Medical tourism can put patients in legal limbo, warn US cosmetic surgeons. There are many legal and ethical issues from medical travel that remain unresolved in this unregulated sector.
Americans travel abroad for cosmetic surgery and other procedures because it costs less.
However, in addition to the potential health dangers of undergoing surgery in a foreign country, patients may find themselves with little or no legal recourse in case something goes wrong, according to the October issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Surgeon Steven Davison, lead author of the article says “Medical tourism is a growing, unregulated industry. While patients may be attracted by the lower costs for cosmetic surgery and other procedures performed in other countries, they must also be aware of the potential risks – legal as well as medical.”
The article says that for cost-sensitive and market-driven procedures such as cosmetic surgery, costs may be 40-50% lower in developing countries. ASPS has highlighted the potential dangers of cosmetic surgery performed abroad. Domestic and international accrediting agencies have attempted to raise the standard of care, but regulation of the medical tourism industry remains virtually non-existent. There is no governing institution to report to when things go wrong.
When complications or other problems occur after surgery abroad, patients are likely to find that they have limited legal recourse. Patients may find they have signed forms waiving their right to file a lawsuit, including against the medical tourism agency with which they booked their trip.
It is difficult to establish jurisdiction against foreign defendants in US courts. And even if they manage to file and win their suit, patients may find it difficult or impossible to enforce the judgment and collect financial damages.
Medical tourism also raises ethical implications, given the inherent risks of surgery. A major question is who will provide necessary follow-up care after the patient returns home. There are also issues related to getting and paying for treatment of complications. Recent reports suggest that Medicaid most often pays for treatment for complications after medical tourism. While US physicians may have an ethical duty to treat patients with complications, any necessary revision cosmetic surgery would be the patient’s responsibility.
Despite these legal and ethical issues, there is little doubt that the medical tourism industry will continue to grow. If this happens, the legal environment for medical tourism could change. Arbitration might become a remedy for medical injury occurring outside the USA, while legislative action may happen to address the public health burden of complications related to these procedures.
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