The insight that soldiers embody multiple moral commitments brings me to a second insufficiently addressed issue in the current concept of moral injury: the (potential) role of political and societal factors in moral distress. In recent decades, it has become increasingly clear that besides the nature of war and individual susceptibilities contextual factors play a crucial role in the onset of war-related suffering, (e.g. Breslau and Davis 1987, Summerfield 2000, Perilla et al. 2002, De Jong 2005, Stein et al. 2007, Finley 2011, Suarez 2013). At the same time, most research on war-related suffering, both in terms of PTSD and moral injury, decouples the suffering from its wider context (ibid).
The concept of PTSD is persistently criticized for failing to attend to context. As various studies have argued, it frames war-related suffering as a condition contained within the individual, thus failing to account for its societal and political context (e.g. Summerfield 2000, Das 2007, Withuis and Mooij 2010, Finley 2011, Hautzinger and Scandlyn 2013, MacLeish 2013). As a medical concept it tends to give war victims the status of patients (Kleinman et al. 1997, Summerfield 2001, Withuis 2002). In response, studies on what is dubbed ‘social suffering’ (Kleinman et al. 1997) have examined how violence is generated and shaped by political, economic and cultural structures, mostly in non-Western settings, attesting to the many ways in which social forces can produce human suffering (e.g. Kleinman et al. 1997, Summerfield 2000, Das 2007, Kienzler 2008). These studies challenge the biomedical notions that characterize suffering as an intra-individual disease.
Although most research on ‘social suffering’ focuses on challenging biomedical notions as Western conceptions (Bracken et al. 1995, Summerfield 2000, Kienzler 2008), it follows that in Western settings, too, war-related suffering may be considered more than an intra-individual disease. A ‘social suffering-lens’ seems particularly important when trying to understand moral dimensions of deployment-related distress. As discussed above, individuals develop their moral beliefs and form their moral judgments not in a social vacuum but in interaction with family, friends, and formal and informal institutions (Bandura 1991). Specifically with respect to a soldier’s conduct, questions of right and wrong are not ‘owned’ by the soldier but explicitly debated by the soldier’s social environment. It is at the societal and political level that debates take place about, for instance, the legitimacy of military missions.
Generally, the military does not operate in isolation from politics and society, but consists of ‘people with arms’ who act in the name of ‘people without arms’ (Rukavishnikov and Pugh 2006, p. 131). This means that in case of military operations, the military is granted exemptions from certain standards that society holds for its citizens. While war and violence are generally considered immoral and criminal, it is also maintained that ‘killing may be necessary to save lives’ and that ‘the devastation of war may be required to prevent the destruction of deeply held values’ (Williams and Caldwell 2006, p. 309). And so, military action is considered ‘justified harm’ (Shue 2005, p. 743). Yet, this is only the case because its justification is not unconditional. On the contrary, the justification of an intervention rests on the condition that it is subject to rules and constraints (MacFarlane 2002, Kennedy 2006, Berkowitz 2013).
The political and public domain thus play an important role in shaping soldiers’
deployment. These domains determine the conditions under which soldiers have to operate,
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Chapter 2 Toward a Broader Theoretical Approach to Moral DistressPart I Setting the Stage
and where their actions are monitored and judged. Today’s military interventions tend to occur in a multilateral context, often on the basis of commitments to international organizations such as the United Nations. Accordingly, decision-making with regard to an intervention is shaped by political alliances, as well as international law and other normative principles and criteria that are considered important (see e.g. MacFarlane 2002, Narine 2016). Abiding to international principles and criteria narrows the possibilities of intervention and shapes the nature of a mission, but as such they also enhance the mission’s legitimacy. Governments may follow such principles and criteria for sincere reasons – to reach a reasonable consensus and abide by moral standards – or, conversely, to mask self-centered motives and bypass moral questions (cf. Berkowitz 2013).
At the national level, decision-making regarding military intervention is often directly influenced by parliamentary demands and indirectly by public sensitivities and attitudes (Everts and Isernia 2003, Klep 2011, Grandia 2015, Dimitriu and Graaf 2016).5 Parliamentarian demands and public opinion usually influence the decision to contribute national troops to a military mission, as well as the ways in which this contribution takes shape, by making the government add so-called national caveats (limitations) for its own troops to the mandate of the mission. For instance, public sensitivities and resultant parliamentarian demands can lead a government to focus the mission on humanitarian activities and restrict the use of force allowed (cf. Born et al. 2010, p. 21). However, the government may also attempt to gain public support by trying to sway parliamentary and public opinion and mobilize support. It may for instance create persuasive narratives of a mission’s ‘why-what-and-how’ – which, notably, may or may not turn out to be an accurate description of the actual mission (Ringsmose and Børgesen 2001).
