In a controversial ruling contradicting the wishes of many returning veterans and their families, the U.S. Army has announced that no Purple Heart medals will be awarded to service members suffering from Post Traumatic Stress Disorder because the condition does not constitute "a physical wound" and its consideration could lead to improperly granted or unearned medals.  

The Purple Heart is, in concept, one of the oldest and most significant honors bestowed upon American servicemen and women, reserved for those who have been wounded by opposing forces during armed conflict. Originally created by General George Washington and referred to as the Badge of Military Merit, the award grew obsolete after the American Revolution and only returned to common use in the aftermath of World War I, when the scope of the battle and rising U.S. casualties demanded a greater public response. It is now one of the highest honors available to serving soldiers and is often awarded posthumously to those deemed to have died bravely in battle. More than 36,000 service members involved in our current wars in Iraq and Afghanistan have received Purple Hearts.  

The chronic nature of severe wartime traumas merits a greater degree of official recognition, especially in an age of post-modern battlefield filled with superior defensive and medical technologies and plagued by an increasing number of improvised attacks designed primarily to upset troop cohesion and morale. Some of the American military's highest-ranking members seem at least somewhat open to the concept of PTSD-related Purple Hearts: in 2008 Defense Secretary Robert Gates called it "something that needs to be looked at." The Pentagon advisory group ruling on the issue, however, disagreed with Gates, stating that "current medical...technologies do not establish PTSD...objectively and routinely" enough to warrant trauma-based Purple Hearts.  

While PTSD does remain "difficult to...quantify" and cannot be rated on any scale, it is a very real and devastating condition resulting directly from the horrors of combat experience. And a declaration, made by the Pentagon-sponsored Military Order of the Purple Heart, that awarding the honor to traumatized soldiers would "debase" it or compromise its integrity offends many in a very elemental way. Some who suffer privately from the traumas of battle have stated in public forums that their wounds are just as real as any traumatic brain injuries or lost limbs and that this refusal amounts to an officially sanctioned snub. They feel that their significant contributions to the American military have not been not fully appreciated. 

Not every soldier agrees - some voice concerns that PTSD, unlike physical injury, is a condition that may be faked or, at the very least, exaggerated by those looking for attention or an excusal from combat duty. And another crucial element colors this controversy: Purple Heart recipients are entitled to expanded benefits that include highest-priority access to health care services and the ability to waive medical co-payments. These issues carry extra relevance with traumatized soldiers whose conditions require long-term counseling and medication that grows very expensive over time. 

While the Pentagon's stance is predictable given the range and quantity of cases under the PTSD banner (at least 30% of active troops could be diagnosed with the disorder), many now read their response as an outright dismissal of a chronic condition that may ultimately prove more harmful than any single wound that can be repaired by surgical means. Despite the Pentagon's insistence that Purple Heart recipients must shed physical blood, bravery on the field is, in theory, the most basic requirement. And the majority of affected soldiers have certainly displayed that. Most importantly, a large number of traumatized individuals return to this country unable to hold down a steady job or perform many of the basic day-to-day functions of civilian life. Skepticism and financial limitations cannot relieve the U.S. military of the responsibility it bears for their well-being.