Risk Communication and Informed Consent in the Medical Tourism Industry: A Thematic Content Analysis of Canadian Broker Websites

Background:Medical tourism, thought of as patients seeking non-emergency medical care outside of their homecountries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and manyare helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in makinginternational medical care arrangements for patients. As a key source of information for these patients, brokers arelikely to play an important role in communicating the risks and benefits of undergoing surgery or other proceduresabroad to their clientele. This raises important ethical concerns regarding processes such as informed consent andthe liability of brokers in the event that complications arise from procedures. The purpose of this article is toexamine the language, information, and online marketing of Canadian medical tourism brokers’ websites in light ofsuch ethical concerns.Methods:An exhaustive online search using multiple search engines and keywords was performed to compile acomprehensive directory of English-language Canadian medical tourism brokerage websites. These websites wereexamined using thematic content analysis, which included identifying informational themes, generating frequencycounts of these themes, and comparing trends in these counts to the established literature.Results:Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourismbroker websites varied widely in scope, content, professionalism and depth of information. Three themes emergedfrom the thematic content analysis: training and accreditation, risk communication, and business dimensions. Thirdparty accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, anddiscussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on theremaining ones. Terminology describing brokers’ roles was somewhat inconsistent across the websites. Finally,brokers’ roles in follow up care, their prices, and the speed of surgery were the most commonly included businessdimensions on the reviewed websites.Conclusion:Canadian medical tourism brokers currently lack a common standard of care and accreditation, and are widely lacking in providing adequate risk communication for potential medical tourists. This has implicationsfor the informed consent and consequent safety of Canadian medical tourists.