Cross-border travel for healthcare is not immune from ethical considerations. Apart from obvious concerns of costs, risks and quality of care, a very real issue emerging in research is the ethical consequences of medical tourism.
The Simon Fraser University Medical Tourism Research Group consists of a team of five researchers who have published many academic papers addressing this subject.
They have indicated that patients may not be aware of these ethical concerns and ongoing education is important. These ethical concerns revolve around effects on the home country, on the patient and on the destination country.
When discussing medical ethics and the medical tourism industry we must first discard the sensational and the absurd. Horror stories of illegal organ donors and non-licensed surgery in questionable facilities are atrocities and are obviously unethical, illegal and universally condemned. The issues that need to be explored are the legitimate questions that can arise from any medical service and how they affect both the patient specifically and healthcare in general.
The physician’s ethical obligation to the patient is usually obvious to do no harm and do their best for the patient. The other partners in healthcare also have obligations. The patient has the theoretical social responsibility to maintain health and reduce burden on society to a minimum. This concept is emphasized to a greater degree in a socialized health system. Finally, society and government carry the obligation to care for the sick and reduce public health risks. These three facets of ethics need to be considered in the medical tourism model.
The Potential of Burden on the Patient’s Home Country
In a recent publication in the British Medical Journal, a Canadian-based team conducted a focus group with health professionals dealing with the ethical concerns of medical tourism. Because Canada has socialized medicine and a national health insurance system, it is not surprising that some
Medical tourism for the classes, but missionary care for the masses.
of the major questions posed were the effect of late-arising complications burdening the national health system and the risk of introducing new antibiotic resistance infections to the home country. Further concerns identified regarded the potential for discontinuity of medical records for the medical traveler and the legitimacy of informed consent at a distance if the patient does not have complete information about the host country before arrival.
The Patients Ethical Perception
The ethical arguments over medical tourism can also have a bearing on the patient’s decision to seek care overseas. Each patient has his or her own ethical considerations justifying health travel. Patients often find it necessary to seek healthcare elsewhere because of the unethical situation in their home health system; be it inflated costs, the inability to obtain insurance or prolonged waiting lists for procedures.
Effects of Medical Tourism on Local Healthcare
Another frequent issue discussed in medical ethical research is the effect of medical tourism on the host nation. A paper in the World Hospital Health Service journal of 2011 discussed that limited expenditures in local healthcare infrastructure and development with concurrent investment targeted for medical tourism can lead to unequal access of health resources in developing nations.
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