A Guide to Understanding Ethical Issues in Medical Tourism by Dr. Prem Jagyasi

Healthcare globalization has brought up several ethical issues surrounding the practice. The fact that people travel from their home country to a medical tourism destination to avail certain treatments that are illegal or unavailable at home brings up several ethical concerns. Besides that, several facilities catering to medical tourism are utilizing unethical practices to woo potential travelers. This section aims to highlight some of the main controversies on ethical issues in medical tourism so that any potential medical traveler is well-informed before commencing travel.

A Guide to Understanding Ethical Issues in Medical Tourism by Dr. Prem Jagyasi – Top Issues and Things to Check

How medical tourism gives rise to ethical concerns?

Ethical issues in medical tourism are evolving with the emergence of new destinations and niche procedures. Apart from creating disparities in healthcare quality and accessibility, the proliferation of therapies and treatments using advanced tech is under scrutiny.

The prime ethical issue is the effectiveness of these treatments. The way these are marketed as if they are magic pills that will create a massive makeover is severely criticized.

Luring consumers with unsubstantiated claims and promises violates the basics of ethical practices. The growing incidences of medical tourism complications don’t come as a surprise; it is rooted in unethical practices.

The patients’ judgment in assessing the risks and rewards of treatments cannot be accurate as the risks often remain masked with enticing rewards.

Lax healthcare regulations in developing countries often pave the way for unethical practices where providers can go scot-free in cases of medical tourism complications.

As a potential medical tourist, you need to check with your local physician and provider abroad before making a decision.

Ethical issues to consider when looking at medical tourism

Generally, the American Medical tourists save a substantial amount with their medical tourism bills, an attraction of lower cost. However, it is slowly receiving some negative feedback due to the associated ethical issues. Following are some of the issues:

Lack of attention to local patients

In the bid to luring the international patients, the local patients are feeling the dearth of good quality medical equipments and resources that are directed to the former. It has been found out that the funds invested by the medical industry are directed towards the health care of the international patients.

Moreover, the quality of the treatment and surgical procedures that are sometimes termed as illegal in a country are still conducted keeping in mind the money involved. This questions the ethical policies of the medical tourism industry.

Specific medical tourism procedures

The US along with many other countries consider a psychological evaluation session before sex reassignment surgeries. These sessions are necessary to understand whether these surgeries need an approval or not.

As a result of these strict regulations, many patients looking forward to such surgeries travel to Thailand which has easy or no laws for such surgeries. Hence, ethical questions about the process can be raised. Similar examples are seen in cancer treatments, stem cell therapies and fertility treatments.

People who do not have such procedures approved in their own countries, travel to countries approving such procedures. As a result, many illegal medical surgeries such as organ transplant are flourishing, causing a concern for the associated government.

Quality Concerns

Medical tourism industry is concerned with the treatment quality it provides. They lure the customers to invest in the policies. Moreover, spas and health care facilities in different countries do provide the best solutions.

However, serious health care conditions need to be investigated, if the practitioners or health care facilities are certified or not. Many such serious operations have recorded to cause side effects such as infection or incomplete process. Hence, a single wrong decision made during such health tourisms can cause you a bomb, affecting your health as well.

Making the right choice

There is a vast range of medical tourism organizations providing the best health care facilities to the individuals while travelling. These are easily available online too. These agencies are the mediators which provide patients with various such facilities to choose from.

However, apart from providing the facility, these agencies do not give you advice as to what is the best for your medical condition. Hence, it leaves the decision solely on you.

Ethical issues for medical tourism: Providing hospital documents in the local language

Also, certain medical tourism facilities only provide documents in their own regional language, leaving the foreign patient confused. These facilities are likely to lack translation services and have no concept of cultural competency. You should certainly avoid hospitals or clinics such as these as it is necessary to ensure the presence of an interpreter to ensure that you can understand all the legal formalities properly. Violations of ethics also entail providing insufficient legal documents to the patient (such as malpractice laws and consent forms), which leads to a lack of information for the medical tourist.

Ethical issues in medical tourism: Over charging a medical tourist

Since catering to the foreign patient, who can usually afford to pay more for a treatment than a local citizen, has become common practice for certain unethical doctors, they tend to do whatever they can to overcharge the medical tourist. This could be in the form of overprescribing hospital tests, charging more than the market price for a treatment and refusing to take care of post-operative complications.

Ethical issues in medical tourism: Dual pricing system

In some developing countries, the doctors pay more importance and attention to medical tourists for personal financial gain and neglect the critical patients in their home country.

This has created a somewhat dual level of healthcare where the more experienced and knowledgeable providers prefer to cater to their high paying foreign patients, and the local patients have a hard time accessing specialist care.

However, on the other hand, some countries are following a dual pricing system, offering treatments to domestic patients at lower prices and the same to the international tourists at a much higher rate.

This could be considered unethical practice, as medial tourists should be charged the market rate, and no more. Some countries enforce standard guidelines and price bands for treatments, established by the government or a health association in order to demonstrate equality for all patients.