Political concessions and persuasive narratives are thus supposed to legitimize a military intervention on several levels. When this is achieved, deployed soldiers are assured that their mission accords with political demands, legal rules and societal wishes. However, in practice, it is not always clear what military conduct is desired, and tensions between sociopolitical justifications and personal experience are not always resolved. In fact, the opposite may be the result. Consider for instance a mission justified by images of the opponents as a violent, terrorist ‘them’ (Bhatia 2005, Chambers 2012), and by rhetoric on national security (Goldstein 2010) and/or liberation and civilization (Abu-Lughod 2002, Kellner 2004). Such framing may initially protect soldiers from worrying about their mission, but this very protection may also lead them to do things they might later regret, and for which they might be condemned in their home country (Lifton 1973, Shay 1994, Bica 1999, Gutmann and Lutz 2009, Boudreau 2011, Sherman 2011). For instance, Bourke (1999), Lifton (1973), Shay (1994) and Ticke (2005), describe the profound shock US soldiers experienced when the Vietnamese ‘gooks’ they were supposed to hate turned out to be human, just like them. Bica (1999) similarly notes that
5 The influence of parliament is especially strong in countries with multi-party systems like the Netherlands, which more often than not have coalition governments and a powerful parliament. Although much like other governments, the Dutch government officially holds the exclusive power to deploy troops, parliament exerts considerable influence over the government’s decision-making (cf. Wagner 2006, p. 49). With respect to recent missions, the Dutch government has always tried to gain a majority of parliamentary support for a mission. With respect to public opinion, it is true that political leaders often do not completely follow public demands, since they also wish to fulfill commitments concerning international cooperation. Yet, they are also unlikely to completely ignore the impact of public pressure or the threat of decreasing electoral support (Ringsmose and Børgesen 2001).
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these soldiers felt deeply confused when they saw the ‘myth’ of the warrior as noble and heroic crumble in war. Moreover, Sherman (2011) describes the deception US soldiers felt on returning from Iraq and discovering that their government’s claims about Iraq stockpiling weapons of mass destruction were untrue. Ex-Marine Boudreau (2008, 2011) stresses that political and legal justifications may encourage soldiers to do things they later came to regret, pointing to his own remorse for the heavy handed actions he ordered in Iraq.
The studies cited above all focus on war and combat operations. But what about other types of missions? Recent years have mostly seen peace missions for which the national and international leadership imposed tight restrictions on the use of force (Rietveld 2009). The UN missions in the former Yugoslavia and Rwanda in the 1990s are well-known examples of such missions, or rather of the possible downsides of such missions (Van der Meulen 1998, Klep and Winslow 1999). They show that while restrictions on the use of force may protect soldiers from doing things they might regret later, they may also render soldiers powerless when confronted by situations that do require force. The trauma literature describes the profound psychological impact that powerlessness may have (Herman 1967, 2011).
In short, political practice and public debate shape the ways in which soldiers are deployed and how they are perceived at home. While the current concept of moral injury keeps moral distress encapsulated at the level of the individual soldier, there is much reason to expect that political practice and public debate may play an equally important role in moral distress.
It is therefore worth examining exactly how political and societal influences affect soldiers’
experience, and particularly whether and how these influences relate to moral distress.
I began this chapter by discussing the potential of the concept of moral injury for capturing moral dimensions of deployment-related distress, yet subsequently noted the current concept’s failure to address and incorporate the complexity of morality and the role of wider sociopolitical contexts in moral distress. Therefore, I complicated the concept by adding philosophical and social scientific perspectives on morality and the impact of sociopolitical factors on soldiers’ experience. First, I established that a soldier’s moral beliefs constitute a complex constellation rather than one coherent system. Second, I contended that this complexity is related to the fact that soldiers are not entirely autonomous, but embedded in a sociopolitical context. Soldiers are, of course, individuals. Yet, they are also institutional instruments, and civilians as well. These contentions led me, first, to propose further examination of moral dimensions of deployment-related suffering, and second, to propose broadening the research scope to examine the role of political practices (including decision-making and mission framing) and public perceptions (including public demands and criticism regarding military interventions) in moral distress. I do so in the present study with the perspectives and insights discussed here serving as a theoretical framework, ultimately to advance the concept of moral injury.
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Chapter 2 Toward a Broader Theoretical Approach to Moral DistressPart I Setting the Stage