Moral injury and the limits of individualised explanation: the policy–institution–ethical constraint (PIEC) model and five questions

Abstract

The concept of moral injury has gained increasing prominence in accounts of occupational distress among professionals working in public-sector and policy-facing roles. However, dominant framings within psychological and clinical literatures largely individualise moral injury, foregrounding personal transgression and emotional response while marginalising the structural role of social policy and institutional governance. As a result, moral injury is often treated as an outcome of individual experience rather than as a condition shaped by the organisation and governance of work. This article argues that moral injury cannot be adequately understood without situating it within the policy environments and institutional arrangements that structure professional practice. Drawing on sociological perspectives on power, governance, and professional work, it identifies three recur-ring analytical absences in the literature: limited engagement with social policy, under-theorisation of institutional power and constraint, and neglect of the cumulative and iterative nature of ethical harm. This article introduces the Policy–Institution–Ethical Constraint (PIEC) model, a conceptual framework that explains how policy environments are translated into institutional practices that constrain professional discretion and normalise ethical compromise. The model reconceptualise moral injury as an individual psychological experience and as a condition that is often structurally produced, while also recognising the role of stabilisation and iterative feedback processes across policy, institutional, and professional levels. The article contributes to social policy scholarship by providing a framework for analysing how ethical harm is structurally produced and sustained, and by pro-posing a set of diagnostic questions to guide institutional and policy analysis. It concludes by considering the implications of this reframing for policy responses that currently prioritise individual resilience over structural redesign.