Mogaka John J O, Mupara Lucia, Tsoka-Gwegweni Joyce M
Discipline of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa.
J Mark Access Health Policy. 2017 May 5;5(1):1309770. doi: 10.1080/20016689.2017.1309770. eCollection 2017.
Global disparities in medical technologies, laws, economic inequities, and social-cultural differences drive medical tourism (MT), the practice of travelling to consume healthcare that is either too delayed, unavailable, unaffordable or legally proscribed at home. Africa is simultaneously a source and destination for MT. MT however, presents a new and challenging health ethics frontier, being largely unregulated and characterized by policy contradictions, minority discrimination and conflict of interest among role-players. This article assesses the level of knowledge of MT and its associated ethical issues in Africa; it also identifies critical research gaps on the subject in the region. Exploratory design guided by Arksey and O'Malley's (2005) framework was used. Key search terms and prior determined exclusion/inclusion criteria were used to identify relevant literature sources. Fifty-seven articles met the inclusion criteria. Distributive justice, healthcare resource allocation, experimental treatments and organ transplant were the most common ethical issues of medical tourism in Africa. The dearth of robust engagement of MT and healthcare ethics, as identified through this review, calls for more rigorous research on this subject. Although the bulk of the medical tourism industry is driven by global legal disparities based on ethical considerations, little attention has been given to this subject.
医疗技术、法律、经济不平等以及社会文化差异方面的全球差距推动了医疗旅游的发展。医疗旅游是指前往国外接受医疗服务的行为,这些服务在本国可能因延误、无法获得、费用过高或法律禁止而无法享受。非洲既是医疗旅游的来源地,也是目的地。然而,医疗旅游呈现出一个全新且具有挑战性的健康伦理前沿领域,该领域在很大程度上缺乏监管,存在政策矛盾、少数群体歧视以及利益相关者之间的利益冲突等问题。本文评估了非洲对医疗旅游及其相关伦理问题的认知水平;同时也确定了该地区在这一主题上的关键研究空白。研究采用了由阿克西和奥马利(2005年)框架指导的探索性设计。使用关键搜索词和预先确定的排除/纳入标准来识别相关文献来源。57篇文章符合纳入标准。分配正义、医疗资源分配、实验性治疗和器官移植是非洲医疗旅游中最常见的伦理问题。通过本次综述发现,在医疗旅游与医疗保健伦理方面缺乏深入探讨,这就需要对该主题进行更严谨的研究。尽管大部分医疗旅游行业是由基于伦理考量的全球法律差异所驱动,但该主题却很少受到关注。