A Therapeutic Application of Philosophy — The Moral Casualties of War

Camillo "Mac" Bica's 1999 paper in the International Journal of Applied Philosophy is one of the earliest articulations of moral injury as a philosophical category. The paper appears in IJAP — a small but established peer-reviewed journal published by the Philosophy Documentation Center — and is structured as a therapeutic application of philosophy: an essay in moral philosophy that is also a clinical intervention, written by a Marine Corps veteran of Vietnam who is working through his own combat experience as part of the analysis. The author is doubled in the text; the analysis and the case material are not separable.

The historical question of priority is genuinely contested. Wikipedia and some secondary literature (the introductory paragraphs of the Truthout and Common Dreams op-eds Bica later wrote, and the Syracuse University Moral Injury Project materials) credit him with originating the modern use of moral injury. The more widely-cited claim of priority goes to Jonathan Shay in Achilles in Vietnam (1994). The construct was being articulated in roughly the same form by several figures in the mid-to-late 1990s — Shay in psychiatry, Bica in applied philosophy, Larry Dewey in VA psychiatry — converging on the same problem from different disciplines. The 2009 Litz reformulation is the moment the construct consolidated under a single citation point, but the prior decade saw parallel articulations.

The philosophical move that distinguishes Bica from Shay and from later clinical reformulations is the location of the wound's etiology in the structural conflict between civilian and military moral worlds. Where Shay locates the wound in a particular betrayal event and Litz locates it in the agent's transgression of held beliefs, Bica's account treats the wound as a kind of normative displacement — the veteran has been required to inhabit a moral world (military) whose rules conflict with the moral world he is returning to (civilian), and the injury is constituted by the incommensurability between them. This framing is closer to Wiinikka-Lydon's later virtue- ethical critique than it is to either of the two dominant clinical framings.

The stake is personal, political, and philosophical at once. Bica writes as a self-identified morally injured veteran working through his own experience, as a peace activist with a long public record (he is a regular contributor to Truthout and Common Dreams on veterans' issues), and as an academic philosopher with institutional standing at School of Visual Arts. The doubling of roles is not concealed; the paper is openly a hybrid of analysis and testimony, and is better for being so.

For the moral-injury corpus the paper's value is that it preserves a non-clinical philosophical articulation of the construct from the same period as Achilles in Vietnam. Bica later appears as one of the four veterans in Soul Repair (2012), which is the place most readers first meet him; the 1999 paper is the prior philosophical articulation in his own voice. Note that the article is paywalled at the Philosophy Documentation Center site; institutional access is required.