddies, friends who actively chose not to enlist, that he killed an entire civilian family? How could they possibly understand, let alone accept, this?

A soldier or marine commonly enlists after high school. At age eighteen, they often have no formative life experiences. They have not gotten married or run a household, held a full-time job, or cared for an elderly parent. A few years later, they are back from the searing experiences of war having seen, perhaps, the depths of human depravity and the heights of human achievement—heroism and that unconditional devotion to another. They have shared in the deeply satisfying, even noble, experience of patriotic service. Small wonder that so many aging veterans still proudly wear their ball cap boasting “Vietnam 1967–68” or “USS Constellation,” or even, as one frail nonagenarian I met at a ceremony marking a young relative's graduation from marine boot camp did, “Iwo Jima” with a Purple Heart insignia.

As awareness of wartime moral injury has grown, so have efforts to figure out the precise mechanism of injury and how the pain of these injuries might be healed. The Department of Veterans Affairs recognizes moral injury and has sponsored a number of research initiatives and treatments (unfortunately, the V.A. classifies moral injury as part of post-traumatic stress disorder, which I believe to be quite different).Footnote 8

While the research is ongoing, one approach I have found useful with veterans experiencing moral injury is simply to ask them to share some of their experiences and then to listen intently and with validation. Starting a conversation with a veteran can be awkward. I usually begin by asking what they did in the service. It is an easy question and gets them talking. Eventually there is room for the essential question, What was that like? It is a question that invites not just sharing of fact—“I was a mortarman in the marines”—but emotion. One veteran I asked, the Iwo Jima survivor who had come to see a relative graduate from marine boot camp, burst out, “Well sir, it was just terrifying!” Our mutual laughter quickly turned to tears, and as he talked and I listened, I hoped his burden of moral regret and survivor's guilt was eased.

Listening with validation means listening without judgment. It means not breezily dismissing the other person's experience (“Oh, you didn't mean to do it,” or “Well, bad things happen in war”) or seeking to justify what happened (“Well, that child was gonna kill you, and I'm glad you killed him first”). I learned this when I got together a half-dozen former marines years after we returned from Afghanistan. The impromptu group included Nic Rudolph, who had shot the child in Afghanistan, and I asked him to tell that story. When he finished, one of his fellow former marines had the perfect response: “Yeah,” he said, “that was screwed up.” Crucially, this response recognizes that something bad happened, that Nic's moral injury is real. But no blame is attached; it happened in the past and is over. We hear you and we are still here.

It is a very modest approach to the moral injuries of our most recent wars, but one that might usefully involve those of us who did not fight. Ultimately, of course, we are the ones who sent them, and we are responsible for truly welcoming them back home. The rising toll of veteran suicides suggests there is little time to lose.


1 U.S. Department of Defense, “Casualty Status,” last updated October 4, 2021,

2 Thomas Howard Suitt III, High Suicide Rates among United States Service Members and Veterans of the Post-9/11 Wars (Providence: Watson Institute for International and Public Affairs, Brown University, June 21, 2021),

3 U.S. Department of Defense, “Immediate Release: Casualty Status,” last accessed January 18, 2022,

4 Verkamp, Bernard J., The Moral Treatment of Returning Warriors in Early Medieval and Modern Times (Scranton, Ill.: University of Scranton Press, 2005), p. 6Google Scholar.

5 Institute of Medicine, Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families (Washington, D.C.: National Academies Press, 2013)Google Scholar.

6 All of the quotes included from veterans in this essay were made directly to the author in interviews that took place over the course of many years and in a variety of settings including in the United States in Camp Lejeune, N.C.; Washington, D.C.; Philadelphia, Penn.; Manteca, Calif.; and the Meadowlands, N.J.; and in Afghanistan in Kandahar, Kabul, and Garmsir; and in the case of the interviews with Jeff Sexton in Farmland, Indiana, by telephone. These interviews took place between 2008 and 2021.

7 Maguen, Shira, Lucenko, Barbara A., Reger, Mark A., Gahm, Gregory A., Litz, Brett T., Seal, Karen H., Knight, Sara J., and Marmar, Charles R., “The Impact of Reported Direct and Indirect Killing on Mental Health Symptoms in Iraq War Veterans,” in “Psychological Consequences of the Wars in Iraq and Afghanistan,” special issue, Journal of Traumatic Stress 23, no. 1 (February 2010), pp. 8690CrossRefGoogle Scholar.

8 Sonya B. Norman and Shira Maguen, “Moral Injury,” U.S. Department of Veteran Affairs,

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