For instance, Turkey has a physician’s association that sets the price standards for most private hospitals. Therefore, in order to avoid being duped by a foreign healthcare system, it would be beneficial to inquire about price differences between local and international patients.

Ethical issues in medical tourism: Organ transplant surgeries

Since organ and tissue transplants are so difficult to obtain owing to long waiting lists, many patients tend to seek foreign options and engage in medical tourism for organ transplants. However, the source of these organs is usually a mystery to most patients.

There have been several issues regarding the legality of organ and tissue transplants in many countries. There were many reports of organs being obtained from prisoners without their consent or acquired by illegal means.

As a patient, you should check with your treating facility to authenticate where the organs are coming from to ensure they are not engaged in any unethical practices.

Lack of informed Consent: A Critical Ethical Issue in Medical Tourism

This is a critical ethical concern where patients are left totally in dark about the potential risks and threats in a medical treatment. Patients under duress easily come under the grasp of unethical facilitators or providers and sign the consent form without understanding the details. Many patients do not know how to ask the right questions to the provider and what to check.

Lack of informed consent can arise due to language barriers, misleading information, cultural differences, and inadequate pre-treatment counseling. The complexity of medical tourism amplifies when the patients face rude shocks in their journey in a foreign land lured by cheap prices and quicker access to services. They lack in comprehensive understanding of the procedures and voluntarily sign the consent form.

Always go deep in understanding every step of the treatment and its possible outcomes. Check whether all these are documented in the consent form. Every question that you have is important. Do not ignore your intuition. Lastly, understand every sentence of the consent form fully even if it is in your language. The best way is to get it checked by an expert.

Cultural Commodification in Medical Tourism

An ethical issue often off the radar is the commodification of cultural practices within the realm of wellness tourism, a subset of medical tourism. Traditional healing practices, spiritual rituals, and indigenous medicine are marketed to attract tourists, sometimes stripping these practices of their cultural significance and context. This not only risks misrepresenting and trivializing sacred traditions but also raises questions about the ethicality of turning cultural heritage into consumer products for international tourists.

Inadequate Data Privacy and Security

Cross-border transfer of medical records across borders introduces complex challenges related to data privacy and security. Patients’ sensitive health information is at risk of being mishandled or inadequately protected when shared with overseas healthcare providers.

This concern is magnified by differing regulations and standards for data protection across countries, potentially leading to breaches of confidentiality and privacy that patients might not be fully aware of when opting for treatment abroad. Make sure your providers guarantee data protection with supporting documentation and protocols.

How to steer away from unethical organizations in Medical Tourism

Medical tourism is riddled with controversies related to ethical practices. Thankfully, consensus building is happening to curb unethical practices in medical tourism courtesy accreditations, recognitions, and thought leadership.

Developing countries like India, Singapore and Thailand, doctors give more importance to medical tourists, obviously for personal financial gain and ignore the condition of the serious patients in their own country. This has created a double level of healthcare, where medical tourists receive high-quality treatment, while local people have a hard time finding specialist care.

It is essential for you to make sure that your selected healthcare facility does not have a dual-quality healthcare system, where foreigners are treated in a better way only to get financial gain. In some countries, healthcare facilities also follow a dual-pricing system, where treatment to local residents is offered at extreme fewer prices than what foreign patients are charged. This is an unethical practice, as medical tourists have to pay more than the market rate.

In some countries, regulatory bodies established by the government or health association, implement standard guidelines and price bands for treatment, in some countries there are no such checks and facilities charge medical tourists at their own will.

You should inquire about the price differences between local and foreign patients and this would be beneficial to protect yourself from such an incident. Certain unethical doctors try to provide more facilities to foreign patients because they generally can afford to pay more than the local patients do.

Foreign patients are usually had to pay more for services, and you might have to pay for unwanted services or tests. In addition to this, some medical tourism facilities provide documents in their local language, so that a medical tourist could not understand those guidelines

Many facilities lack translation services or have no concept of cultural aptitude and you should try to avoid such healthcare facilities. It is important for you to determine that the healthcare facility you have chosen will provide all documents at least in English or provide the services of an interpreter to ensure that you can understand all legal formalities.

It is important for you to discuss all these concern before setting out your journey and make sure that the government departments or healthcare associations control the prices to demonstrate equality for all patients.

Get Support from Dr. Prem and Associates – The World’s Leading Medical Tourism Consultant

Doing good is good for your medical tourism business. Dr. Prem Jagyasi, a globally-recognized medical tourism expert, award-winning speaker, and masterclass leader has helped healthcare leaders, government authorities, budding and veteran medical tourism organizations to scale new highs in their business. His invaluable insights in medical tourism consultancy stem from his vast traveling experience to 65+ countries studying diverse patients- their backgrounds, needs, and behavior. Championing ethics in medical tourism, his medical tourism advisory outlines best practices to build patient loyalty and spread word of mouth. To establish yourself as an ethical brand, book a one-on-one consultation with Dr. Prem and experience surprising benefits.

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