Background: Medical tourism involves voluntary travel across national borders in search of health, wellbeing and medical care. The global scope of the medical tourism industry thriving in the high income and low income countries raises important ethical and normative concerns regarding well-being and safety of patients and the impact on health care systems in patients’ home countries as well as destination countries. Scarce scholarly evidence on ethical, legal and economic aspects of medical tourism stems mainly from research groups based in the US and Canada. There is a clear lack of data from European countries and particularly in the Swiss context. Not only is Switzerland an interesting case study to analyze ethical, legal and economic concerns of medical tourism in a high income country, there is also a need to better understand the ethical problems health care professionals might face when treating such “medical tourists” in Switzerland. This empirical and ethical analysis is important, first, to support individual health care professionals in their daily work. Second such research is crucial to maintain high standards of professional health care in Switzerland and to provide stakeholders with necessary data and ethical arguments to strive towards an evidence-based, efficient and just health care system.
Objectives: This exploratory research study has two main sets of objectives related to empirical and normative investigations respectively. The empirical part is designed to obtain much needed and presently lacking data on medical tourism in Switzerland, particularly on the experience of health professionals and other stakeholders involved. The second set of objectives involves the normative ethical analysis - whether Swiss authorities and policy makers have morals obligations towards the patients from abroad and (to some extent) towards the health care systems in their home countries in terms of follow-up care and management of complications.
Design and methods: Limited academic literature on medical tourism in Switzerland requires this exploratory research to employ a multipronged approach to explore the scope of medical tourism in Switzerland and its ethical, legal and economic implications from the perspectives of key stakeholders and health care professionals. The empirical investigation will begin with the content analysis of gray literature and the scarce scholarly publications on medical tourism in the Swiss context. It will permit to shed light on the scale of the practice, provide insight into the organization of the medical tourism industry, and permit to identify key stakeholders. This will be followed by 40 in-depth interviews with stakeholders and health care professionals (in public and private health set-ups) directly involved in caring for patients from abroad. The normative part of the project will be based first on the literature review aimed at examining the relevance of normative ethical concerns discussed in global medical tourism literature to the Swiss context, followed by traditional ethico-legal analysis of the unique empirical data newly collected as part of this project.
Expected outcomes/implications for future research: The findings of this research project will be relevant to stakeholders of the medical tourism industry in terms of recommendations for improving the practice, to influence professional ethical codes and recommendations by physician associations, and to provide health authorities with the evidence and arguments to shape policy. Apart from disseminating results through scientific conferences and relevant peer reviewed medical and bioethical journals, we will prepare follow-up grant proposals to quantitatively assess the practice of medical tourism and to qualitatively investigate the perspectives, experiences and expectations of medical tourists seeking health care in Switzerland.