Puteri Nemie Jahn Kassim

Medical tourism service quality: finally some empirical findings

The purpose of this paper is to examine service quality, perceived value, overall satisfaction and future intention among medical tourists who seek treatment in Malaysian private hospitals. Self-administered questionnaire was the main method of data collection. Respondents comprised foreign patients who seek medical treatment, and/or related medical services such as tests and medical check-ups. Expatriates and foreign nationals residing in Malaysia were excluded. Altogether 173 responses were received and analysed by SPSS 17. Three dimensions of medical tourism service quality were identified, namely, medical staff quality, supporting services quality and administrative services quality. Medical staff quality was found to predict all three variables of patient satisfaction, perceived value and future intention for treatment. Very limited empirical research has been carried out with actual data from patients due to difficulty in getting access to international patients, and patients’ reluctance to participate. This study is among the first few which examines medical tourism service quality with actual patient data. The research identifies important constituents of medical tourism which may assist policy-makers and hospital managers in better understanding the industry.

Religious, Ethical and Legal Considerations in End-of-Life Issues: Fundamental Requisites for Medical Decision Making

Religion and spirituality have always played a major and intervening role in a person’s life and health matters. With the influential development of patient autonomy and the right to self-determination, a patient’s religious affiliation constitutes a key component in medical decision making. This is particularly pertinent in issues involving end-of-life decisions such as withdrawing and withholding treatment, medical futility, nutritional feeding and do-not-resuscitate orders. These issues affect not only the patient’s values and beliefs, but also the family unit and members of the medical profession. The law also plays an intervening role in resolving conflicts between the sanctity of life and quality of life that are very much pronounced in this aspect of healthcare. Thus, the medical profession in dealing with the inherent ethical and legal dilemmas needs to be sensitive not only to patients’ varying religious beliefs and cultural values, but also to the developing legal and ethical standards as well. There is a need for the medical profession to be guided on the ethical obligations, legal demands and religious expectations prior to handling difficult end-of-life decisions. The development of comprehensive ethical codes in congruence with developing legal standards may offer clear guidance to the medical profession in making sound medical decisions.