Military service often requires engaging in activities, witnessing acts, or immediate decision‐making that may violate the moral codes and personal values to which most individuals ascribe. If unacknowledged, these factors can lead to injuries that can affect the physical, psychological, social, and spiritual health of military men and women. The term moral injury has been assigned to these soul‐ceasing experiences. Although researchers have attempted to define moral injury and what leads to such experiences, inconsistencies across definitions exist. In addition, nearly all existing definitions have lacked empirical support. The purpose of the present systematic review was to explore how moral injury has been defined in research with military populations, using Cooper's approach to research synthesis as well as PRISMA guidelines. An in‐depth review of 124 articles yielded 12 key definitions of moral injury across the literature. Two of these 12 definitions were grounded in empirical evidence, suggesting that much more research is needed to strengthen the face validity and reliability of the construct. Quality rankings were developed to categorize each of the included articles. The findings punctuate the need for empirical evidence to further explore moral injury, particularly among samples inclusive of service members and the biopsychosocial–spiritual experiences associated with such injuries.

The suppression of fear and other strong emotions is not demanded only of men in the trenches. It is constantly expected in ordinary society.-Elliott Smith and T. H. Pear, 1917 1 Sheena M. Eagan Chamberlin, a doctoral candidate in the medical humanities at the University of Texas Medical Branch, is majoring in medical ethics and the history of medicine, with a special focus in military medicine. She is also an adjunct instructor of philosophy at St Mary's University. Her research and teaching interests include medical humanities, medical ethics, history of medicine, military medicine, public health ethics, research ethics, and health policy.

Often known as ‘globalhealth diplomacy’, the provision of medical care to accomplish strategic objectives, advance public diplomacy goals and enhance soft power is increasingly emphasised in international affairs and military policies. Despite this emergent trend, there has been little critical analysis and examination of the ethics of military actors engaging in this type of work. This type of mission represents the most common form of military medical deployment within the International Security Assistance Force in Afghanistan and is now explicitly emphasised in many militaries’ defence doctrine. The growth of these programmes has occurred with little analysis, examination or critique. This paper examines the history of global health diplomacy as directly related to humanitarian assistance, focusing on the difference in intention to highlight ethical dilemmas related to military involvement in the humanitarian sphere. The relationship between non-military humanitarian actors and military actors will be a focal point of discussion, as this relationship has been historically complicated and continues to shift. Relevant differences between these two groups of actors, their motivations and work will be highlighted. In order to examine the morally important differences between these groups, analysis will draw on relevant international doctrine and codes that attempt to provide ethical guidance within the humanitarian sphere.

Since 2000 there has been a 17% increase in the number of women serving in the U.S. military. As women enter the services in more significant numbers and are increasingly deployed to combat operations, the military must adopt policies and practices that accommodate the health care needs of female warriors. According to the American College of Obstetricians and Gynecologists, it is essential that obstetrician–gynecologists are knowledgeable and prepared to address the unique risks to women's reproductive health that are associated with military service. This article responds to this call by focusing on issues related to menstrual regulation or suppression in the female active-duty population. Analysis shows that although servicewomen have consistently reported a desire to suppress or regulate menstruation, rates of this practice remain low. Potential reasons for this include barriers to care and issues related to health literacy within the military population of patients and health care providers. This article provides an overview of the growing body of survey and interview data focusing on military women's health to show that there are gaps in knowledge and significant barriers to care that must be addressed. Ultimately, this work argues that medical care and counseling should be more responsive to the needs of female service members. Educating female service members on the option of menstrual suppression should be made a standard part of routine well-woman care and predeployment physicals, thereby removing sex-specific barriers and enabling more women to take on forward combat roles.

While physicians are generally understood as owing moral obligation to the health and well being of their individual patients, military health professionals can face ethical tensions between responsibilities to individual patients and responsibilities to the military mission. The conflicting obligations of the two roles held by the physician-soldier are often referred to as the problem of dual loyalties and have long been a topic of debate. This paper seeks to enrich the dualloyalties debate by examining the embedded case study of medical civilian assistance programs. These programs represent the use of medicine within the military for strategic goals. Thus, a physician is expected to meet his obligation to his role as a soldier while also practicing medicine. These programs involve obligations inherent in both roles of the physician-soldier and thusly they serve as excellent exemplars for the problem of dual loyalties at an institutional level. This paper focuses on Medical Readiness Training Exercises (MEDRETEs). These programs are short-term, generally taking place in low-income nations in order to accomplish strategic goals including training opportunities for military medical professionals that are not possible on the home front. This form of temporary program raises ethical concerns regarding the exploitation of vulnerable populations and the value of what is termed "parachute medicine". The short-term nature of these interventions makes long-term treatment and follow-up impossible, begging the question as to whether this peak and trough approach to foreign civilian aid is of any use. Physicians are generally understood as having obligations towards the well being of the patient, which these programs do not necessarily prioritize. Rather, the programmatic intent is military, with political and strategic aims of furthering international relations, increasing US military global presence and providing austere and tropical training opportunities for military healthcare providers. This can be morally problematic for the physician-soldier.