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Leigh Turner

University of Minnesota, Center for Bioethics, Faculty Member

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My research addresses ethical and social issues related to transnational medical travel (aka “medical tourism”) and the emergence of a global marketplace in health services. I have a particular interest in studying health-related travel originating in Canada and the United States. Though I try to follow developments i...see more

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Books by Leigh Turner

The View From Here: Bioethics and the Social Sciences

From book jacket: Although the field of bioethics is about 40 years old, its emergence and growth... more From book jacket: Although the field of bioethics is about 40 years old, its emergence and growth have only recently become an object of study for social scientists. The View From Here presents the best of this new work: research that explores how bioethics is shaped by, and gives shape to, not just medicine and health care, but law, religion, politics, and emerging global markets. Moving beyond armchair theorizing about bioethics, the articles collected here--empirical studies of bioethics, as it is practiced on the ground in the clinic, the laboratory, and in the creation of social policy--engage the field of bioethics and suggest new avenues for collaboration between social scientists and bioethicists.

41 Views

Papers by Leigh Turner

Dental Tourism: Issues Surrounding Cross-Border Travel for Dental Care

Journal-Canadian Dental Association, Jan 1, 2009

123 Views

The tyranny of'genethics'[opinion]

Georgetown University Home. The tyranny of &#x27;genethics&#x27; [opinion]. DSpace/Manaki... more

11 Views

The English SurgeonDirected and Produced by Geoffrey Smith

Developing World Bioethics, Jan 1, 2010

313 Views

Biotechnology as religion [opinion]

Biotechnology as religion [opinion]. DSpace/Manakin Repository. ...

7 Views

VIEWS AND REVIEWS-PERSONAL VIEWS-Let's wave goodbye to" transplant tourism"

BMJ (CR)-print, Jan 1, 2010

3 Views

The Fountain of Youth: Cultural, Scientific, and Ethical Perspectives on a Biomedical Goal

JAMA: The Journal of the American Medical …, Jan 1, 2004

... Dr. Zaleski's articles and reviews have appeared in First Things, The New York Times Boo... more

10 Views

Canadian medical tourism companies that have exited the marketplace: Content analysis of websites used to market transnational medical travel

Globalization …, Jan 1, 2011

308 Views

Canadian medicare and the global health care bazaar

POLICY OPTIONS-MONTREAL-, Jan 1, 2007

11 Views

Social science and bioethics: the way forward

Sociology of health & …, Jan 1, 2006

48 Views

"Medical tourism" and the global marketplace in health services: U.S. patients, International hospitals, and the search for affordable health care

Health services are now advertised in a global marketplace. Hip and knee replacements, ophthalmol... more Health services are now advertised in a global marketplace. Hip and knee replacements, ophthalmologic procedures, cosmetic surgery, cardiac care, organ transplants, and stem cell injections are all available for purchase in the global health services marketplace. "Medical tourism" companies market "sun and surgery" packages and arrange care at international hospitals in Costa Rica, India, Mexico, Singapore, Thailand, and other destination nations. Just as automobile manufacturing and textile production moved outside the United States, American patients are "offshoring" themselves to facilities that use low labor costs to gain competitive advantage in the marketplace. Proponents of medical tourism argue that a global market in health services will promote consumer choice, foster competition among hospitals, and enable customers to purchase high-quality care at medical facilities around the world. Skeptics raise concerns about quality of care and patient safety, information disclosure to patients, legal redress when patients are harmed while receiving care at international hospitals, and harms to public health care systems in destination nations. The emergence of a global market in health services will have profound consequences for health insurance, delivery of health services, patient-physician relationships, publicly funded health care, and the spread of medical consumerism.

62 Views

Quality in health care and globalization of health services: accreditation and regulatory oversight of medical tourism companies

Patients are crossing national borders in search of affordable and timely health care. Many medic... more Patients are crossing national borders in search of affordable and timely health care. Many medical tourism companies are now involved in organizing cross-border health services. Despite the rapid expansion of the medical tourism industry, few standards exist to ensure that these businesses organize high-quality, competent international health care. Addressing the regulatory vacuum, 10 standards are proposed as a framework for regulating the medical tourism industry. Medical tourism companies should have to undergo accreditation review. Care should be arranged only at accredited international health-care facilities. Standards should be established to ensure that clients of medical tourism companies make informed choices. Continuity of care needs to become an integral feature of cross-border care. Restrictions should be placed on the use of waiver of liability forms by medical tourism companies. Medical tourism companies must ensure that they conform to relevant legislation governing privacy and confidentiality of patient information. Restrictions must be placed on the types of health services marketed by medical tourism companies. Representatives of medical tourism agencies should have to undergo training and certification. Medical travel insurance and medical complications insurance should be included in the health-care plans of patients traveling for care. To protect clients from financial losses, medical tourism companies should be mandated to contribute to compensation funds. Establishing high standards for the operation of medical tourism companies should reduce risks facing patients when they travel abroad for health care.

