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Medical Outsourcing

Medical Outsourcing: Amy Faces a Medical Tourism Dilemma

Step 1: Identification

Amy holds a fine art bachelors degree and works as a model. However, the true passion that Amy is to become a photographer and to open her own studio. The profession of a model does provide her means to cater for expenses. Amy desires to explore the rest of the world, and by outsourcing medical surgery abroad she will get a chance to exploit her individual delights. The assigned question is, “what moral and ethical concerns are arising from the case of Amy in Outsourcing medical care?”

I deem that the central issue is the one that is the most at hand. Amy is not in a position to afford the cost of health care in the United States; therefore, she has got every right to indulge in outsourcing for better and cheap medical services in countries abroad. On the other hand, as medical tourism is hardly novel, that is to say, the majority of Americans have always resolved to look for cosmetic surgery in discounted rates in other places such as Thailand, Mexico and India, the awareness of medical health care services in countries abroad among individuals who are insured or individuals who are underinsured has indeed become a growing trend (Crooks et al., 2010).


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Step 2: Research

The following articles offer an insight into the dilemma that Amy can resolve.

  1. “The globalization of health care: legal and ethical issues”

This article highlights how medical tourism has been driven by forces in the global health care systems that occur outside the control and the view of the healthcare system. Medical tourism offers vital challenges and concerns and potential opportunities. The private hospitals found in foreign countries also provide excellent medical treatment as well as care to their patients as they recuperate. The institutions are well equipped with the necessary facilities that ensure the patients are comfortable and able to regain their health. The safety of a patient is very essential as it promotes a sense of belongingness thus, creating an avenue for quick recovery (Cohen, 2013).

Amy should also understand the limitations of outsourcing medical care: finding a doctor who is well trained and qualified outside the United States is difficult. Nonetheless, there are several things that Amy can do in finding out whether the doctor is certified or qualified. She can inquire where the doctor was trained and licensed. Amy can also inquire about the rate of mortality among the patients of the doctor, as well as the complications of the procedures that she will be undertaking throughout the surgery. In terms of standards, Amy should not be afraid since the majority of hospitals in foreign countries meet similar standards as the hospitals in the United States (Cohen, 2013).

  1. “Stuck in the middle: Many moral challenges of the bariatric surgery”

This article describes the moral challenges that are associated with the surgery. The increase of medical tourism, in many states worldwide has also some negative impacts to the public which brings about issues of moral concern. For instance, in the case study, it is pointed out that public hospitals in India are no longer being funded by the government. The transformation, that took place, shifted the support to private hospitals. Consequently, the move led to much suffering among the ordinary Indians who cannot afford medical attention. It is therefore unethical for people to continue seeking such services that are provided by states which do not consider their own people’s medical welfare. Those governments have focused a lot on gaining the revenues from such medical procedures. Furthermore, the elective cosmetic surgery that Amy intends to undertake can be avoided since it is not an emergency procedure that requires immediate medical attention. At the same time, there are other procedures such as organ transplants which require instant treatment thus, determining the survival rate of the patients. The increasing demand for cosmetic surgery in the United States is an issue that has raised numerous debates. Arguments have been put forward to either support or criticize such procedures. Majority of people however consent that it is ethical to go abroad for the procedures for medical reasons and not merely for beauty or self satisfaction. Furthermore, the costs to be spent in such operations would be channeled to other productive activities which would assist in improving the lives at both individual and societal levels (Hofmann, 2010).

  1. “Medical tourism: Globalization of the healthcare marketplace”

Majority of citizens from several countries in the recent past travelled to Europe and the U.S to seek medical care. However, medical tourism has taken root whereby citizens from extremely developed countries bypass medical care in their own country to go to less developed countries to get a broad range of medical care. This article highlights how medical tourism is becoming more and more popular. The seeking of medical attention in the overseas countries is not done at individual level only. Several companies in the United States also do provide medical coverage for their employees in foreign hospitals. Moreover, these health care institutions have a good reputation due to the quality of services they offer. The presence of qualified medical attendants has led to numerous surgical procedures performed at successful levels. Therefore, it is evident that Amy is not the only one who takes the advantage of seeking medical care in the overseas market.

