Exploring ethical issues in medical tourism facilitation


As communication technologies continue to develop, notable progress has been made, with the result being what has now famously come to be known as the ‘global village’. 

Accessing information is much easier today, as is ease of travel.  These two aspects of information access and travelling ease have combined to open up an avenue of obtaining medical care which now seems to be revolutionising Medicare across the world. 

Today, all one needs is an Internet connection, and with a click of the mouse or a tap on the Smartphone, solutions to medical needs are displayed almost immediately. Finding and booking medical care sessions and appointments has become accessible for many people, resulting in a surge in medical tourism. 

However, while it may be an easier and more convenient option, there are serious ethical concerns about medical tourism facilitators, that are yet to be addressed and resolved.  Experts and scholars across the world have already taken note of this and documented their findings in articles, which I have reviewed in this current paper.

1. Wagle, S. (2019). Web-based medical facilitators in medical tourism: the third party in decision-making.

Wagle Suchitra takes a keen interest in the authenticity of the information displayed by facilitators on their websites, as well as the question as to whether these facilitators follow ethical standards and guidelines. 

On authenticity, his study shows that there is no control over how and what medical tourism facilitators may display on their web portals. This leaves the discretion to them, resulting in most of them prominently displaying pictures and information likely to attract potential patients, and leaving out important aspects like risks and legal liabilities. 

Wagle also notes that since most of these facilitators operate online, ethical issues like patient privacy and confidentiality are left unattended. Guaranteeing privacy or confidentiality while communicating online is never easy, given the nature of the medium. 

To address these concerns, Wagle recommends that self-regulation of and by the medical tourism facilitators be made a requirement, while international bodies carry out oversight and accreditation. 

2. Snyder, J., Crooks, V., Adams, K., Kingsbury, P., & Johnston, R. (2011). The ‘patient's physician one-step removed’: the evolving roles of medical tourism facilitators.

Another article that has probed ethical concerns addressed here is by Snyder, Crooks, Adams, Kingsbury and Johnston who focus on interpersonal relationships of involved parties, along with their responsibilities. Synder et al note that while the facilitators play a major role linking patients to medical care providers, their responsibilities are not matched by accountability attached to them, and especially where legal liabilities are concerned. 

The authors recommend a collective approach towards addressing ethical concerns, where all stakeholders are to be involved.

3. Dalstrom, M. (2019). Medical travel facilitators: connecting patients and providers in a globalized world

Dalstrom explores the nature of medical tourism facilitators’ operations, focusing in on the way these facilitators “remake patients into consumers”. By this, he attempts to assess the possibility that, in an attempt to turn patients into consumers, ethical considerations may take backstage. He also identifies the common attribute of facilitators operations; in that they all advertise logistical support alongside quality assurance. This again alludes to the absence of critical information and obligations. 

4. Makinde, O. (2016). Physicians as medical tourism facilitators in Nigeria: ethical issues of the practice

This final article shines a light on the omissions that may happen in medical tourism. Specifically, he cites the issue of follow-up after surgery. While medical tourism may help people access medical care with ease, there are aspects to it that could be overlooked initially, but that which pose a danger to its effectiveness and sustainability. He also notes that “some of the services that medical tourists seek are not ethically allowed in their home countries”. This means that despite providing ways to get around national laws and policies, the issue of after-care follow up is further complicated. 


It is already evident that medical tourism is here for the long term,  but it is equally evident that there are ethical challenges that come with it. Scholars and stakeholders have offered suggestions that could help streamline the sector and rid it of the unethical tag that the sector in some countries is acquiring. 

Although it is an international issue and challenge, individual governments will have to be at the front line in supporting existing international entities and accreditation bodies to spur the process of regulating and ensuring that ethical guidelines are adhered to. With proper regulation and checks, medical tourism facilitators can gradually be turned into the missing jigsaw that would orchestrate successful treatment for many of the world’s health problems. 

About the Author

Dr Nureini Mohamed is a medical tourism consultant at HYF Medical Centre in Dubai and a co-founder of start-up, i-HealthGate, a medical travel and case management agency. He graduated from a medical school in China, and has experience working for medical tourism agencies in the USA and Germany.  [email protected]




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