63 Views

Promoting medical tourism to India: messages, images, and the marketing of international patient travel

The practice of medical tourism depends on successfully informing potential patients about proced... more The practice of medical tourism depends on successfully informing potential patients about procedure options, treatment facilities, tourism opportunities, travel arrangements, and destination countries. The promotion of medical tourism includes a wide range of marketing materials such as flyers, booklets, and websites. Yet, there is a paucity of knowledge about the dissemination, content, and reception of these promotional materials. Drawing on a thematic content analysis of the promotional print material distributed at the first medical tourism trade show in Canada in 2009, the main purpose of this article is to identify and understand the messages and images that companies use to market India as a global destination. While researchers and news media frequently cite low cost procedures as a key determinant for international patient travel, particularly to developing nations, our analysis reveals few low cost-related images or messages in the promotional materials distributed at the trade show. To help explain this surprising disjuncture, we consider four related issues: (1) promotional materials may be designed to be circulated amongst potential patients' concerned family and friends who privilege knowing about things such as the use of advanced technologies; (2) developing nations need to portray safe and advanced treatment facilities in order to dispel potential patients' suspicions that their medical care is inferior; (3) companies may avoid making cost saving claims that cannot be fulfilled for all of their international patients, especially those traveling from developing nations; and (4) messages of low cost may detract from and even undermine messages about quality. We conclude by identifying numerous avenues for future research by social and health scientists, and by considering the implications of our findings for existing knowledge gaps and debates within health geography specifically.

248 Views

Bioethics and Transnational Medical Travel: India, "Medical Tourism", and the Globalization of Health Care

Health-related travel, also referred to as "medical tourism", is historically well-known. Its eme... more Health-related travel, also referred to as "medical tourism", is historically well-known. Its emerging contemporary form suggests the development of a form of globalised for-profit healthcare. Medical tourism to India, the focus of a recent conference in Canada, provides an example of the globalisation of healthcare. By positioning itself as a low-cost, high-tech, fast-access and high-quality healthcare destination country, India offers healthcare to medical travellers who are frustrated with waiting lists and the limited availability of some procedures in Canada. Although patients have the right to travel and seek care at international medical facilities, there are a number of dimensions of medical tourism that are disturbing. The diversion of public investments in healthcare to the private sector, in order to serve medical travellers, perversely transfers public resources to international patients at a time when the Indian public healthcare system fails to provide primary healthcare to its own citizens. Further, little is known about patient safety and quality care in transnational medical travel. Countries that are departure points as well as destination countries need to carefully explore the ethical, social, cultural, and economic consequences of the growing phenomenon of for-profit international medical travel.

109 Views

Issues and Challenges in Research on the Ethics of Medical Tourism: Reflections from a Conference

The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a confer... more The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a conference on ethical issues in medical tourism. Medical tourism involves travel across international borders with the intention of receiving medical care. This care is typically paid for out-of-pocket and is motivated by an interest in cost savings and/or avoiding wait times for care in the patient’s home country. This practice raises numerous ethical concerns, including potentially exacerbating health inequities in destination and source countries and disrupting continuity of care for patients. In this report, we synthesize conference presentations and present three lessons from the conference: 1) Medical tourism research has the potential for cross- or inter-disciplinarity but must bridge the gap between researchers trained in ethical theory and scholars unfamiliar with normative frameworks; 2) Medical tourism research must engage with empirical research from a variety of disciplines; and 3) Ethical analyses of medical tourism must incorporate both individual and population-level perspectives. While these lessons are presented in the context of research on medical tourism, we argue that they are applicable in other areas of research where global practices, such as human subject research and health worker migration, are occurring in the face of limited regulatory oversight.

503 Views

Medical tourism: Family medicine and international health-related travel

Canadian Family Physician, Jan 1, 2007

With some treatments unavailable in Canada and other medical interventions available only after l... more With some treatments unavailable in Canada and other medical interventions available only after long delays, medical tourism companies use problems with Canada’s provincial health care systems to promote out-of-country health care. Though few Canadians can afford the high price of care at US medical centres, the international facilities offer less expensive access to private health care.
The number of medical tourism companies in Canada is growing. At present, however, these businesses are relatively small, have few employees, and appear to have a limited client base. As these companies become better known, standardize their operations, and benefit from considerable media coverage, it is possible that more Canadians will travel to other countries for treatment.

