Monday, 16 February 2009

Medical tourism

Globalization of medical practice
Bernardo Villegas
The Manila Bulletin

Thanks to Dr. George Garcia and his team of doctors at the Asian Hospital Corporation, the Philippines is increasingly on the international map of medical tourism. There are foreigners who come to the Philippines for heart surgery and other medical procedures that would cost five to ten times in the United States, Japan, and European countries.

Also very much already in the international network of medical tourism are world-class hospitals like St. Luke (the first to obtain international certification), Medical City, Makati Medical and Cardinal Santos Hospital. This list will be enlarged as hospitals outside of Metro Manila, like those in Batangas, Pampanga, Baguio, Cebu, Iloilo, and Davao improve their facilities and attract some medical practitioners returning from the US and other developed countries, where they had cultivated their respective specializations catering to patients from all over the world.

We can call this phenomenon the globalization of medical practice. It can earn substantial foreign exchange as already demonstrated by hospitals in Thailand. It can reverse the brain drain of health personnel since we can retain more and more of our doctors, nurses, physical therapists, radiologists and other health workers. If properly structured, some of these hospitals can also address the needs of the poor patients by getting their richer patients – especially those from abroad – to subsidize the free medical services to the underprivileged. I am glad that the Government and the private sector are united in developing a strategy for medical tourism in the Philippines.

There is, however, a danger we have to avoid. As medical practice becomes globalized, there may be certain unethical procedures that foreign patients may expect local doctors to indulge in. I am not referring only to blatantly immoral practices like abortion, which is both criminal and unconstitutional in the Philippines. I am referring also to such practices as invitro fertilization and human cloning. I would like to remind doctors in the Philippines about the social doctrine of the Church concerning some of these practices. Special regard to this doctrine is called for in hospitals where you have Catholic nuns working or in which the Church is an important stakeholder like Cardinal Santos Hospital. I am sure the Episcopelians involved in St. Luke would also be careful about the practices to which I refer.

Let me first discuss the whole area of assisted reproduction. The Compendium of the Social Doctrine of the Church clearly states in Paragraph 235: "The desire to be a mother or a father does not justify any ‘right to children’, whereas the rights of the unborn child are evident. The unborn child must be guaranteed the best possible conditions of existence through the stability of a family founded on marriage, through the complementarities of the two persons, father and mother. The rapid development of research and its technological application in the area of reproduction poses new and delicate questions that involve society and the norms that regulate human social life."

Given the general principle cited above, doctors in the Philippines should proceed very cautiously in the area of artificial insemination. The Compendium continues: "We must repeat the ethical unacceptability of all reproductive techniques – such as the donation of sperm or ova, surrogate motherhood, heterologous artificial fertilization – that make use of the uterus of another woman or of gametes of persons other than the married couple, injuring the right of the child to be born of one father and one mother who are father and mother both from a biological and from a legal point of view. Equally unacceptable are methods that separate the unitive act from the procreative act by making use of laboratory techniques, such as homologous artificial insemination or fertilization, such that the child comes about more as the result of an act of technology than as the natural fruit of a human act in which there is a full and total giving of the couple."

Here, the key principle is the dignity of each and every human person born to this earth: "Avoiding recourse to different forms of so-called ‘assisted procreation’ that replace the marriage act means respecting – both in the parents and in the children that they intend to generate – the integral dignity of the human person. On the other hand, those methods that are meant to lend assistance to the conjugal act or to the attainment of its effects are legitimate."

Then there is human cloning, strictly defined as the reproduction of individuals at the embryonic stage with methods that are different from those of natural fertilization and in such a way that the new beings are genetically identical to the individual from which they originate. This cloning is contrary to the dignity of human procreation because it takes place in total absence of an act of personal love between spouses, being agamic and asexual reproduction. In the second place, this type of reproduction represents a form of total domination over the reproduced individual on the part of the one reproducing it. The fact that cloning is used to create embryos from which cells can be removed for therapeutic use does not attenuate its moral gravity, because in order that such cells may be removed the embryo must first be created and then destroyed."

It is well known that the issues of human cloning and stem cell research are highly debated in the United States, with the party of President Obama taking aggressive positions which gloss over the dignity owed to the embryo which is the beginning of human life. We cannot allow the morally erroneous views of some American politicians to contaminate our cultural and religious practices which assign the highest value to human life from conception. It is hoped that at least the Catholic doctors – whose consciences are well formed by their respective bishops and parish priests – will be vigilant in preventing unethical practices of test tube reproduction and human cloning in their respective hospitals. For comments, my email address is

1 comment:

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