![]() Methods: A systematic literature search of peer-reviewed research was conducted using databases MEDLINE, EMBASE, APA PsychInfo, CINHAL PLUS, Web of Science, SCOPUS, and Google Scholar. Objective: This scoping review was designed to identify the extant empirical research regarding the construct of moral injury, its associated constructs, and how it relates to moral distress in firefighters, paramedics, and police officers. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury however, moral injury extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Such decisions can affect their psychological wellbeing. 4King’s University College, University of Western Ontario, London, ON, Canadaīackground: Public Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering and need to make quick, morally challenging decisions.3Heroes in Mind Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.2Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada.1Faculty of Health Science, Western University, London, ON, Canada.Nicholas Carleton 2† Suzette Brémault-Phillips 3† Lentz 1,2*† Lorraine Smith-MacDonald 1,3† David Malloy 4† R.
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