42 Views

First World Health Care at Third World Prices': Globalization, Bioethics, and Medical Tourism

Bioethics and Medical Tourism. BioSocieties, Jan 1, 2007

India, Indonesia, Malaysia, the Philippines, Singapore, Thailand and many other countries market ... more India, Indonesia, Malaysia, the Philippines, Singapore, Thailand and many other countries market themselves as major destinations for ‘medical tourism’. Health-related travel, once promoted by individual medical facilities such as Bumrungrad International Hospital and Bangkok International Hospital, is now driven by government agencies, public–private partnerships, private hospital associations, airlines, hotel chains, investors and private equity funds, and medical brokerages. ‘Medical tourists’ include patients trying to avoid treatment delays and obtain timely access to health care. Medical travellers also include uninsured Americans and other individuals unable to afford health care in their home settings. Destination nations regard medical tourism as a resource for economic development. However, attracting patients to countries such as India and Thailand could increase regional economic inequalities and undermine health equity. International medical travel might also have unintended, undesired outcomes for patients seeking affordable health care. With globalization, increasing numbers of patients are leaving their home communities in search of orthopaedic surgery, ophthalmologic care, dental surgery, cardiac surgery and other medical interventions. Reductions in health benefits offered by states and employers will likely increase the number of individuals looking for affordable medical care in a global market of privatized, commercial health care delivery.

77 Views

The Coming Backlash Against "Medical Tourism"

18 Views

Cross-border dental care: 'dental tourism' and patient mobility

Patient mobility is increasing. 'Dental tourism' is driven by numerous factors. These factors inc... more Patient mobility is increasing. 'Dental tourism' is driven by numerous factors. These factors include the high cost of local care, delays in obtaining access to local dentists, competent care at many international clinics, inexpensive air travel, and the Internet's capacity to link 'customers' to 'sellers' of health-related services. Though dental tourism will benefit some patients, increased patient mobility comes with numerous risks. Lack of access to affordable and timely local care plays a significant role in prompting patients to cross borders and receive dental care outside their local communities.

69 Views

Dental tourism: cross-border travel for dental care

410 Views

Medical tourism'initiatives should exclude commercial organ transplantation

JR Soc Med, Jan 1, 2008

Whatever the general advantages and disadvantages of a global marketplace in health services, man... more Whatever the general advantages and disadvantages of a global marketplace in health services, many risks accompany the inclusion of organ transplant packages among the medical pro- cedures sold to international patients. These dangers are magnified in countries where kidneys are purchased in underground economies or black markets. In these settings, promoting organ transplant packages to international patients risks escalating the number of kidneys purchased from poor citizens. Growing demand for transplants prompts organ brokers to increase the number of kidneys bought from impoverished individuals and sold to international patients.

264 Views

Commercial organ transplantation in the Philippines

Cambridge Quarterly of Healthcare Ethics, Jan 1, 2009

Countries throughout Asia promote themselves as leading destinations for international travelers ... more Countries throughout Asia promote themselves as leading destinations for international travelers seeking inexpensive healthcare. India, Indonesia, Malaysia, Singapore, the Philippines, and Thailand are all trying to attract greater numbers of what their promotional campaigns call “medical tourists.” Government tourism initiatives, hospital associations, medical tourism companies, and individual hospitals advertise hip and knee replacements, spinal surgery, cosmetic surgery, and other medical procedures. In contrast to most nations marketing treatments to international patients, the Philippines differentiates itself by selling “all inclusive” kidney transplant packages. Patients from other countries travel to the Philippines and receive kidneys purchased from poor individuals.

1,146 Views

Let's wave goodbye to transplant tourism

BMJ, Jan 1, 2008

Transplant tourism is a phrase to which we should say goodbye. True, the term has an alliterati... more

12 Views

From Durham to Delhi:Medical Tourism and the Global Economy

MCIS BRIEFINGS, Jan 1, 2007

62 Views

Bioethics and social studies of medicine: overlapping concerns

Cambridge Quarterly of Healthcare Ethics, Jan 1, 2009

Polemicists and disciplinary puritans commonly make a sharp distinction between the normative, “p... more Polemicists and disciplinary puritans commonly make a sharp distinction between the normative, “prescriptive,” philosophical work of bioethicists and the empirical, “descriptive” work of anthropologists and sociologists studying medicine, healthcare, and illness. Though few contemporary medical anthropologists and sociologists of health and illness subscribe to positivism, the legacy of positivist thought persists in some areas of the social sciences. It is still quite common for social scientists to insist that their work does not contain explicit normative analysis, offers no practical recommendations for social reform or policy making, and simply interprets social worlds.

