But while Dolovich hypothesized that this psychological distress would “tend to subside the farther away from [Harvard Law School] people get,” that does not seem to be the case. While at least one study has suggested lawyers may not be any more unhappy than anyone else—perhaps more of a condemnation of our society rather than an acquittal of the legal profession—researchers and industry stakeholders have repeatedly sounded the alarm, suggesting that American legal profession is facing a well-being crisis. 

For example, in Massachusetts, a 2023 study commissioned by the state’s Board of Bar Overseers found that among the Massacchusetts lawyers surveyed, 77% reported work-related burnout, along with anxiety (26%), depression (21%), suicidal ideation (7%), and unhealthy alcohol use (42%). 

“We also identified an alarming gap between lawyers who reported anxiety, depression, suicidal ideation, and hazardous or unhealthy alcohol use and those who sought care,” the researchers wrote in their report. “The largest perceived barriers preventing lawyers from seeking care include concerns about stigma, including loss of dignity, embarrassment, injury to pride, not acknowledging their own need for care, or family, friends, or colleagues finding out.”

At the same time, emerging trends in organizational studies seem to suggest corporate professionals more broadly are increasingly experiencing the impacts of a psychological phenomenon known as “moral injury.” Which leads us to two questions: when it comes to lawyers’ mental health and wellbeing challenges, is moral injury playing a role? And, if so, is that something law students should factor into their career decision making? 

Moral injury refers to “the lasting strong cognitive and emotional response that is caused by performing, witnessing, or failing to prevent an action that violates one’s own moral beliefs and expectations.”

Although the term can be traced back to at least the 1990s—often attributed to Department of Veterans Affairs psychiatrist Dr. Jonathan Shay—it remains a developing concept; one of which “acceptance … has outpaced scientific knowledge.” In comments to the Military Times in 2023, Brett Litz, Professor of Psychiatry and Psychology at Boston University School of Medicine and a leading expert of moral injury, suggested that this could be down to moral injury’s intuitive appeal, as people “understand from personal experience that [morally injurious events] can have lasting existential impact.” 

In 2022, an international group of moral injury researchers—among them Professor Litz—undertook the task of defining moral injury, ultimately producing the first standardized assessment, the “Moral Injury Outcome Scale.” 

In investigating the parameters of moral injury, Litz et. al. identified associations between experiencing a “potentially morally-injurious event” (PMIE) and certain symptoms typically linked to PTSD and depression—such as re-experiencing the event(s) in question through flashbacks or nightmares, avoidance in terms of thinking about the event(s), hopelessness and loss of joy or pleasure. 

The Moral Injury Outcome Scale itself, meanwhile, asks patients to scale their response to various statements related to feelings of shame or violation of trust, including: “I have lost faith in humanity,” “I am not the good person I thought I was,” or “I am angry all the time.”

Source: U.S. Department of Veterans Affairs

At the same time, though, some scholars, writing in the context of climate-related distress, have argued moral injury is not necessarily itself a pathology—but rather a “painful reality” that “represents the best of humanity, our ability for kindness and care, and is therefore something we should strive for.” 

Historically, much of the academic research into moral injury has documented its prevalence among military members and veterans. Moral injury has recently received increasing attention among frontline health care workers in Europe and the United States, in relation to, for example, the Covid-19 pandemic. 

“We need to start with honesty, and with clarity that what many are now calling ‘burnout’ is actually moral injury.” 

However, there has also been increasing interest in the psychological and spiritual harm that can arise from experiencing potentially morally injurious events in corporate settings—which, in the U.S. context would, of course, actually implicate health care workers. 

Indeed, shortly before the Covid-19 pandemic arrived in Europe and the United States in January 2020, Dr. Wendy Dean, a former practicing physician and co-founder of the non-profit The Moral Injury of Healthcare, wrote for WBUR: “We need to start with honesty, and with clarity that what many are now calling ‘burnout’ is actually moral injury.” 

