Medical Tourism: Controversies and Complexities

Representing the National Core for Neuroethics, I recently attended a conference hosted by Simon Fraser University (SFU) convened exclusively to discuss ethical issues related to medical tourism. Participants attended from Canada, the United States, India, Spain and China and represented a diversity of academic disciplines, including anthropology, health sciences, law, philosophy, public health and women’s studies, as well as medical tourism brokers/facilitators and health care providers.

The conference opened with two plenary presentations.  First, Dr. Leigh Turner, University of Minnesota, provided a “roadmap” of numerous ethical issues related to the practice of medical tourism.  Second, Dr. George Thomas, Editor of the Indian Journal of Medical Ethics, and speaking from the perspective of a “donor” country, outlined how medical care in India suffers from a potential imbalance between serving the needs of those who travel to India for medical treatment and delivering publicly funded care to the nation’s own citizens; an imbalance he described as “private profit, public pain.”  Panelists responding to the presentations focused on the economic and political conditions that underscore medical tourism and, in the process, reduce health equity. Heated comments from audience members illuminated the value tensions between those developing new economic opportunities in an increasingly technological and commercialized health care industry, and the ideological and ethical issues outlined by the panel.

The conference program ranged across a broad swath of topics related to medical tourism such as social justice perspectives, messaging and marketing, and reproductive health. Representing the Core, I presented a paper dealing with stem cell tourism and spinal cord injury advocacy – that paper being the culmination of a project largely undertaken by Sara Parke, a recent alumna of the Core who has the distinction of being the Core’s first Fulbright scholar.

Since advocacy groups are essentially meant to be the collective voice of stakeholders, we conducted an empirical study of stem cell information available on SCI advocacy group websites. Our findings document absence of stem cell tourism information on SCI advocacy sites, and hence underscore the need to improve internet-based resources to enable stakeholders to distinguish between research, clinical trials, and untested procedures.

One might wonder how this conference aligns with neuroethics. People considering whether to seek treatment abroad face incredibly complex decisions, often imbued with mounting frustration and desperation. Medical tourism related to stem cell therapy could place individual persons at risk but also jeopardize legitimate scientific progress toward safe and effective clinical translation. Neuroethics has an opportunity to engage in the debate related to new technologies of the brain and spinal cord so that progress does not inexorably lead to exploitation of persons with intractable illnesses and disabilities.

Some useful links:

Simon Fraser University site about the conference: http://www.sfu.ca/medicaltourism/

Article from The Peak, The Independent Student Newspaper of Simon Fraser University: http://www.the-peak.ca/article/21585

Recent report, Patients Beware:  Commercialized Stem Cell Treatments on the Web, published by the International Society for Stem Cell Research (ISSCR) in Cell Stem Cell, July 2010.

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