On Medical Tourism Overseas: Ethical Analysis of the Duties of NHS Doctors in Managing the Negative Health Consequences of Accessing Medical Treatments Abroad

Abstract

Introduction

An increasing number of UK residents are travelling overseas to access medical treatments, the negative health consequences of which are largely managed by NHS doctors.

Methods

This paper performs an ethical analysis, using the ethical framework of principlism, of the duties of NHS doctors in managing these negative health consequences of medical tourism overseas.

Findings

While the doctor's duty to respect patient autonomy contains a negative duty to not interfere with their choice to access medical treatment overseas, it also contains a positive duty to ensure this choice is informed. This requires those considering medical tourism overseas to be counselled on the risks. This should take place directly by counselling, and indirectly through public health messaging. Beneficence requires the doctor to promote the patient's health, therefore obligating them to treat complications of medical tourism overseas, to intervene if poor cosmetic outcomes negatively impact the patient's mental health, and to refer the patient if the necessary aftercare is insufficiently or entirely unavailable on the NHS. Beneficence also requires doctors to remove harm, meaning they must counsel patients about the risks of medical tourism overseas to minimise the risk of negative health consequences. Justice requires NHS doctors to care for patients according to their clinical needs regardless of how that need has arisen, including the negative health consequences of medical tourism abroad, and requires NHS doctors to minimise these negative health consequences to minimise the scarce resources allocated to addressing them. The duty of non-maleficence is not relevant in this context.

Conclusion

Amongst other requirements, this paper finds that NHS doctors must counsel those considering medical tourism overseas on the risks of doing so, and existing efforts to do so should be increased to reflect the increasing prevalence of medical tourism overseas by UK residents and the associated negative health consequences.