More recently, in the 2023 book If I betray these words: Moral injury in medicine and why it’s so hard for clinicians to put patients first, Dr. Dean and her co-author, surgeon and Harvard Medical School Professor Dr. Simon G. Talbot, tracked how economist Milton Friedman’s doctrine of shareholder primacy has in fact created a moral injury epidemic among mission-driven health care workers. 

“At the heart of nearly every conversation we have had with clinicians in the last five years is some version of ‘this wasn’t what I signed up for,” a nagging sense that the covenant between physicians and their employers is broken,” they write. 

Moreover, even beyond particular corporate-captured fields such as health care—where, arguably, employees are distinctively mission-driven—the Harvard Business Review in 2022 proclaimed that even in more traditional corporate contexts, “employees are sick of being asked to make moral compromises.”

Meanwhile, Robert Prentice, a professor of business law and business ethics at the University of Texas at Austin, speculates: “If much of your career has involved hiding debt for Enron, creating fake customer accounts for Wells Fargo, manipulating LIBOR for Deutsche Bank, creating software cheat devices for Volkswagen, or saddling minorities with sub-prime mortgages for Countrywide Financial, you might well feel moral injury.” 

These hypotheses are starting to be borne out in recent academic literature—including in legal contexts. For example, in one recent study from the United Kingdom published in the Journal of Business Ethics in February 2024, British researchers Karina Nielsen, Claire Agate, Joanna Yarker and Rachel Lewis undertook a novel, qualitative examination of moral injury in business settings. 

“employees are sick of being asked to make moral compromises.”

“Moral transgressions in business settings may not entail life or death situations as in healthcare and military settings,” the authors explained, “Yet they may significantly impact on those whose moral beliefs are transgressed.”

Through interviews with workers across professions—including law—the authors found that in corporate contexts, potentially morally injurious events might, broadly speaking, fall within two categories.

The first category involved ongoing moral transgressions that threatened the reporting worker’s identity as a “good person who would do the right thing”. The second concerned participants being asked to do something against their moral values—whether as “part of daily business in the organisation” or “related to a specific role or responsibility.” 

Reflecting on the latter, the authors quote one lawyer interviewed for the study, whose words might sound familiar to many in the legal profession.“It doesn’t matter what I personally believe about whether this person was racist, or sexist, or what about trans rights,” that lawyer said. “My job is just to defend this claim to the best of my ability and that’s what I’m getting paid for.”

Similarly, in U.S. corporate law, one can imagine how moral injury might arise in the context of being involved in, or adjacent to, the representation of controversial clients. However, say a corporate lawyer spends their days facilitating the corporate processes and formalities necessary to immunize a corporation from veil-piercing—in other words, the shielding of shareholders’ assets from claims against a corporation found liable for wrongdoing. Or perhaps their role frequently involves invoking cases like Graham vs. Allis-Chalmers, In re Caremark or In re Citigroup to protect corporate directors from liability in the face of significant corporate harms. 

“My job is just to defend this claim to the best of my ability and that’s what I’m getting paid for.”

Indeed, in those kinds of situations, one can also easily imagine a lawyer who considers themselves to be—as Nielson et al describe—a person who “would do  the right thing” experiencing an ongoing, morally injurious transgression arising via participating in, and thus legitimizing, corporate law—a doctrinal system that places shareholders (a euphemism for, as Jessica Graham argues, profits) above all else. 

If the hypothesis that lawyers are experiencing moral injury is in fact onto something, the question then becomes: how should lawyers respond? Beyond the notion of law students self-selecting out of corporate law—or certain firms—altogether, climate crisis activism in Europe offers an early example of responses from lawyers already established in the profession.

In March 2023, one UK-based coalition of lawyers organized under the name “Lawyers Are Responsible,” attempted to raise awareness about the problem moral injury. In its “Declaration of Conscience,” dozens of signatories pledged to withhold legal services related to supporting new fossil fuel projects and actions against peaceful climate protesters—such as Dr. Sarah Benn, a physician who received a 32-day prison sentence and, in April 2024, a 5-month medical license suspension after participating in a 2022 protest outside an oil terminal.

