![]() Public safety personnel (PSP e.g., border services officers, public safety communications officials, correctional workers, firefighters paramedics, police, ( Canadian Institute of Public Safety Research and Training, 2019) work in fast-moving and unpredictable environments ( Angehrn et al., 2020) that typically involve exposures to potentially psychologically traumatic events ( Corneil et al., 1999 Carleton et al., 2019). Further research is needed to better understand moral distress or moral injury specific to public safety personnel and inform training and treatment in support of public safety personnel mental health. Most studies were qualitative and focused on four topics: values, ethical decision-making, organizational betrayal, and spirituality.Ĭonclusion: Public safety organizations appear to recognize the experience of moral distress or moral injury among public safety personnel that results from disconnects between personal core values, formal and informal organizational values, vocational duties, and expectations. There were two studies that included mixed populations (i.e., one study with police officers, firefighters, and other emergency service workers one study with paramedic and firefighter incident commanders). Participants in the articles were primarily police officers, with fewer articles focusing on paramedics and firefighters. Following review of titles, abstracts, and full texts, 32 studies were included in the current review. Results: The initial database search returned 777 articles, 506 of which remained after removal of duplicates. ![]() Included studies were selected based on the inclusion criteria before being manually extracted and independently screened by two reviewers. 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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