13 Views

Anthropological and sociological critiques of bioethics

Journal of Bioethical Inquiry, Jan 1, 2009

Anthropologists and sociologists offer numerous critiques of bioethics. Social scientists critici... more Anthropologists and sociologists offer numerous critiques of bioethics. Social scientists criticize bioethicists for their arm-chair philosophizing and socially ungrounded pontificating, offering philosophical abstractions in response to particular instances of suffering, making all-encompassing universalistic claims that fail to acknowledge cultural differences, fostering individualism and neglecting the importance of families and communities, and insinuating themselves within the “belly” of biomedicine. Although numerous aspects of bioethics warrant critique and reform, all too frequently social scientists offer ungrounded, exaggerated criticisms of bioethics. Anthropological and sociological critiques of bioethics are hampered by the tendency to equate bioethics with clinical ethics and moral theory in bioethics with principlist bioethics. Also, social scientists neglect the role of bioethicists in addressing organizational ethics and other “macro-social” concerns. If anthropologists and sociologists want to provide informed critiques of bioethics they need to draw upon research methods from their own fields and develop richer, more informed analyses of what bioethicists say and do in particular social settings.

418 Views

Bioethics, Social Class, and the Sociological Imagination

Cambridge Quarterly of Healthcare Ethics, Jan 1, 2005

557 Views

Social Science and bioethics: morality from the ground up

This article contains a brief summary of ideas explored at greater length in The View from Here: ... more

12 Views

An anthropological exploration of contemporary bioethics: the varieties of common sense.

Journal of medical ethics, Jan 1, 1998

Patients and physicians can inhabit distinctive social worlds where they are guided by diverse un... more Patients and physicians can inhabit distinctive social worlds where they are guided by diverse understandings of moral practice. Despite the contemporary presence of multiple moral traditions, religious communities and ethnic backgrounds, two of the major methodological approaches in bioethics, casuistry and principlism, rely upon the notion of a common morality. However, the heterogeneity of ethnic, moral, and religious traditions raises questions concerning the singularity of common sense. Indeed, it might be more appropriate to consider plural traditions of moral reasoning. This poses a considerable challenge for bioethicists because the existence of plural moral traditions can lead to difficulties regarding "closure" in moral reasoning. The topics of truth-telling, informed consent, euthanasia, and brain death and organ transplantation reveal the presence of different understandings of common sense. With regard to these subjects, plural accounts of "common sense" moral reasoning exist.

100 Views

Zones of consensus and zones of conflict: questioning the" common morality" presumption in bioethics

Kennedy Institute of Ethics Journal, Jan 1, 2003

Many bioethicists assume that morality is in a state of wide reflective equilibrium. According to... more Many bioethicists assume that morality is in a state of wide reflective equilibrium. According to this model of moral deliberation, public policymaking can build upon a core common morality that is pretheoretical and provides a basis for practical reasoning. Proponents of the common morality approach to moral deliberation make three assumptions that deserve to be viewed with skepticism. First, they commonly assume that there is a universal, transhistorical common morality that can serve as a normative baseline for judging various actions and practices. Second, advocates of the common morality approach assume that the common morality is in a state of relatively stable, ordered, wide reflective equilibrium. Third, casuists, principlists, and other proponents of common morality approaches assume that the common morality can serve as a basis for the specification of particular policies and practical recommendations. These three claims fail to recognize the plural moral traditions that are found in multicultural, multiethnic, multifaith societies such as the United States and Canada. A more realistic recognition of multiple moral traditions in pluralist societies would be considerable more skeptical about the contributions that common morality approaches in bioethics can make to resolving contentious moral issues.

135 Views

From the local to the global: Bioethics and the concept of culture

Journal of Medicine and Philosophy, Jan 1, 2005

Cultural models of health, illness, and moral reasoning are receiving increasing attention in bio... more Cultural models of health, illness, and moral reasoning are receiving increasing attention in bioethics scholarship. Drawing upon research tools from medical and cultural anthropology, numerous researchers explore cultural variations in attitudes toward truth telling, informed consent, pain relief, and planning for end-of-life care. However, culture should not simply be equated with ethnicity. Rather, the concept of culture can serve as an heuristic device at various levels of analysis. In addition to considering how participation in particular ethnic groups and religious traditions can shape moral reasoning, bioethicists need to consider processes of socialization into professional cultures, organizational cultures, national civic culture, and transnational culture. From the local world of the community clinic or oncology unit to the transnational workings of human rights agencies, attentiveness to the concept of culture can illuminate how patients, family members, and health care providers interpret illness, healing, and moral obligations.