At the time, the Declaration sparked a national debate—one with clear echoes of the justifications for entering corporate law heard in the hallways of elite American law schools, and even in the New York Times’ ethics column. While U.S. law students often hear, as Marty Strauss reported for The [F]law, that “it’s not our job as lawyers to determine who gets representation, and every client deserves a lawyer,” at the heart of the discussion in the UK was the so-called “cab rank rule,” which (at least in theory) requires English and Welsh barristers—in American terms, more or less equivalent to trial lawyers—to accept cases in their practice area if they are available to do so. 

“[The cab rank rule] is a bedrock obligation for us as a profession – the barristers’ equivalent of the doctors’ Hippocratic oath,” Chair of the Bar of England and Wales for 2023, Nick Vineall KC, said in a written statement.

“[Some barristers] now say that they support the cab rank rule but that their conscience would not permit them to take such a case. That overlooks the critical point that by representing someone you are not saying that you agree with them,” he added.

However, Lawyers are Responsible signatory barrister Matt Hutchings KC told The Times of London he signed the declaration out of “personal conviction connected in a loose but important way to my relatives who were nonconformists and conscientious objectors during the Second World War.” 

Situating the declaration in a broader movement of professionals seeking to “fill the moral vacuum” resulting from the British government’s failure of “moral leadership,” Hutchings suggested signatories were, essentially, “consciously objecting to being accessories to killing people by fossil fuels.”

Back in the United States, however, while there are indications that moral injury has gained some salience among at least some American lawyers, so far, it is less clearly part of discussions about lawyers’ wellbeing and the legal profession.

Patrick Krill has studied mental health and wellbeing among lawyers—in particular, corporate lawyers—for 15 years. In the course of that work, he has played a key role in highlighting troubling trends in American lawyers’ mental health, including being a member of the task force behind the American Bar Association’s well-being pledge campaign, signed by over 200 firms and law schools (although not Harvard Law School). 

Krill does agree there’s at least potential for moral injury to occur in legal practice—corporate or otherwise. “In criminal defense, you might be encountering behaviors that you find reprehensible which can cause moral injury,” he said. “Or there might be conflicts between work and personal values in corporate settings on issues like the environment.” 

That observation also tracks growing attention afforded to moral injury by a range of American legal practitioners. However, while some criminal defense attorneys do, as Krill suggests, locate moral injury in representing clients who have been accused of particular charges, others have described the “soul wounds” that result from representing clients day-to-day within brutal systems of oppression. 

Speaking to the Public Defenseless Podcast in 2023, Jenny Andrews, Director of Training at the California Office of the State Public Defender, recounted how it feels to experience moral injury while representing indigent clients as a public defender.

She said: “You think, if I stand up in court and I just explain it clearly enough, well, of course the judge is going to release this person and the prosecutor is not going to object.”

But then, she adds, “[T]hat doesn’t happen—there are all of these forces and reasons propelling outcomes to go other directions and … it is this deep soul wound,” she added. “Sometimes as the public defender who’s trying to fight against it, you also feel complicit in it; you feel like people pointed to the fact that you were there to say that it was fair.” 

“Watching the system just destroy people and communities, predominantly people in communities of color, and be fighting against it, but also feel like part of the system that is doing that harm sometimes, that moral injury … it’s discouraging, it’s demoralizing. It wounds people, it definitely does.”

These distinct experiences of moral injury within the same non-corporate practice area do appear to map onto Nielsen et al’s taxonomy of morally injurious events in corporate contexts as 1) discrete tasks that represent an individual transgression (such as representing a client facing particular criminal charges) and 2) ongoing, identity-threatening transgressions (such as playing a role in legitimizing the criminal legal system) . 

However, Patrick Krill emphasizes that even where lawyers’ dissatisfaction in corporate law does not rise to the level of a potentially morally injurious event, lawyers could still find themselves facing other distinct—albeit related—risks to their wellbeing.

