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The purpose of this paper is to identify and gain a deeper understanding of environmental, organizational, and group conditions, and leadership-related issues in particular, in severely stressful situations involving a moral stressor faced by military and police officers.

A combined deductive and inductive approach was used, and in total 23 military and police officers, all having experience of morally difficult decisions during severely stressful conditions, were interviewed.

A hierarchical conceptual framework of contextual characteristics was developed. The environmental, organizational, leadership-related, and group aspects identified in this study on morally stressful situations resemble findings from general research on work and stress. However, a stronger emphasis was put on leaders’ handling of values and his or her ability to confront senior management when needed.

The results suggest that well-documented methods aimed at the prevention of, and recovery from, work-related stress, also can be used in the case of extreme situations involving moral stressors.

The interplay between leadership and extreme situations involving moral stressors is, to the best of the knowledge, understudied.