155 Views

Is cultural sensitivity sometimes insensitive?

Canadian Family Physician, Jan 1, 2005

Physicians and other health care professionals are often urged to provide “culturally sensitive” ... more Physicians and other health care professionals are often urged to provide “culturally sensitive” care. Numerous guidebooks describe how clinicians should provide care to patients from different cultures. Synthesizing survey data, case studies from the medical literature, ethnographic reports, and cultural guides for clinicians offer general standards and practical tips concerning how members of particular ethnic groups should be treated. By now, clinicians will be familiar with many of the assertions made in such guides. Navajos want to hear positive news; they do not want to receive “bad” news about terminal diagnoses. Koreans are highly sociocentric; family members of patients will most likely want to make health-related decisions for these patients when they are seriously ill. Many other standard claims about the values, social practices, family arrangements, and rites of passage of particular cultures could be added to this list. The concept of culture can play a useful role in medical education, medical research, and clinical practice. Attending to the role of culture in various social settings can serve as a useful reminder that what seems obvious to one person might not be obvious at all to someone else. While some scholars argue that it is time to discard the concept of culture, I do not think it is possible to eliminate all references to culture. We need to be cautious, however, when making claims about a particular patient’s “cultural framework.”

106 Views

Bioethics in a multicultural world: medicine and morality in pluralistic settings

Health Care Analysis, Jan 1, 2003

Current approaches in bioethics largely overlook the multicultural social environment within whic... more Current approaches in bioethics largely overlook the multicultural social environment within which most contemporary ethical issues unfold. For example, principlists argue that the "common morality" of "society" supports four basic ethical principles. These principles, and the common morality more generally, are supposed to be a matter of shared "common sense." Defenders of case-based approaches to moral reasoning similarly assume that moral reasoning proceeds on the basis of common moral intuitions. Both of these approaches fail to recognize the existence of multiple cultural and religious traditions in contemporary multicultural societies. In multicultural settings, patients and their families bring many different cultural models of morality, health, illness, healing, and kinship to clinical encounters. Religious convictions and cultural norms play significant roles in the framing of moral issues. At present, mainstream bioethics fails to attend to the particular moral worlds of patients and their family members. A more anthropologically informed understanding of the ethical issues that emerge within health care facilities will need to better recognize the role of culture and religion in shaping modes of moral deliberation.

2,426 Views

Bioethics in pluralistic societies

Medicine, Health Care and Philosophy, Jan 1, 2004

Contemporary liberal democracies contain multiple cultural, religious, and philosophical traditio... more Contemporary liberal democracies contain multiple cultural, religious, and philosophical traditions. Within these societies, different interpretive communities provide divergent models for understanding health, illness, and moral obligations. Bioethicists commonly draw upon models of moral reasoning that presume the existence of shared moral intuitions. Principlist bioethics, case-based models of moral deliberation, intuitionist frameworks, and cost-benefit analyses all emphasise the uniformity of moral reasoning. However, religious and cultural differences challenge assumptions about common modes of moral deliberation. Too often, bioethicists minimize or ignore the existence of multiple traditions of moral inquiry. Careful consideration of the presence of multiple horizons for moral deliberation generates challenging questions about the capacity of bioethicists to effectively resolve complex cases and social policy disputes.

347 Views

Euthanasia and distinctive horizons of moral reasoning

Mortality, Jan 1, 1997

Rather than articulating and defending a particular normative stance concerning assisted suicide ... more Rather than articulating and defending a particular normative stance concerning assisted suicide and euthanasia, attention here is directed toward the background, often tacit, interpretive horizons within which such judgements are formulated. Historical transformations can alter the contours of moral reflection, so that what is construed as “reasonable” and “common sensical” can shift over time. When core presuppositions constituting the public moral imagination undergo considerable change, what was once placed beyond dispute can become a site for open disagreement or widespread public affirmation. Four distinctive historical themes related to the contemporary debate concerning assisted suicide and euthanasia are addressed. First, the medicalization of dying and death is explored. Second, the paper addresses the way in which the bureaucratization of dying places decision-making near the end of life within the realm of public moral deliberation. Third, tensions between competing sources of moral authority are explored. Finally, conflicting understandings of human suffering are described.

