Huffpo has a long article on the "moral injury" suffered by combat troops.

It is what experts are coming to identify as a moral injury: the pain that results from damage to a person’s moral foundation. In contrast to Post-Traumatic Stress Disorder, which springs from fear, moral injury is a violation of what each of us considers right or wrong. The diagnosis of PTSD has been defined and officially endorsed since 1980 by the mental health community, and those suffering from it have earned broad public sympathy and understanding. Moral injury is not officially recognized by the Defense Department. But it is moral injury, not PTSD, that is increasingly acknowledged as the signature wound of this generation of veterans: a bruise on the soul, akin to grief or sorrow, with lasting impact on the individuals and on their families. Moral injury raises uncomfortable questions about what happens in war, the dark experiences that many veterans have always been reluctant to talk about. Are the young Americans who volunteer for military service prepared for the ethical ambiguity that lies ahead? Can they be hardened against moral injury? Should they be?

I'm still trying to sort this out. I'm tempted to engage in a lot of finger pointing--American society happily celebrates warmongering--just try to think of a holiday where we don't stir in the idea of a soldier fighting or a soldier coming home from battle. We see and hear war images and sounds at many public events, especially sports events. On the other hand, though they are young when they sign up to join the war machine, members of the military are not children. To some extent, they know or should know what they are getting into. They know that they are willing to accept money in order to kill or to support killing on behalf of the United States. Some of them go because they will get to wield weapons and kill. Those people are getting exactly what they want. Those members of the military who don't actually shoot the weapons are complicit. Those of us who are civilians who fail to speak out are also complicit. Perhaps we should be said to be suffering moral injury too, but that's a hard argument to make, because most of us don't give a shit that our soldiers are overseas invading other lands and killing people who are typically poor and brown-skinned. Most of us don't call this kind of killing, where soldiers kill, "murder." After all, there are self-defense murders, and in some cases military actions, including some large-scale military actions do seem like acts of defense. The military PR machine has tapped into this idea by renaming the war machine the "Department of Defense," even those most U.S wars are wars of choice, acts of strategic aggression to suit the needs of banks and businesses. To get us reoriented, we should rename the Defense Department. As stated at Common Dreams,

America's discerning have long recognized that the country can never live without war. It is a country made for war. Small detail: Up until 1947, the Defense Department was called Department of War.

I do think we ought to reframe what it means to kill in uniform. That means that we should stop glorifying the act of killing in uniform unless the reason for the war itself is edifying. We should rename the act of killing in uniform as "situational murder." The analogy is situational homosexuality. Killing in war is a brutal act of ending lives that we are working hard to see in a special context. Akin to money laundering, we could call such killing "murder laundering." It's a matter of killing where innocent lives are blithely written of as collateral damage, something that is really hard to sell back home when police kill innocent people. I am keenly aware of the consequences posed by determinism. Embraced fully, it is an excuse for any action, because we were not really "free" to make our choices. This sets up a monumental paradox, because to keep order and sanity we are forced to assume that we are "free." It is in this crazy context that I resent the attempt to turn non-medical problems into medical problems. "Moral injury" is the suffering one experiences for making choices that are often bad choices. Why did you sign up for the military? Yes, it seemed like the right thing to do at the time, but only on the battle field did you realize that you were engaged in (I'm speaking of all of America's recent wars of choice) gussied up murder. Back when you signed up, you failed to think things through. The banality of evil was at play--Hannah Arendt's notion that the failure to think causes much more damage than intentional wrongdoing. "Moral injury" is not a medical problem. It is coming to grips with one's choices. It is usually a good thing that one focuses in on one's moral compass, even when the result is self-condemnation. Perhaps the occurrence of moral injury is to be applauded as an awakening of conscience, a terrible lesson learned, and a chance to take public positions warning others to say no to the seduction of wars of choice.