There is a perception that ethical issues most commonly arise at the limits of medical care. For example, deciding whether or not to take someone off life support or making a decision about continuing treatment for someone with a terminal condition. While this may be true to some extent, the reality is that ethical considerations will come up frequently during all phases of healthcare delivery.
The subject of ethics is especially relevant in medical travel due to the unique circumstances and challenges facing patients traveling for care. Ethical concerns may arise if healthcare providers are not transparent with traveling patients about the potential risks and safety concerns in medical travel and the implications of this for patients’ abilities to achieve informed consent.1 For example, flying after surgery can increase the risk for blood clots. Additionally, if medical malpractice occurs, patients may not have the same rights to seek legal redress as they would in their own country. Medical travelers could also fall prey to unscrupulous facilitators or intermediaries whose primary motivation is the referral fee rather than the patient’s best interests.
Traveling patients may be unaware of these concerns due to lacking familiarity with the destination health care system, language or cultural barriers to adequate communication between medical tourists and health care workers, and/or lacking transparency regarding quality of medical facilities or health care workers.2
How do healthcare providers ensure that traveling patients are adequately educated about the potential risks associated with medical travel? Are there steps we can take to assure that the integrity of care is maintained across the medical travel care continuum? These are legitimate questions that should be carefully considered by healthcare providers caring or seeking to care for medical travelers.
Promoting ethically responsible care
Fortunately, healthcare providers can take specific steps aimed at promoting ethically responsible practices. The first step is to acknowledge the uniqueness of medical travel and set guidelines and protocols that address the challenges medical travelers face. These should include:
- Employee orientation and education: Ethics, like most other disciplines, must be learned. New employee orientation and all educational programs should include ethics content, with specific examples of how to apply theoretical principles to concrete issues,3 including those faced by medical travelers.
- Demonstrating transparency: This occurs by providing honest, accurate information about the risks associated with surgery and travel, medical outcomes, your medical staff’s qualifications, the effectiveness of the medical equipment you possess, pricing (and situations that could lead to additional expenses) and even legal or financial claims against the healthcare institution. Far from hurting you, being open and transparent with patients – even in situations where you may have made a mistake – will foster trust and respect. Patients will be genuinely impressed with your courage and willingness to put their interests ahead of your bottom line.
- Respecting Patient Rights: This occurs when the healthcare organization provides the patient with written patient rights documentation that is explained in a language and manner that the patient understands and that these rights are respected during the entire treatment process. Patients should be informed that they have the right at any time to seek assistance from the healthcare organization whenever they believe that their rights have not been respected.
- Improving patient communication and education: Healthcare providers should evaluate whether or not their current education and communication platforms are serving the needs of medical travelers. Is your website available in the language or languages of traveling patients? Does your staff – clinical and non-clinical – have the skills and tools to communicate effectively with traveling patients? New technologies such as patient portals, telehealth technologies, and mobile apps are supporting communication between providers and patients anytime and anywhere.4
We hope that by creating awareness of the ethical concerns that impact medical travelers, it will motivate healthcare providers and other stakeholders in the medical tourism industry to prioritize transparency, respect for patients’ rights and effective education/communication in the treatment and care provided to traveling patients.
[1] https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-8-19
[2] Penney K, Snyder J, Crooks VA, Johnston R: Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites. BMC Med Ethics. 2011, 12: 17- 10.1186/1472-6939-12-17
[3] https://www.amnhealthcare.com/latest-healthcare-news/10-Best-Practices-Addressing-Ethical-Issues-Moral-Distress/
[4] http://www.himss.org/news/improving-patient-communication-improve-outcomes
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