42 Views

Bioethics and religions: Religious traditions and understandings of morality, health, and illness

Health Care Analysis, Jan 1, 2003

For many individuals, religious traditions provide important resources for moral deliberation. Wh... more For many individuals, religious traditions provide important resources for moral deliberation. While contemporary philosophical approaches in bioethics draw upon secular presumptions, religion continues to play an important role in both personal moral reasoning and public debate. In this analysis, I consider the connections between religious traditions and understandings of morality, medicine, illness, suffering, and the body. The discussion is not intended to provide a theological analysis within the intellectual constraints of a particular religious tradition. Rather, I offer an interpretive analysis of how religious norms often play a role in shaping understandings of morality. While many late 19th and early 20th century social scientists predicted the demise of religion, religious traditions continue to play important roles in the lives of many individuals. Whether bioethicists are sympathetic or skeptical toward the normative claims of particular religious traditions, it is important that bioethicists have an understanding of how religious models of morality, illness, and healing influence deliberations within the health care arena.

406 Views

Bioethics and end-of-life care in multi-ethnic settings: cultural diversity in Canada and the USA

Mortality, Jan 1, 2002

This paper addresses cultural dimensions of end-of-life care in Canada and the USA. In both count... more This paper addresses cultural dimensions of end-of-life care in Canada and the USA. In both countries contemporary health care providers commonly encounter patients with quite variable understandings of what constitutes compassionate end-of-life care. Participation in particular ethnic and religious groups can have a significant effect upon how patients and their families communicate with health care providers, make decisions about treatment alternatives, engage in advance care planning, and frame moral deliberations. Much of the contemporary literature in the field of bioethics emphasizes the importance of truth telling, the principle of autonomy and the significance of patient choice, the value of advance care planning, and the right to have treatment withdrawn or withheld. However, a growing body of scholarship on the cultural dimensions of end-of-life care reveals a plurality of attitudes towards what constitutes appropriate forms of communication and decision making. While there are limits to the kind of social practices and moral claims that should be accommodated in liberal democracies, health care providers should take steps to ensure that they are providing culturally sensitive end-of-life care.

238 Views

Bioethics in a pluralistic world: truth telling, informed consent, and euthanasia

15 Views

Time to drop the language of'consensus'

Nature Biotechnology, Jan 1, 2003

23 Views

Biotechnology as religion

Nature biotechnology, Jan 1, 2004

24 Views

The View From Here: Bioethics and the Social Sciences

From book jacket: Although the field of bioethics is about 40 years old, its emergence and growth... more From book jacket: Although the field of bioethics is about 40 years old, its emergence and growth have only recently become an object of study for social scientists. The View From Here presents the best of this new work: research that explores how bioethics is shaped by, and gives shape to, not just medicine and health care, but law, religion, politics, and emerging global markets. Moving beyond armchair theorizing about bioethics, the articles collected here--empirical studies of bioethics, as it is practiced on the ground in the clinic, the laboratory, and in the creation of social policy--engage the field of bioethics and suggest new avenues for collaboration between social scientists and bioethicists.

41 Views

Dental Tourism: Issues Surrounding Cross-Border Travel for Dental Care

Journal-Canadian Dental Association, Jan 1, 2009

123 Views

The tyranny of'genethics'[opinion]

Georgetown University Home. The tyranny of &#x27;genethics&#x27; [opinion]. DSpace/Manaki... more

11 Views

The English SurgeonDirected and Produced by Geoffrey Smith

Developing World Bioethics, Jan 1, 2010

313 Views

Biotechnology as religion [opinion]

Biotechnology as religion [opinion]. DSpace/Manakin Repository. ...

7 Views

VIEWS AND REVIEWS-PERSONAL VIEWS-Let's wave goodbye to" transplant tourism"

BMJ (CR)-print, Jan 1, 2010

3 Views

The Fountain of Youth: Cultural, Scientific, and Ethical Perspectives on a Biomedical Goal

JAMA: The Journal of the American Medical …, Jan 1, 2004

... Dr. Zaleski's articles and reviews have appeared in First Things, The New York Times Boo... more

10 Views

Canadian medical tourism companies that have exited the marketplace: Content analysis of websites used to market transnational medical travel

Globalization …, Jan 1, 2011

308 Views

Canadian medicare and the global health care bazaar

POLICY OPTIONS-MONTREAL-, Jan 1, 2007

11 Views

Social science and bioethics: the way forward

Sociology of health & …, Jan 1, 2006

48 Views

"Medical tourism" and the global marketplace in health services: U.S. patients, International hospitals, and the search for affordable health care

