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Bioethics Across Borders : Mapping Key Cases and Exploring the Ethical Implications of Patient and Healthcare Staff
Anna Sierawska1, Saskia Metan2, Florian Bruns2
1Institute of History and Ethics in Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany. anna.sierawska@tum.de.
Abstract:
Despite the physical proximity between Poland and Germany, there are differences between the two countries in terms of language, customs, healthcare systems, legal frameworks, and socio-economic conditions. These differences and the membership of both countries in the European Union make cross-border healthcare a complex bioethical field. This paper examines the key areas of healthcare provision that are influenced by the political and geographical circumstances between Poland and Germany. This work employs an exploratory approach to map ethical risks and challenges using literature reviews and diverse sources (policy documents, local media reports, etc.). Ethical analysis is rooted in various established frameworks. We outline six areas where patient and healthcare staff mobility may raise ethical issues: (1) access to termination of pregnancy, (2) implications of differing regulations on artificial reproductive technologies, (3) dental care, (4) patient mobility for planned treatments under Directive 2011/24/EU, (5) healthcare challenges in border regions, and (6) migration of healthcare staff. The German and Polish healthcare systems, rooted in principles of solidarity, aim to provide equal access to healthcare services. European Union regulations allow patients to receive treatment abroad, but this can strain state budgets, particularly in less affluent countries. Language barriers might also impact doctor-patient interactions and the process of gaining informed consent. Political and economic differences further complicate ethical dilemmas, affecting healthcare migration and treatment availability. Asymmetric resources might contribute to the growth of private healthcare, affecting integrated public services locally and internationally.
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