Evidence map›Paper›PMID 41989654›Full record

ArticleJournal of religion and health2026

Moral Injury as Tragedy: The Tragic Arc as a Narrative Heuristic for Clinical Practice.

Wesley H Fleming

Abstract read
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In one paragraph

Article in Journal of religion and health, 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

1 author.

Wesley H FlemingClinical Chaplain, Syracuse VAMC, 800 Irving Ave, Syracuse, NY, 13210, USA. weshfleming@gmail.com.ORCID http://orcid.org/0000-0003-4334-5554

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Moral injury is increasingly recognized as a form of suffering that extends beyond conventional psychiatric models, encompassing moral, existential, and relational dimensions of human experience. Building on Jonathan Shay's seminal use of classical tragedy-particularly Homeric narratives-to conceptualize moral injury as a rupture in moral order and communal trust, this article reframes moral injury through the lens of the tragic narrative arc, offering both an interpretive framework and a clinically useful heuristic. Informed by narrative theory and narrative therapy, the model integrates processes such as externalization, contextual reappraisal, perspective-taking, and re-authoring disrupted identity narratives, without prescribing specific therapeutic techniques. Drawing on structural elements of the tragic arc-hamartia, reversal, recognition, and catharsis-moral injury is conceptualized not as pathology but as a process of moral reckoning shaped by constrained agency, ethical conflict, and irreversible loss. While broadly applicable across clinical and care-oriented disciplines, chaplains are particularly well suited to engage this framework due to their training in moral reflection and existential meaning-making. The model invites empirical evaluation and further development into formal narrative-based interventions.

Indexed as

MoralsNarrationClergyHumansChaplaincyChaplainsMoral injuryNarrative therapyTragedyTragic arc

Identifiers

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.