Health services are now advertised in a global marketplace. Hip and knee replacements, ophthalmol... more Health services are now advertised in a global marketplace. Hip and knee replacements, ophthalmologic procedures, cosmetic surgery, cardiac care, organ transplants, and stem cell injections are all available for purchase in the global health services marketplace. "Medical tourism" companies market "sun and surgery" packages and arrange care at international hospitals in Costa Rica, India, Mexico, Singapore, Thailand, and other destination nations. Just as automobile manufacturing and textile production moved outside the United States, American patients are "offshoring" themselves to facilities that use low labor costs to gain competitive advantage in the marketplace. Proponents of medical tourism argue that a global market in health services will promote consumer choice, foster competition among hospitals, and enable customers to purchase high-quality care at medical facilities around the world. Skeptics raise concerns about quality of care and patient safety, information disclosure to patients, legal redress when patients are harmed while receiving care at international hospitals, and harms to public health care systems in destination nations. The emergence of a global market in health services will have profound consequences for health insurance, delivery of health services, patient-physician relationships, publicly funded health care, and the spread of medical consumerism.

62 Views

Quality in health care and globalization of health services: accreditation and regulatory oversight of medical tourism companies

Patients are crossing national borders in search of affordable and timely health care. Many medic... more Patients are crossing national borders in search of affordable and timely health care. Many medical tourism companies are now involved in organizing cross-border health services. Despite the rapid expansion of the medical tourism industry, few standards exist to ensure that these businesses organize high-quality, competent international health care. Addressing the regulatory vacuum, 10 standards are proposed as a framework for regulating the medical tourism industry. Medical tourism companies should have to undergo accreditation review. Care should be arranged only at accredited international health-care facilities. Standards should be established to ensure that clients of medical tourism companies make informed choices. Continuity of care needs to become an integral feature of cross-border care. Restrictions should be placed on the use of waiver of liability forms by medical tourism companies. Medical tourism companies must ensure that they conform to relevant legislation governing privacy and confidentiality of patient information. Restrictions must be placed on the types of health services marketed by medical tourism companies. Representatives of medical tourism agencies should have to undergo training and certification. Medical travel insurance and medical complications insurance should be included in the health-care plans of patients traveling for care. To protect clients from financial losses, medical tourism companies should be mandated to contribute to compensation funds. Establishing high standards for the operation of medical tourism companies should reduce risks facing patients when they travel abroad for health care.

63 Views

Promoting medical tourism to India: messages, images, and the marketing of international patient travel

The practice of medical tourism depends on successfully informing potential patients about proced... more The practice of medical tourism depends on successfully informing potential patients about procedure options, treatment facilities, tourism opportunities, travel arrangements, and destination countries. The promotion of medical tourism includes a wide range of marketing materials such as flyers, booklets, and websites. Yet, there is a paucity of knowledge about the dissemination, content, and reception of these promotional materials. Drawing on a thematic content analysis of the promotional print material distributed at the first medical tourism trade show in Canada in 2009, the main purpose of this article is to identify and understand the messages and images that companies use to market India as a global destination. While researchers and news media frequently cite low cost procedures as a key determinant for international patient travel, particularly to developing nations, our analysis reveals few low cost-related images or messages in the promotional materials distributed at the trade show. To help explain this surprising disjuncture, we consider four related issues: (1) promotional materials may be designed to be circulated amongst potential patients' concerned family and friends who privilege knowing about things such as the use of advanced technologies; (2) developing nations need to portray safe and advanced treatment facilities in order to dispel potential patients' suspicions that their medical care is inferior; (3) companies may avoid making cost saving claims that cannot be fulfilled for all of their international patients, especially those traveling from developing nations; and (4) messages of low cost may detract from and even undermine messages about quality. We conclude by identifying numerous avenues for future research by social and health scientists, and by considering the implications of our findings for existing knowledge gaps and debates within health geography specifically.

248 Views

Bioethics and Transnational Medical Travel: India, "Medical Tourism", and the Globalization of Health Care

Health-related travel, also referred to as "medical tourism", is historically well-known. Its eme... more Health-related travel, also referred to as "medical tourism", is historically well-known. Its emerging contemporary form suggests the development of a form of globalised for-profit healthcare. Medical tourism to India, the focus of a recent conference in Canada, provides an example of the globalisation of healthcare. By positioning itself as a low-cost, high-tech, fast-access and high-quality healthcare destination country, India offers healthcare to medical travellers who are frustrated with waiting lists and the limited availability of some procedures in Canada. Although patients have the right to travel and seek care at international medical facilities, there are a number of dimensions of medical tourism that are disturbing. The diversion of public investments in healthcare to the private sector, in order to serve medical travellers, perversely transfers public resources to international patients at a time when the Indian public healthcare system fails to provide primary healthcare to its own citizens. Further, little is known about patient safety and quality care in transnational medical travel. Countries that are departure points as well as destination countries need to carefully explore the ethical, social, cultural, and economic consequences of the growing phenomenon of for-profit international medical travel.

