Should We Award the Purple Heart for PTSD?
Should the DoD recognize servicemembers with post-traumatic stress syndrome with a Purple Heart? Most combat veterans would say ‘no.’ One says yes – and recently published an essay on the political news and commentary website, The Daily Beast.
The author, Benjamin Tupper, isn’t some silver-ponytailed hippie on the faculty at Columbia University or Olympia College. He’s actually a Guardsman, an infantry officer, an Afghanistan War veteran and the author of two books about his experiences in Afghanistan, Greetings From Afghanistan: Send More Ammo and Dudes of War.
Tupper doesn’t attempt to make an affirmative argument for the inclusion of PTSD as a qualifying criteria for the Purple Heart. He cites the anecdotal case of a soldier in his platoon having received a Purple Heart for a minor wound, but not receiving one for injuries incurred when he spent months in a hospital after getting drunk and speeding – his preferred method of self-medication for dealing with PTSD after returning home from Afghanistan – and driving his car off the road.
Ultimately, Tupper advocates that so long as the DoD is trying to remove the stigma of seeking help for PTSD, then not awarding the Purple Heart for PTSD sends a mixed and inconsistent message. Tupper is looking to use the Purple Heart as a means to help legitimize PTSD, and remove any stigma from the diagnosis for those who struggle with it.
From his column:
Granting the Purple Heart is just the first step in fully legitimizing and addressing PTSD. We also need systemic reform of the VA and a better system for providing the long-term clinical treatment that its casualties deserve. But awarding the medal in cases of PTSD will accomplish one essential goal: giving the respect and acknowledgement to those who are suffering from invisible wounds that we already bestow on those with scars we can see. By doing this, we would acknowledge that the anxiety, rage, depression and disrupted emotional and social lives that veterans with PTSD experience are a result of war, and not some personal defect. By honoring them like we honor those scarred by bullets and IEDs we may be able to alleviate some of the shame and fear that have led so many to suicide.
But if the irresponsible and reckless actions of Tupper’s friend represent the positive case for awarding one of our most prestigious decorations, Tupper’s argument doesn’t get off the ground.
He does somewhat better countering some of the obvious arguments against awarding the Purple Heart for PTSD:
Argument 1: It’s not a real wound. Tupper argues that “more combat veterans from Iraq and Afghanistan die from suicide related to wartime service and mental health issues, than from enemy bullets and bombs. That should offer grave and definitive proof that PTSD is very real and that its consequences can be as deadly as an IED.” However, recent research into veteran’s suicides indicates that there’s not much of a link between direct combat experience and suicides.
Argument 2: The mental disorder does not cause physical damage. Tupper responds that there is nothing in the regulations that limits the Purple Heart to physical wounds. He then argues that traumatic brain injury, or TBI, also causes no physical disfigurement but qualifies for the Purple Heart. However, the TBI is a brain injury that frequently causes identifiable physical symptoms and has effects that show up in MRIs and other tests that are certainly physical, as opposed to psychological.
Argument 3: There’s no clear chain of causation from a specific event to a PTSD diagnosis. Tupper’s argument is that this is also true of TBI, where there may have been a pre-existing injury from playing high school sports that got aggravated by an IED, for example. However, Tupper fails to address that you still have the TBI, and you still have an IED or other explosion caused by enemy action. Awarding the Purple Heart for PTSD will require much less of a chain of causation than that.
Argument 4: People will fake symptoms to earn the award. Tupper argues that this can be the case with any award, which is why we have sworn statements documenting combat experience. However, there are many more ways to get PTSD in the military than combat. Military sexual trauma is an obvious example. If we’re going to award the Purple Heart to people who suffer from combat-related PTSD – or claim to – what is the message we are sending to those who contract PTSD through rape or sexual assault or some other act of violence? Yes, the regulations state that the Purple Heart must be awarded for causes attributable to enemy action. But if the goal here is to destigmatize PTSD and encourage those who suffer from it to get help, then awarding it to combat-related PTSD cases and withholding it from MST-related PTSD sufferers will create two classes of PTSD patients – the combat ones with Purple Hearts and the others.
Tupper also fails to consider the effect on the award itself. The minute we take this award long established for recognition of actual combat wounds received in the service of this country and award it for a nebulous complex of psychological ailments, we will essentially put an asterisk on all subsequent Purple Hearts. It will also cause a flood of claims, as all of a sudden every single fobbit who never left the wire now has a basis for a claim from a single mortar shell – and can push to receive the award.
Let’s not turn the Purple Heart into the CAB. The value and prestige of the award will be cheapened, not enhanced, by Tupper’s proposed measures. Expanding the award criteria to include a PTSD diagnosis is an insult to generations of warriors who earned it the old-fashioned way: shedding blood on the battlefield.
What are your thoughts on this? Hacce you experienced PTSD and do you think it merits an award such as the Purple Heart? Tell us in the comments.