Lidingö-clinic, Torsvägen 30, 181 32, Lidingö, Sweden.
Aesthetic Plast Surg. 2012 Feb;36(1):202-6. doi: 10.1007/s00266-011-9766-0. Epub 2011 Jun 30.
The growing phenomenon of patients seeking medical procedures abroad (MPA), formerly known as a medical tourism, is discussed. The dark side of the trend is exemplified by the tragic case of a 31-year-old Swedish woman who upon seeing a web advertisement went to Gdansk, Poland, to have breast augmentation. The operation was performed in an old hospital quite different from the modern hospital depicted in the ad. As a result of the grave mistakes in anesthetic care and lack of a postoperative recovery routine, the patient sustained severe brain injury because of prolonged hypoxia. Now, 6 months after the fateful operation, the patient is decorticated and has only vegetative functioning of the left side of the brain. Firm managers, who do not have any medical training, entice patients to believe that the doctors and the facilities abroad have the same technical and safety standards as at home. We question the gap in the law that allows a lay person to screen the candidates for surgery and decide who will operate and in what kind of environment. The trade in human organs is internationally banned but brokering operations on organs goes uncontrolled. Twenty other patients were operated on abroad at different facilities, but all told the same story: lack of adequate postoperative care, unfriendly nursing staff, and the feeling of abandonment upon the return home. The four facets of the ISAPS Patient Safety Diamond--the patient, the procedure, the facility, and the surgeon--are described. ISAPS decided to support the MPA policy with prescreening of the prospective patient, travel and medical insurance for the patient, and surgery abroad, but only if the surgeon is an ISAPS member in a fully accredited facility. This policy will be available first for UK residents who travel abroad for surgery, and later for patients and ISAPS surgeons worldwide. Many plastic surgeons have seen or heard of various tragedies or disasters following medical treatments in foreign countries. We propose to raise the plea for the introduction of legislation forbidding lay persons to trade in or act as an intermediary or broker of medical treatments abroad.
越来越多的患者选择出国（境）接受医疗服务（MPA），也就是所谓的“医疗旅游”。该趋势的负面影响可见一斑，一名 31 岁的瑞典女性看到一则网络广告，便前往波兰格但斯克做隆胸手术。然而，实际手术地点却与广告中描述的现代化医院大相径庭，这家医院位于一家老旧的医院内。由于麻醉护理方面的严重失误以及术后恢复流程的缺失，患者因长时间缺氧导致严重脑损伤。目前，在那次致命手术发生 6 个月后，这名患者已接受去颅骨手术，大脑左半边仅能维持植物人的功能。缺乏医学背景的中介机构会引诱患者相信，国外的医生和医院与国内的一样拥有同等的技术和安全标准。我们质疑法律存在漏洞，允许未经医学培训的人筛选手术候选人，并决定谁来主刀以及在何种环境下手术。国际上已经禁止买卖人体器官，但器官交易却仍不受管控。另外还有 20 名患者在不同的医疗机构接受了境外手术，但他们都讲述了同样的故事：术后护理不足、医护人员不友好以及回国后面临被抛弃的感觉。ISAPS 患者安全钻石的四个方面——患者、手术、医疗机构和外科医生——被描述。ISAPS 决定通过对潜在患者进行预筛选、为患者提供旅行和医疗保险、并仅在外科医生是在完全认可的机构中执业的 ISAPS 会员的情况下在境外开展手术，来支持 MPA 政策。该政策将首先面向前往国外接受手术的英国居民提供，随后再面向全球的患者和 ISAPS 外科医生提供。许多整形外科医生都曾听说或目睹过患者在国外接受治疗后遭遇各种悲剧或灾难。我们提议呼吁引入立法，禁止非专业人士从事或充当国外医疗服务的交易中介。
