@article{463a9e5d-2b30-4cb7-93fd-d31c57e19ef6,
  abstract     = {{Psychiatric inpatient care for individuals who engage in self-injury involves<br/>tensions between preventing harm, respecting autonomy, sustaining relational<br/>care, and managing organizational demands. Sta may experience emotional<br/>burden and moral distress, while patients may experience care as invalidating,<br/>coercive, or insu ciently responsive to their needs. This article develops a<br/>theory-informed conceptual framework applying Albert Bandura’s theory of<br/>moral disengagement to psychiatric inpatient care for self-injury. Drawing on an<br/>interpretive synthesis of Bandura’s theory and clinical literature identified through<br/>a focused, non-systematic search, it examines how moral disengagement<br/>related processes may shape the interpretation, justification, and normalization<br/>of problematic care practices. The framework maps Bandura’s eight moral<br/>disengagement mechanisms across four loci of moral self-regulation: conduct,<br/>agency, consequences, and recipients. It illustrates how practices may be<br/>interpreted as protective, reframed through euphemistic language, or made<br/>acceptable through comparison with more severe alternatives. Responsibility<br/>may be displaced onto institutional authority or di used across teams, while<br/>the interpersonal and psychological consequences of care may be minimized<br/>or treated as secondary to immediate safety demands. At the recipient<br/>locus, patients may be dehumanized through reduction to diagnoses, risk<br/>profiles, or behavioral categories, or blamed for their self-injury and for the<br/>emotional and organizational burdens associated with care. The framework<br/>situates these mechanisms within a recursive multilevel process in which<br/>sta appraisals, care practices, patient responses, and team and organizational<br/>conditions may mutually shape one another over time. The analysis is<br/>conceptual and hypothesis-generating, not an empirical demonstration that<br/>moral disengagement has occurred in specific situations. Rather than locating<br/>problematic care primarily in individual failure, the framework directs attention to the relational, organizational, and societal conditions under which ethical<br/>responsiveness may be weakened or restored. Future research should<br/>operationalize these processes and examine them across sta and patient<br/>perspectives and individual and collective levels,}},
  author       = {{Bjärehed, Jonas and Bjärehed, Marlene}},
  issn         = {{1664-1078}},
  language     = {{eng}},
  month        = {{09}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Psychology}},
  title        = {{Moral disengagement in psychiatric inpatient care for individuals who engage in self-injury : a conceptual framework for understanding staff responses and patient experiences}},
  url          = {{http://dx.doi.org/10.3389/fpsyg.2026.1900173}},
  doi          = {{10.3389/fpsyg.2026.1900173}},
  volume       = {{17}},
  year         = {{2026}},
}