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Moral injury and distress: influence of emergency services leadership and organisational dynamics
Journal article   Open access   Peer reviewed

Moral injury and distress: influence of emergency services leadership and organisational dynamics

Greg Drummond, Joseph Cuthbertson, Kate Baecher and Matthew B. Thompson
Australian journal of emergency management, Vol.41(3), pp.25-34
2026
DOI: https://doi.org/10.47389/41.3.25
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Open Access CC BY-NC V4.0

Abstract

Life Sciences & Biomedicine Public, Environmental & Occupational Health Science & Technology
This study explores how leadership behaviours and organisational characteristics influence moral distress and moral injury among frontline emergency services personnel. Fifty-four Australian emergency responders completed an online survey containing 6 openended questions addressing their experiences, influential organisational and leadership factors, alignment between personal and organisational values and recommendations for organisational change. Responses were analysed using thematic analysis. Organisational factors, rather than direct exposure to trauma incidents, were frequently described as primary drivers of moral distress and injury. Specifically, distrust in leadership and perceptions of procedural injustice commonly amplified respondents' vulnerability to moral distress or injury. Participants reported a disconnect between organisational and personal moral values and indicated perceptions of inconsistency between the stated and enacted values of their organisations. Empathetic and supportive leadership behaviours were identified as protective factors, while bullying, unethical actions and leader detachment were commonly perceived as exacerbating experiences of moral distress and injury. These findings underscore the potential importance of attending closely to leadership practices, organisational ethics and the alignment of organisational values.

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