The Ethics of International Medical Tourism

Abstract

Medical tourism describes the phenomenon of traveling for the purpose of seeking medical treatment, whether or not treatment is obtained [1][2][3] . Medical tourism can occur when patients travel from less developed countries to more developed countries to seek higher-quality care. Conversely, there has been a more recent trend of patients from more developed countries traveling to less developed countries to seek care, often incentivized by lower costs and shorter wait times 2 . Medical tourism can be international or domestic 4 , and this article focuses on medical tourism in the global context.The industry of international medical tourism has grown substantially in the last 2 decades, with an estimated twenty-fold increase in the total number of medical tourists outbound from the United States each year from 2007 to 2017 3,5 . Moreover, it has been estimated that $600 million are spent each year by Americans on health care outside the United States, representing a 13% increase from 2004 to 2009 5 . The growth of medical tourism is due in part to the evolution of the internet, which has allowed for rapid free information exchange and for health to be viewed as a cosmopolitan commodity 3 . It has been estimated that between 0.5 and 1.3 million Americans travel abroad each year to seek health treatment 3,5 . The elective nature of many orthopaedic surgical procedures has been favorable for the growing medical tourism market, and the most common orthopaedic procedures performed abroad include adult joint reconstruction, joint arthroscopy, spinal decompression and fusion, and disc space reconstruction 6,7 . It is important to note that the increased utilization of medical tourism is largely driven by market factors, as there has been a paucity of evidence on the quality and safety of these treatments abroad 6 . The Potential Benefits of Medical TourismThere are a number of potential benefits of medical tourism that may allow it to contribute to the welfare of patients. TheThe Potential Harms of Medical Tourism Potential Risks Despite the advantages, there are a number of potential harms of medical tourism that must be considered. By its nature, the act of seeking health care far away from one's home carries the potential to delay treatment. Some conditions, such as infection, trauma, or nerve compression, may be time-sensitive, and delayed treatment may adversely affect patient outcomes. Inefficiencies in the transfer of care, such as incomplete medical *Members of the American Society for Surgery of the Hand Ethics and Professionalism Committee are included in a note at the end of the article.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/H937).