Stem Cell Tourism in China: The Dynamics of a Moral Economy

Recent decades have seen the rise of so-called ‘stem cell tourism’, whereby patients travel to access clinically unproven stem cell treatments, fuelled by the hope for treatment or cure represented by the regenerative promise of stem cells. This phenomenon has attracted increasing interest and concern from a variety of actors (doctors, scientists, policy-makers, patient groups, and fellow patients) over the potential physical and financial harm of undergoing clinically unverified treatments, as well as threats to public trust in stem cell research. Despite this, the numbers of people travelling seem to have only continued to grow, and China has emerged as one of the key destinations. Previous studies of the problem have explored the dimensions of hope, expectations and political economy. This thesis examines the economy of stem cell tourism in China as a moral economy, drawing on data from research undertaken with patients and/or their carers in Australia who have travelled to China for treatments, as well as with providers of stem cell treatments and other stakeholders in China. It asks: What can be learnt from an analysis of treatment practices in Chinese clinics and their internet-based marketing strategies about the factors shaping patients’ treatment decisions? What factors enhance or inhibit effective regulation of these practices in China? And, what can be learnt from this study about the dynamics driving the availability and uptake of promising, yet clinically unproven medical treatments that are offered outside one’s home country. It argues that stem cell tourism is underpinned by moral discourses involving contending conceptions of value, rightness and justice that shape the actions of patients and carers, clinicians, regulators, and other influential actors.
   As a leading destination, the market for treatments in China provides fertile ground to examine these dynamics. The market for stem cell treatments in China has often been characterised by media and other commentators through the nationalised discourse of the ‘Wild East’. Yet, the findings of this study suggest that the market for stem cell treatments in China is considered problematic by many local stakeholders, and that China has also become host to non-Chinese entrepreneurs and doctors with their own hopes invested in the promise of stem cells, giving it a globally integrated dimension. The findings also demonstrate how this market is situated within neoliberal discourses around the active, engaged and healthy citizen, with the associated moral imperative to ‘do something’—a discourse on which treatment providers also draw to attract patients and justify their actions. These moral discourses have proved powerful motivators for patients, and have become institutionalised in the marketplace. Going beyond the simple tropes of ‘desperate patients’ and ‘snake-oil salesmen’, this thesis concludes that interventions from regulators and other stakeholders with an interest in supporting the rights and wellbeing of those who travel require a greater understanding of how this moral economy operates, taking into account these competing perspectives, as well as the limitations of existing regulatory models when treatment providers and patients demonstrate a high degree of geographical mobility.