A structural analysis of ethical violations in health tourism: A qualitative review of the 2015–2025 period

This study aims to examine ethical violations in the field of health tourism from a comprehensive perspective. Although health tourism has become a strategic sector for many countries due to its economic benefits and international mobility, the cross-border provision of health services brings significant ethical challenges. Issues such as patient rights, informed consent, data privacy, misleading promotional activities, and unauthorized intermediaries are among the most frequently discussed ethical concerns in health tourism. The research analyzes ethical violation cases related to health tourism between 2015 and 2025 using a qualitative content analysis method. In this context, news articles, court decisions, official inspection reports, and documents published by national and international institutions were examined. The collected data were coded and thematically analyzed according to types of ethical violations, affected stakeholders, underlying causes, and the effectiveness of existing regulations. The findings reveal that ethical violations in health tourism have shown an increasing trend over the years and tend to concentrate around specific themes. Misleading advertising practices, deficiencies in informed consent processes, the use of unauthorized intermediaries, and violations of personal data protection were identified as the most prominent ethical issues. The results indicate that patients are the most directly affected group; however, healthcare professionals, healthcare institutions, and national reputation are also significantly impacted. Furthermore, although existing ethical regulations are conceptually adequate, they remain insufficient in terms of implementation and enforcement. In conclusion, the study emphasizes that ethical principles must play a central role in ensuring the sustainability of health tourism. Strengthening monitoring mechanisms, increasing ethical awareness among stakeholders, and aligning national practices with international ethical standards are considered essential steps to prevent ethical violations in health tourism. Keywords: Health tourism, ethics, ethical violations, informed consent, patient rights, qualitative content analysis, ethical governance