Potentially morally injurious event
An event with the structural potential to cause moral injury — doing, failing to stop, witnessing, or learning of acts that violate deeply held moral beliefs. The word potentially does real work: the event is only a candidate cause, and whether lasting harm follows depends on how the person makes sense of what happened. Framing the event this way keeps it measurable, which is what lets the idea be studied in clinical trials — and is also what its critics object to.
The clinical-research term for an event that has the structural potential to cause moral injury — perpetrating, failing to prevent, witnessing, or learning about acts that transgress deeply held moral beliefs and expectations. The term carries the potentially deliberately: the event is the candidate cause; whether the resulting condition is moral injury depends on how the agent makes sense of and integrates what happened.
Etymology§
Coined in Litz et al. (2009) as part of the operational vocabulary needed to make moral injury measurable and amenable to clinical-trial research. The qualifier potentially parallels the Criterion-A language in the PTSD literature (potentially traumatic event) and was chosen in conscious analogy with it — to keep the diagnostic burden on the response and the meaning-making, not only on the event itself.
The PMIE is the clinical-research workhorse of the Litz-style framework. Measurement instruments — the Currier Moral Injury Questionnaire — Military Version, the Litz-led Expressions of Moral Injury Scale, the Koenig Moral Injury Symptom Scale — all rely on respondents identifying PMIEs in their own combat or work history, and then on assessing the affective and cognitive sequelae. The construct is what makes the field empirically tractable, and it is also what most of the philosophical and theological critics object to.
The objection from the Wiinikka-Lydon / Kinghorn side is that locating the potential of the injury in the event — rather than in the relation between the event, the agent, and the community — already imports a clinical-individualist frame that Shay's original betrayal of thémis framing did not. The construct is serviceable inside the VA's research apparatus and in DoD-funded treatment trials; it is also the place where the clinical and theological branches of the field most clearly diverge.