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Some companies that face the dilemma of offering health cover and remaining solvent like North Carolina Blue Ridge endeavors to send their staff abroad to seek medical treatment. However, it is not only individuals and companies that desire to exploit the advantage of medical tourism, but also the government. For instance, a legislator in West Virginia has been involved in the development of a bill that will encourage all the employees of the state to seek for medical surgeries that are non emergency in countries abroad. This is quite unethical and demoralizing. The government should instead be focused on reducing the medical expenses and offering its citizens medical coverage that is sufficient. Furthermore, some companies have started to specialize in medical services and insurance sales that depend on hospitals in the foreign countries. Therefore, it is ethical for Amy to consider medical services of foreign countries since the majority of parties from individuals, companies to the state are seeking for medical tourism, as well (Horowitz, Rosensweig & Jones, 2007).

  1.  “Psychiatric issues in surgery-Part 2: Specific topics”

From a moral or ethical perspective, the step that Amy Pothoven should take, can be discussed from different angles. Based on the information provided in the case study concerning medical outsourcing, it is ethical for Amy Pothoven to go ahead and seek medical treatment abroad. The major reason she wants to carry out the elective cosmetic surgery is because it would save her some income since it is not very costly in overseas countries as compared to the United States. Furthermore, it is also vital to consider the fact that Amy is not insured. Therefore, the option of seeking medical treatment in her native country would be quite impossible due to the lack of medical cover. On the other hand, the same procedure would be carried out less costly in countries such as India or Thailand. It is, therefore, logical for Amy to go to an abroad hospital for cheaper services considering the harsh economic times that people go through (Levenson, 2007).

  1. “What is known about the patient experience of medical tourism? A scoping review”

This article elaborates the experiences of medical tourism patients. Amy needs to consider the limitations in seeking medical attention abroad. One of the limitations is that sometimes during the surgery, complication do happen and therefore, she ought to consider what she will do if such a case arises. Ideally, Amy’s surgery can go smoothly, but complications still may happen. Therefore, she needs to be prepared. Although the surgery is affordable in foreign countries, but when complications occur and additional care becomes a necessity, the surgery abroad becomes quite expensive. Furthermore, Amy should work out her actions if things go wrong. Seeking medical care in foreign hospitals lacks the legal resources that Amy can access if something goes wrong. It will be extremely difficult to take legal action against foreign hospitals and doctors. Furthermore, she will not have luck in taking a legal action against the country in which she has had her surgery. Therefore, Amy should be aware and put in place measures to handle the problems in case they arise. People always seek acceptable outcomes at low costs which drive them to the realization of the need for medical outsourcing. Before Amy decides to have the elective cosmetic surgery, it is ethical for her to consider the fact that it can be quite risky, as any procedure performed on a person can endanger the life of the individual in several ways if it becomes unsuccessful. Therefore, such procedures that are done for personal elegance are not morally right (Crooks et al., 2010).

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Step 3: The Analysis

This section will highlight the options that Amy may have in outsourcing medical care. The stakeholders who may be affected include Amy, her family and her country. The options are as follows:

  • Amy is unsecured and has less money to undertake the surgery in the United States.
  • One option that Amy would go through with this surgery out the Country.
  • Another suggestion that Amy would reflect on the complication out of USA and not go.
  •  Maybe she would decide save more money, wait and do USA.
  • Perhaps, Amy decided exercising vigorously to change herself, her body image.
  •  Amy invest many years in this career, but she’s thought is time to change, the demand and time is too consuming.
  • Amy with all the expectations, she decide not do anything.  


Step 4: Application

In this part, ethical theories will be applied to the three mentioned options.

I will apply the casuist theory for the options mentioned above. The casuist theory compares existing ethical dilemmas that are similar together with their outcomes. Therefore, the casuist theory determines the situation severity and develops the best solution possible according to one’s experience. The theory offers one an opportunity to compare a current ethical problem with examples of similar dilemmas and their outcomes, which are hopefully rooted in the wisdom gained from prior experiences, in order to find a solution, People should generalize their intuitive understanding which they use in specific cases to take a morally right decision in a specific case. Medical outsourcing has several economic advantages, and as a result, outsourcing of health care procedures has widely been publicized as a universal remedy. Amy faces a challenge since outsourced health procedures are far from the reach of the majority of working class in the United States. Furthermore, such procedures have failed to reduce the expenses of medical care in the United States. Such concerns together with insufficient care after the surgery as the patients leave hospitals in countries abroad, poses risks to patients health. The majority of people tend to be afraid of the low health care quality they can get outside the United States. Amy should understand that it is hard for anyone to know and to determine whether the foreign doctors are well-qualified or not (Levenson, 2007).

