Beyond Good Intentions: A Justice-Based Critique of Short-Term Medical Missions

Short-Term Medical Missions (STMMs) are healthcare initiatives that serve underserved populations in low- and middle-income countries, typically lasting from one to four weeks. Often driven by altruistic aims-including religious and humanitarian motivations-these missions raise significant ethical concerns related to effectiveness, sustainability, and the potential to unintentionally harm vulnerable communities. This article offers an interdisciplinary contribution by bridging clinical experience with theories of justice and Christian spirituality. Using a theoretical-normative methodology, it applies four ethical frameworks-Utilitarianism, Contractualism, Cosmopolitanism, and Catholic Social Teaching-to the ethical examination of STMMs. The analysis unfolds in two stages: first, a comprehensive review of key academic literature and foundational texts; second, the application of each framework to a composite case study drawn from the author's academic and professional experience. While each framework offers valuable insights, all reveal important limitations when confronted with complex real-world dilemmas. To navigate such ethical ambiguity, the article proposes Ignatian discernment as a complementary approach-not a competing framework, but a structured practice already used in decision-making under uncertainty. Applied to STMMs, discernment draws on the strengths of the four frameworks to help practitioners weigh competing values, engage local partners, and make context-sensitive decisions in settings marked by asymmetry, urgency, and cultural difference.