Potential for circumvention medical tourism

 

A report by the medical tourism unit at Simon Fraser University - 'Circumvention medical tourism' - looks at circumvention medical tourism in the Bahamas.

Circumvention tourism is when patients travel abroad for medical care that is illegal or unapproved by regulators in their home countries. In some cases, circumvention tourists may be seeking unproven medical interventions. This practice avoids the regulatory restrictions that protect patients from harm and fraud and can threaten patient safety and the safety of third parties who come into contact with these patients or serve as donors of tissue or reproductive services. Circumvention tourism also has the potential to slow the process of research, as patients go abroad for interventions and opt out of domestic clinical trials. Untested interventions that are disguised as clinical trials may also undermine the legitimacy of real clinical trials, especially in the eyes of the public for whom the distinction could be hard to discern.

The Bahamas offers individuals access to treatments that have been approved in other places, but not yet in the in the country where the medical tourist lives. High Intensity Focused Ultrasound (HIFU) treatment for prostate cancer is approved in Canada and the EU but not the USA.

In the Bahamas HIFU treatment is done by US based doctors in cooperation with local health workers, which allows doctors to gain new skills that will be useful when and if HIFU is approved in the USA.

Patients may believe the intervention is effective because it has been approved elsewhere and that their domestic regulatory agency is acting too slowly to approve the treatment.

Recently, the Bahamas passed legislation that will ease the way for offering unproven stem cell interventions for a range of conditions including vascular disease, cancer, kidney disease, and others. While some stem cell treatments have received regulatory approval, others have not been demonstrated as safe and effective in clinical trails, let alone been approved for human use by any major Western regulator.

Circumvention stem cell tourism can complicate informed decision making, as individuals may be vulnerable to engage in decision-making based on hope without a full understanding of the likelihood of success or understanding of risk.

Countries receiving circumvention tourists can benefit through economic diversification and less reliance on the volatile traditional tourism industries.

The Bahamas has a hard time competing with other Caribbean countries on costs for medical services, so the opportunity to offer HIFU and stem cell injections gives the Bahamas a chance to compete for international patients.

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