109 Views

Issues and Challenges in Research on the Ethics of Medical Tourism: Reflections from a Conference

The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a confer... more The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a conference on ethical issues in medical tourism. Medical tourism involves travel across international borders with the intention of receiving medical care. This care is typically paid for out-of-pocket and is motivated by an interest in cost savings and/or avoiding wait times for care in the patient’s home country. This practice raises numerous ethical concerns, including potentially exacerbating health inequities in destination and source countries and disrupting continuity of care for patients. In this report, we synthesize conference presentations and present three lessons from the conference: 1) Medical tourism research has the potential for cross- or inter-disciplinarity but must bridge the gap between researchers trained in ethical theory and scholars unfamiliar with normative frameworks; 2) Medical tourism research must engage with empirical research from a variety of disciplines; and 3) Ethical analyses of medical tourism must incorporate both individual and population-level perspectives. While these lessons are presented in the context of research on medical tourism, we argue that they are applicable in other areas of research where global practices, such as human subject research and health worker migration, are occurring in the face of limited regulatory oversight.

503 Views

Medical tourism: Family medicine and international health-related travel

Canadian Family Physician, Jan 1, 2007

With some treatments unavailable in Canada and other medical interventions available only after l... more With some treatments unavailable in Canada and other medical interventions available only after long delays, medical tourism companies use problems with Canada’s provincial health care systems to promote out-of-country health care. Though few Canadians can afford the high price of care at US medical centres, the international facilities offer less expensive access to private health care.
The number of medical tourism companies in Canada is growing. At present, however, these businesses are relatively small, have few employees, and appear to have a limited client base. As these companies become better known, standardize their operations, and benefit from considerable media coverage, it is possible that more Canadians will travel to other countries for treatment.

42 Views

First World Health Care at Third World Prices': Globalization, Bioethics, and Medical Tourism

Bioethics and Medical Tourism. BioSocieties, Jan 1, 2007

India, Indonesia, Malaysia, the Philippines, Singapore, Thailand and many other countries market ... more India, Indonesia, Malaysia, the Philippines, Singapore, Thailand and many other countries market themselves as major destinations for ‘medical tourism’. Health-related travel, once promoted by individual medical facilities such as Bumrungrad International Hospital and Bangkok International Hospital, is now driven by government agencies, public–private partnerships, private hospital associations, airlines, hotel chains, investors and private equity funds, and medical brokerages. ‘Medical tourists’ include patients trying to avoid treatment delays and obtain timely access to health care. Medical travellers also include uninsured Americans and other individuals unable to afford health care in their home settings. Destination nations regard medical tourism as a resource for economic development. However, attracting patients to countries such as India and Thailand could increase regional economic inequalities and undermine health equity. International medical travel might also have unintended, undesired outcomes for patients seeking affordable health care. With globalization, increasing numbers of patients are leaving their home communities in search of orthopaedic surgery, ophthalmologic care, dental surgery, cardiac surgery and other medical interventions. Reductions in health benefits offered by states and employers will likely increase the number of individuals looking for affordable medical care in a global market of privatized, commercial health care delivery.

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The Coming Backlash Against "Medical Tourism"

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Cross-border dental care: 'dental tourism' and patient mobility

Patient mobility is increasing. 'Dental tourism' is driven by numerous factors. These factors inc... more Patient mobility is increasing. 'Dental tourism' is driven by numerous factors. These factors include the high cost of local care, delays in obtaining access to local dentists, competent care at many international clinics, inexpensive air travel, and the Internet's capacity to link 'customers' to 'sellers' of health-related services. Though dental tourism will benefit some patients, increased patient mobility comes with numerous risks. Lack of access to affordable and timely local care plays a significant role in prompting patients to cross borders and receive dental care outside their local communities.

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Dental tourism: cross-border travel for dental care

410 Views

Medical tourism'initiatives should exclude commercial organ transplantation

JR Soc Med, Jan 1, 2008

Whatever the general advantages and disadvantages of a global marketplace in health services, man... more Whatever the general advantages and disadvantages of a global marketplace in health services, many risks accompany the inclusion of organ transplant packages among the medical pro- cedures sold to international patients. These dangers are magnified in countries where kidneys are purchased in underground economies or black markets. In these settings, promoting organ transplant packages to international patients risks escalating the number of kidneys purchased from poor citizens. Growing demand for transplants prompts organ brokers to increase the number of kidneys bought from impoverished individuals and sold to international patients.

264 Views

Public Health Research Ethics

393 Views