The setting of cross-cultural medicine inherently produces moral injury. This moral injury occurs because different cultures have different deeply held values, and medical care intersects with some of the most emotionally and spiritually powerful values. Moral injury is one of the most common reasons for distress in healthcare missionaries, and the consequences can be severe and lifelong. This calls for adequate preparation, ongoing mentoring, institutional boundary-setting, and further research. 

Moral injury is one of the most common reasons for distress in healthcare missionaries, and the consequences can be severe and lifelong. Our study found seven core conflicts of values that can lead to moral injury. What can be done?