Risks

RisksMedical tourism carries some risks that locally provided medical care does not.

Some countries, such as South Africa, or Thailand have very different infectious disease-related epidemiology to Europe and North America. Exposure to diseases without having built up natural immunity can be a hazard for weakened individuals, specifically with respect to gastrointestinal diseases (e. g. Hepatitis A. amoebic dysentery. paratyphoid ) which could weaken progress and expose the patient to mosquito-transmitted diseases. influenza. and tuberculosis. However, because in poor tropical nations diseases run the gamut, doctors seem to be more open to the possibility of considering any infectious disease, including HIV. TB, and typhoid. while there are cases in the West where patients were consistently misdiagnosed for years because such diseases are perceived to be “rare” in the West. [ 27 ]

The quality of post-operative care can also vary dramatically, depending on the hospital and country, and may be different from US or European standards. Also, traveling long distances soon after surgery can increase the risk of complications. Long flights and decreased mobility associated with window seats can predispose one towards developing deep vein thrombosis and potentially a pulmonary embolism. [ 28 ] Other vacation activities can be problematic as well — for example, scars may become darker and more noticeable if they sunburn while healing. [ 29 ]

Also, health facilities treating medical tourists may lack an adequate complaints policy to deal appropriately and fairly with complaints made by dissatisfied patients. [ 30 ]

Differences in healthcare provider standards around the world have been recognised by the World Health Organization. and in 2004 it launched the World Alliance for Patient Safety. This body assists hospitals and government around the world in setting patient safety policy and practices that can become particularly relevant when providing medical tourism services. [ 31 ]

If there are complications, the patient may need to stay in the foreign country for longer than planned or if they have returned home, will not have easy access for follow up care. [ 32 ]

Legal issues

Receiving medical care abroad may subject medical tourists to unfamiliar legal issues. [ 33 ] The limited nature of litigation in various countries is one reason for the lower cost of care overseas. While some countries currently presenting themselves as attractive medical tourism destinations provide some form of legal remedies for medical malpractice. these legal avenues may be unappealing to the medical tourist. Should problems arise, patients might not be covered by adequate personal insurance or might be unable to seek compensation via malpractice lawsuits. Hospitals and/or doctors in some countries may be unable to pay the financial damages awarded by a court to a patient who has sued them, owing to the hospital and/or the doctor not possessing appropriate insurance cover and/or medical indemnity. [ 34 ] Issues can also arise for patients who seek out services that are illegal in their home country. In this case, some countries have the jurisdiction to prosecute their citizen once they have returned home, or in extreme cases extraterritorially arrest and prosecute. [ 16 ] In Ireland, especially, in the 1980s-90s there were cases of young rape victims who were banned from traveling to Europe to get legal abortions. Ultimately, Ireland’s Supreme Court overturned the ban; they and many other countries have since created “right to travel” amendments. [ 16 ] [ 35 ]

Ethical issues

There can be major ethical issues around medical tourism. [ 33 ] For example, the illegal purchase of organs and tissues for transplantation had been methodically documented and studied in countries such as India, [ 36 ] [ 37 ] China, [ 38 ] [ 39 ] Colombia [ 40 ] and the Philippines. [ 41 ] The Declaration of Istanbul distinguishes between ethically problematic “transplant tourism” and “travel for transplantation”. [ 42 ]

Medical tourism may raise broader ethical issues for the countries in which it is promoted. For example, in India, some argue that a “policy of ‘medical tourism for the classes and health missions for the masses’ will lead to a deepening of the inequities” already embedded in the health care system. [ 43 ] In Thailand, in 2008 it was stated that, “Doctors in Thailand have become so busy with foreigners that Thai patients are having trouble getting care”. [ 44 ] Medical tourism centered on new technologies, such as stem cell treatments. is often criticized on grounds of fraud, blatant lack of scientific rationale and patient safety. However, when pioneering advanced technologies, such as providing ‘unproven’ therapies to patients outside of regular clinical trials, it is often challenging to differentiate between acceptable medical innovation and unacceptable patient exploitation. [ 45 ] [ 46 ]

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