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The options are again as follows:

  • She will take a chance to go and do her surgery.
  • Amy will reflect on the complications and she will decide to stay USA.
  • Amy decided save money, she will do the surgery on USA.
  •  She decided exercising by her own and by doing she didn’t need surgery.
  •  The demanding of her career has consuming her health, so she will change career.
  • Amy passively decides not do anything about, she got deep depressed.

How would these options relate to virtue ethics? Below is a chart where each option and how it affects the important outcomes sought in Virtue ethics is considered.







Health Dangerous Cause Cost


I will also apply the principle of beneficence in evaluating the options stated above. The principle offers people to act for the benefit of the individuals or the society in general. The main urge to do good things demands the solutions that are morally acceptable. At the same time, the principle requires ethical theories to strive and achieve the largest amount of goodness. Even though the amount of income that Amy earns from her modeling career is significant, she is still uninsured. Therefore, it is apparent that the insurance is not likely to cover the elective surgery procedure. However, the major incentive for Amy to outsource procedures in health care is that they are of high quality, as well as of considerably low cost. For instance, the prices in countries that offer elective surgery such as Thailand and India are 70-80% less than in America. In the United States, surgery of heart bypass can cost above $130,000, but in India, it can be performed for only $10,000 and in Turkey for $19,000. This indicates how the American society is being exploited by its government. Furthermore, Amy as a surgery patient will receive a health care of a high quality in a hospital that is luxurious and exclusively designed to serve tourists. For instance, as a patient recovers from a surgery in an Indian hospital’s luxurious suite that is fully erected with a mini fridge, a computer and a TV, Amy can be certain that all her needs will be taken care of. Furthermore, Amy can be assured of her safety since private hospitals, for instance, in India, possess a better rate of mortality for heart surgery as compared to hospitals in the United States (Horowitz, Rosensweig & Jones, 2007).

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Step 5: Decision Making

Amy ought to understand that seeking medical care in a foreign country has various benefits. For instance, in the United States, it is apparent that there exists a crisis in health care, which has resulted to several hardworking people like Amy being left without insurance. Even for those who have been insured, the insurance is not sufficient and cannot cover all the needed treatments. After the options have been analyzed with the principles of beneficence and the casuist theory, it is apparent that Amy should understand that outsourcing medical attention in foreign countries offers her the options of deciding what and how surgery can be done, unlike in the United States, where elective or complicated surgeries have been banned. Amy should not be afraid since she can get excellent medical treatment abroad.            

Step 6: Evaluation

There are counterarguments for the choice I have chosen.

  1. Amy is not in a position to afford the cost of health care in the United States, so she has got every right to indulge in outsourcing for better and cheap medical services in countries abroad.
  2. It is ethical for Amy to consider medical services in foreign countries since the majority of parties starting from individuals and companies and to the state is seeking for medical tourism, as well.

Step 7: Reflection

My reflection is that I support Amy’s decision to seek medical care abroad since foreign countries provide excellent medical treatment, as well as care to their patients. Furthermore, Amy should choose to be treated abroad since the option of seeking medical treatment in Amy’s native country would be quite impossible due to lack of medical cover. Besides, medical tourism offers Amy the options of deciding what and how surgery can be done, unlike in the United States, where elective or complicated surgeries have been banned. Therefore, she should not be afraid since she can get excellent medical treatment abroad at a relatively cheap cost as compared to the United States.

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In conclusion, the arguments above have clearly defined, from the moral and ethical perspective, what Amy should do and take into consideration when outsourcing medical treatment and care. It is apparent from the options that medical outsourcing raises various concerns about the quality, privacy, safety and financial needs of health care providers. However, health care creates distinctive attributes that magnifies such concerns. Medical outsourcing fills the gap to access medical care. Therefore, to prevent questions concerning medical outsourcing, a framework should be developed. As a result, health care will be enhanced; costs decreased, while at the same time preserving quality, ethical and moral concerns.



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