The 'Moral Dilemma' and 'Moral Injury' of psychologists in relation to Palestine
Exploring ethical conflict, professional silence, and psychological distress among practitioners
In times of extreme political violence, psychologists are often positioned at the intersection of professional ethics, personal values, and societal injustice. Nowhere is this more apparent than in the case of Palestine. As the humanitarian crisis deepens under military occupation, systemic apartheid, and repeated assaults, psychologists—both within and outside Palestine—are faced with profound moral dilemmas. These dilemmas can escalate into what is increasingly recognised in the literature as moral injury—the deep psychological distress that results from betraying one's moral code, whether through action or inaction (Litz et al., 2009).
This blog explores the concept of moral injury in the context of Palestine, considering how psychologists are affected by witnessing or being implicated in structural violence, ethical paralysis, and global silence. It also reflects on how inaction or enforced neutrality, especially from psychologists in the Global North, may perpetuate harm while undermining core principles of justice and care that are central to psychological practice.
Defining Moral Dilemma and Moral Injury
A moral dilemma arises when a person is forced to choose between two or more conflicting ethical principles, each of which has significant moral weight. In the context of Palestine, psychologists may struggle between maintaining "professional neutrality" and speaking out against occupation, settler-colonial violence, and apartheid (Hugman, 2005). For instance, psychologists employed in NGOs or academic institutions may fear professional repercussions if they publicly condemn Israeli military actions, especially in countries where political criticism of Israel is framed as antisemitism (Mills, 2020).
Moral injury, while originally conceptualised in military psychology, has evolved to include a broader range of professions. Litz et al. (2009) describe it as the lasting psychological, emotional, and spiritual harm caused by actions that violate one’s moral or ethical code. In psychology, this can occur when clinicians feel complicit in injustice—by remaining silent, by working in institutions that ignore global oppression, or by witnessing suffering without being able to intervene.
The Psychologist’s code of ethics and Palestine
Most professional psychological bodies, including the British Psychological Society (BPS) and the American Psychological Association (APA), espouse ethical principles such as justice, respect for people's rights, and the responsibility to promote human welfare (APA, 2017; BPS, 2018). These values suggest an ethical imperative for psychologists to speak out against violations of human rights—including ethnic cleansing, occupation, and military aggression.
Yet in practice, psychologists often face institutional or professional pressures to remain “apolitical.” In the context of Palestine, this pressure may manifest in reluctance to use terms such as “genocide,” “apartheid,” or “colonialism,” despite these being widely recognized by human rights experts and scholars (Human Rights Watch, 2021; United Nations, 2022). This dissonance between ethical commitment and professional silence can itself become a form of moral injury, leading to guilt, shame, and disillusionment with the field (Kienzler, 2008).
Witnessing atrocity from afar: the global Psychologist’s burden
For psychologists not based in Palestine, the moral injury may stem not from direct exposure to trauma, but from indirect witnessing, through news, social media, or conversations with clients. Psychologists working with Palestinian refugees or diaspora communities may absorb vicarious trauma through their clinical work. At the same time, they may feel helpless, especially if their professional environments discourage political advocacy.
This tension between knowing and doing has been described as a form of “ethical distress,” where the psychologist recognises what should be done but feels constrained by professional, institutional, or social limitations (Jameton, 1984). Over time, this distress can undermine a clinician's sense of integrity, leading to emotional burnout and disengagement.
Silence as ‘Complicity’
One of the most troubling aspects of moral injury in the context of Palestine is the realisation that silence may not be neutral. The decision not to speak out—or to frame the situation in purely humanitarian rather than political terms—can be experienced as complicity in structural violence (Summerfield, 2001). Psychologists may begin to question whether their profession’s silence perpetuates harm by allowing dominant narratives to go unchallenged.
For example, when psychological organisations issue statements about mental health in “conflict zones” without naming the occupation, the military blockade, or the asymmetry of power, they risk contributing to depoliticised understandings of trauma. This not only invalidates the lived experience of Palestinians but also distorts the psychologist's role from one of advocacy to one of passive observation (Qouta et al., 2008).
Resisting Moral Injury: acts of solidarity
Despite these challenges, many psychologists have begun to frame their roles in terms of solidarity. This includes issuing open letters, organising advocacy groups, and integrating social justice perspectives into clinical training. Such actions can serve as protective factors against moral injury by aligning professional action with moral conviction (Watkins & Shulman, 2008).
Psychologists for Palestine, for example, represents an emerging network of professionals committed to naming and addressing the psychological impacts of occupation and apartheid. By creating space for ethical reflection, public education, and activist scholarship, these groups help restore a sense of agency and reduce the dissonance that fuels moral injury.
Conclusion
The moral dilemma and moral injury of psychologists in relation to Palestine is an underexplored but urgent topic. As the violence escalates and the humanitarian crisis deepens, psychologists face critical choices about how to embody their ethical principles in the face of systemic injustice. Silence, avoidance, or forced neutrality may protect professional standing but at a deep psychological cost.
To mitigate moral injury, psychologists must engage in collective reflection, ethical dialogue, and acts of resistance. Most importantly, the profession must reckon with its responsibility not just to treat trauma but to oppose the conditions that cause it. Speaking truth to power, even at personal or professional risk, is not outside the scope of psychological work—it is central to its integrity.
References
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Human Rights Watch. (2021). A threshold crossed: Israeli authorities and the crimes of apartheid and persecution.
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Summerfield, D. (2001). The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category. BMJ, 322(7278), 95–98. https://doi.org/10.1136/bmj.322.7278.95
United Nations. (2022). Report of the special rapporteur on the situation of human rights in the Palestinian territories.
https://www.un.org
Watkins, M., & Shulman, H. (2008). Toward psychologies of liberation. Palgrave Macmillan.