The following is an unsigned editorial from the April 14 issue of America, a national Catholic weekly magazine run by the Jesuits.

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The wars in Iraq and Afghanistan have so far resulted in more than 5,000 American deaths and 50,000 wounded, as well as hundreds of thousands of Afghan and Iraqi casualties. In addition to the loss of life, a new report from the Kennedy School of Government at Harvard estimates the economic cost for the American people at $6 trillion, or $75,000 per household.

But there is still another cost, incalculable but still manifest in men and women returning from the battlefield: moral injury. It is the long-lasting damage to soldiers who experience moral contradiction when they kill another human being or are devastated by their failure to rescue a comrade. When ethical ideals meet the harsh realities of war, it can afflict a person’s core identity.

According to David Wood, author of “The Grunts: Damned If They Kill, Damned If They Don’t,” a three-part study published on The Huffington Post (March 18), moral injury is the “signature wound” of this generation of veterans. It is not the familiar post-traumatic stress disorder triggered by crowds, noise or arguments that results in “startle” reflexes or flashbacks. Moral injury results from a violation of what a person considers right or wrong, and it provokes grief, shame and alienation.

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Both illnesses share the effects of depression, nightmares and self-medication with alcohol and drugs; but unlike PTSD, moral injury is not officially recognized by the Pentagon. Nevertheless, a moral wound may transform a young person otherwise committed to ideals like loyalty and courage — on which military life depends — to one crippled for years by survivor’s guilt.

Wood’s report tells the story of Nick Rudolph, 22, who is taking aim at a young boy, maybe 13, firing shots at U.S. soldiers. With a split second to decide, Nick pulls the trigger and kills the boy. Then what? “We just collected up that weapon and kept moving,” he explained. “He was just a kid. … You know it’s wrong. But … you have no choice.”

Another soldier, Stephen Canty, described how a person’s “morals start to degrade” in a warzone. When a dying Afghan man was pulled into a Marine camp, “I just lit him up,” Stephen said. “One of the bullets bounced off his spinal cord and came out his eyeball.” Then Stephen just walked away, feeling nothing. Now he wonders in what kind of a world “some dumb 20-year-old” can “smoke” a 40-year-old (probably with children at home) and feel nothing. “Once you’re able to do that, what is morally right anymore?”

Amy Amidon, a clinical psychologist at the U.S. Naval Medical Center in San Diego, knows the symptoms well. She oversees the center’s moral injury/moral repair therapy group, a safe space for veterans to share stories of war trauma, and to listen to and support each other. To help overcome their isolation, the participants are encouraged to do community service and acts of kindness. “The idea here is for them to begin to recognize the goodness in themselves, and to reinforce their sense of being accepted in the community,” she explained.

Near the end of the eight-week program, the veterans are invited to write themselves a letter of empathy and acceptance. Some also choose to draft an apology, even if they cannot send it to another person. One soldier wrote to a boy he witnessed trembling during a Marine raid on his family’s house. The letter, he explained, “wasn’t about me forgiving myself,” but “more about accepting who I am now.”

A study conducted in the first year of the Iraq War found that two-thirds of Marines in Iraq had killed an enemy combatant, 28 percent felt responsible for a civilian death and more than half had handled human remains. The mental and moral wounds that result from experiences like these far outnumber the physical injuries. The Pentagon reports that between 275,000 and 500,000 veterans of Iraq and Afghanistan are affected by PTSD — a reminder that soldiers are human beings, not machines that can be repeatedly sent into battle without consequence.

To help prevent these wounds, national leaders must seriously examine the act of war itself and remember its long-term effects, especially on young people, whenever contemplating armed conflict. For those already afflicted, faith communities can play a crucial role in the healing process. In the report, Mr. Wood tells the story of a chaplain who invited a group of soldiers to write down things they regret. He then collected the papers, put them in a basin and set them on fire to be rid of them.

For Catholics, the sacrament of reconciliation offers a privileged opportunity for healing and forgiveness. Parishes should reach out to veterans, make them feel welcome and, whenever possible, create opportunities like the therapy group in San Diego. Military chaplains also need more support so they can be more effective ministers of mercy. Veterans want and need more than a “thank you” for their service. The church can be of service to them.

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