Don’t Pay the Ferryman: International Aeromedical Transport of Patients to or From Treatments Prohibited in Their Place of Residence

Patients seek planned health care outside of their home country for several reasons, one being that the treatment of choice might not be legally available in their respective place of residence (eg, abortion of pregnancy, assisted dying/suicide, gender transition). The practice of traveling abroad with the intention of participating in a health-related activity that is prohibited in one's own country but not in the destination country has been coined as circumvention. In the context of international medical transportation, someone who assists a person in accessing a procedure that is illegal in the person's home country, state, or jurisdiction may face significant legal consequences for facilitating a criminal act under domestic law, even if that act is not committed in the country in which it is illegal. Commercial entities engaging in international medical transportation are well advised to protect their employees and organizations from these substantial legal risks by thoroughly investigating the legal and ethical background of cross-border transports to or from treatments that are not legally available in the country of patient origin or destination. Patients who cannot travel independently may be exposed to a disadvantaged and potentially harmful situation.