In their 2022 study “People, Professionals, and Profit Centers: The Connection between Lawyer Well-Being and Employer Values”—the latest of ongoing efforts to “go upstream” and investigate what’s causing the widespread, profound unhappiness that’s come to be synonymous with the legal profession—Krill and his co-authors found that lawyers who believed their employers valued them for financial worth or productivity—as opposed to their skills or professionalism—displayed worse mental health outcomes. 

In other words, lawyers might experience negative mental health effects from values tensions in the workplace that don’t necessarily involve a potentially morally injurious environment or event. Instead, in a workplace environment driven by billable hours, Krill explains the conflict arises from clashes between lawyers’ values and their self-perception regarding meaning and purpose in the profession.

“There’s been a shift from thinking about the law as a profession to the law as a business,” he explained. “People go to law school with ideas of what their career in the law is going to be like. So once they’re in the workplace, and people end up feeling like their work is meaningless, or it isn’t contributing anything to society, or they’re just fungible units of production who could be switched out with any other person, that can lead to experiences of depression or feelings of “what am I doing with my life”.”

Krill and his colleagues’ findings seem to dovetail with a vast academic literature exploring the concept of “meaningful work.” Sitting at the intersection of organizational studies and ancient philosophy, scholars of meaningful work have often invoked the concept of eudaimonia—a state of human flourishing or well-being associated with the ancient Greek philosopher Aristotle, who considered eudaimonia as the highest human good; an indication of a life well-lived. 

Indeed, in a conversation on the Meaningful Work Matters podcast, Michael Pratt of Boston College’s Caroll School of Management said: “Eudamonia is what separates meaningful work from job satisfaction.” 

Similarly, Professors Neal Chalofsky and Elizabeth Cavallaro write in the Oxford Handbook of Meaningful Work: “Given our understanding of eudaimonic well-being as a fundamental, overarching aim of living, and our work as a significant and influential factor in how we live, the search for meaningful work is clearly an inherent part of our humanness—our human pursuit of the good life, the life well lived.”

Of course, what constitutes meaningful work differs from person to person, and scholars have determined it can be impacted by an individual’s “work orientation”— their “internalized evaluations about what makes work worth doing.” Indeed, in a 2019 analysis also featured in the Oxford Handbook, Michael Pratt, along with co-authors Laura Boova and Douglas Lepisto, described several distinct “work orientations”: utilitarian (colloquially speaking, a “work to live,” rather than a “live to work” mindset), status, passion, service, craftsmanship and kinship orientations—arguing that a particular orientation’s prominence in a given society may also be connected to the society’s cultural context.

It makes sense, then, that Krill believes not all lawyers are vulnerable to a crisis of purpose—as some instead approach their work in a “very transactional way.” “They’re good at something, they can make money from it, and they can structure their life to find meaning elsewhere,” Krill says—offering an account of legal practice that would seem to correspond closely with the utilitarian work orientation described by Pratt, Boova and Lepisto. 

Instead, for Krill, as far as wellbeing in the legal profession goes, the issue is one of “informed decision-making.” Moreover, he argues that law schools and law firms have a role to play in terms of educating students about the realities of day-to-day legal practice, and encouraging the kind of self-reflection needed to identify career paths that could lead a student to work they will find fulfilling. 

“Law students might not have the experience or self-awareness to realize how being in a particular work setting might affect them or cause dissatisfaction,” Krill said. “Law school is part of a continuum into the legal profession,” he added. “What happens in law school sets the tone.” 

What does all of this mean, then, for law students beginning to chart their path in the legal profession? Most, if not all, law students have at some point heard the arguments as to why a career in corporate law is a good decision, a bad decision, or something along the spectrum in between. However, the discontent experienced by so many in the legal profession—and the availability of frameworks such as moral injury and meaningful work to interrogate these trends—seem to suggest it’s worth digging deeper. 

“What happens in law school sets the tone.” 

Whether it’s the risk of “deep soul wounds” resulting from moral injury, or simply the feeling of having been put on earth to be more than just a “fungible unit of production,” it may well be time for law students to consider not only the external consequences of their career decisions, but also the personal, internal costs of prolonged exposure to injustice or disillusionment in the workplace—whatever form that might take.