Surgical missions to developing countries: Ethical conflicts.

Each year scores of American physicians and nurses travel overseas, usually at their own expense, aiming to improve the lot of desperate patients in developing countries. Our journals are filled with images of smiling children who have benefited from these gifts of care. Still, practicing medicine, and especially surgery, in a sporadic fashion in distant lands can lead to poor outcomes. It does little to improve public health or advance medical education. We address some of the ethical dilemmas intrinsic to international surgical missions and discuss how we might redirect our resources to provide better care to more people.