Evidence map›Paper›PMID 41836668›Full record

ArticleFrontiers in psychiatry2026

Moral orienting systems: reconceptualizing moral injury as moral disorientation.

Zachary Moon, L Callid Keefe-Perry

Abstract read
In one paragraph

Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Zachary MoonBrite Divinity School, Fort Worth, TX, United States.
L Callid Keefe-PerryClough School of Theology and Ministry, Boston College, Chestnut Hill, MA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Current conceptualizations of moral injury are limited by a reactive, symptom-based focus that risks pathologizing what are often systemic failures. This paper proposes a shift from a "triage model" to a proactive framework of Moral Orienting Systems (MOS). We define a moral orienting system as the dynamic stabilizing interplay of meaningful values, beliefs, behaviors, and relationships that shape moral identity. Drawing on chaplaincy experiences and interdisciplinary theory, we argue that moral wellbeing is not a static trait but a dynamic relation between an individual's moral stress and the stability and strength of their moral orientation. When systemic strength is sufficient to metabolize stress, the result is moral affirmation; when overwhelmed, the result is moral disorientation. We contrast this framework with existing measures (e.g., MIES, MIOS) to highlight their limitations in capturing chronic, non-event-based moral erosion. Finally, we close by noting the need for a Moral Orienting System Assessment (MOSA) as an operational tool to map these vectors, offering a multi-actor case study to demonstrate how this framework might guide systemic intervention and moral reorientation.

Indexed as

moral disorientationmoral distressmoral injurymoral orienting systemmoral stresssystemic assessment

Identifiers

PMID41836668
PMCPMC12982414

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.