ethical issues in tourism industry

• What is ethical tourism and why is it important?

Disclaimer: Some posts on Tourism Teacher may contain affiliate links. If you appreciate this content, you can show your support by making a purchase through these links or by buying me a coffee . Thank you for your support!

Ethical tourism is on everyone’s mind these days. Over the past decade or two, people have become far more conscious of their actions. Whether it’s by turning off the lights when we leave the room, recycling our empty cereal box, not riding elephants in Thailand or eating at local restaurants in Costa Rica, there are many ways that we can be ethical tourists.

However, whilst you might read simplistic articles that give you a list of ‘things that you should do to be an ethical tourist’, these are exactly that- over simplified. In reality, ethical tourism is a multifaceted concept that requires a deep understanding if a person truly wants to demonstrate ethical behaviour.

In this article, I will tell you what is meant by the term ethical tourism, why ethical tourism has become more prominent around the world and what ethical issues the tourism industry is up against. I will also give you lots of examples of ethical tourism, discuss the criticisms of ethical tourism (because it is not perfect!) and then give you that infamous list- how to be an ethical tourist.

Don’t want to read it all? Use the list below to scroll to the bit that interests you most.

What is ethical tourism?

A definition of ethical tourism

Why is ethical tourism important?

The rise in ethical tourism

The global code of ethics for tourism, distribution of income, access to services and facilities, exploitation of children, exploitation of women, sex tourism, animal welfare, environmental destruction, cultural impacts of tourism, agritourism, charity tourism, community-based tourism, cultural tourism, pro-poor tourism, rural tourism, slow tourism, sustainable tourism, volunteer tourism, tourists are naive, small-scale projects don’t solve larger-scale problems, the subjectivity of the term ‘ethical’, ethical operators may have unethical motives, can tourism ever really be ethical, #1 be kind to the environment, #2 be kind to society, #3 be kind to the economy, ethical tourism: key takeaways, ethical tourism: faqs, ethical tourism: further reading.

Ethical tourism is a concept that has been developed in response to the critiques of mass tourism . Essentially, ethical tourism encourages tourists to move away from’ the four Ss’ (Sun, Sea, Sand and Sex), and exchange these for ‘the three Ts’ (Travelling, Trekking and Trucking).

To put it simply, ethical tourism is a form of responsible tourism . Ethical tourists consider the impact of their actions with regards to the three pillars of sustainable tourism – the environment, the economy and society. They minimise negative impacts and maximise the positive impacts.

Sounds great, doesn’t it? There problem is however, that many people are undereducated in these areas. Tourists are inherently naive. A person may think that they are demonstrating ethical behaviours and adhering to ethical practices, but in reality this may not be the case. This is through no fault of the tourist. The simple issue is that they do not know everything that they need to know in order to be an ‘ethical tourist’….

So lets delve into the concept of ethical tourism a little deeper….

As with many concepts that I attempt to define here on this website, there is a degree of ambiguity over what ethical tourism actually means. It is somewhat subjective. Ultimately, what one person may believe is ‘ethical’, another person may not .

This problem is particularly evident when we compare the way that the term ethical tourism is understood between those who live in the global north to those who live in developing countries.

The concept of ethical tourism has been developed predominantly by Western nations, in response to global concerns about the impact of mass tourism and the negative impacts that this often has. But whilst these problems are increasingly recognised in the northern hemisphere, many countries in the south lack the education and experience to facilitate the same level of comprehension. This has resulted in different interpretations of the term ‘ethical tourism’ around the world.

Nonetheless, there have been some attempts at providing a universal definition of ethical tourism.

The World Tourism Organisation (1999) state that;

‘The understanding and promotion of the ethical values common to humanity, with an attitude of tolerance and respect for the diversity of religious, philosophical and moral beliefs, are both the foundation and consequence of responsible tourism’.

Ryan (2002, p. 17) further suggests that although it may be easy for tour operators to agree with the principles outlined by demands for an ethical approach to tourism development, it is sometimes hard to implement them because of the complex and ‘pragmatic issues of management’. He argues that although laudable in intention, ethical tourism has been an extremely difficult niche product to provide.

Harold Goodwin, the director of the International Centre for Responsible Tourism (ICRT), supports this, reporting that ‘currently what tour operators are looking for help with is ways to make themselves more responsible’ (Goodwin, 2003).

This demonstrates that there are also disparities between the way that ethical tourism is understood (either intentionally or naively) between the different stakeholders in tourism . Businesses, for example, may promote ethical practices as a means of enhancing their corporate image, whereas tourists may have a true and natural desire to lessen their carbon footprint, for instance.

Ethical tourism is paramount.

Ultimately, we have been destroying our world for centuries and the pace at which this has happened has increased exponentially in recent years. We simply cannot continue to act in the way that we have been.

Yes, people are are recycling more than they used to. Governments are funding the building of solar and wind power plants as an alternative to coal. Biofuels are being developed for use in aircraft and electric car technology is rapidly developed. Children are taught to be ‘global citizens’ at school. BUT we are not doing enough.

If you haven’t yet watched the Netflix series Travellers , then you should do. This dystopian drama gives us insight into what our future world might look like if we continue living the way that we are… I highly recommend it.

If we want to continue to travel the world, then we must do it responsibly . And this is what ethical tourism is all about…

Ethical tourism is not a new concept, but it is one that has become more recognised in recent years.

Over the last 30 years or so, ethical tourism has become an important discussion point for academics, businesses, Governments and the general public, plenty of people are talking about it now, from ethical family travel to how to use less plastic , ethical tourism is much more in the public eye than it once was.

It’s scary to think that when our parents travelled in their youth, there was little regard for ethics. In fact, holidays were seen as a time to ‘let loose’ and to be ‘care-free’. Turning off the lights when you left a room was often the last thing on a tourist’s mind.

Fast-forward a generation and the picture is quite different….

The emergence and growth of the ‘ethical consumer’ has been apparent since the 1990s (Shaw & Clarke, 1999). In response, companies began to realise the importance of social responsibility and began to implement ethical practices into their business models. Sadly, this often means that companies have little regard for ethics, but instead their motives are profit-driven. But nonetheless, ethical practices are adopted, which is a good thing!

Ethical tourism over the years has moved from a micro form of niche tourism to a macro niche in tourism . However, it remains just that- a niche.

However, there are a number of predictions that show an accelerated growth in the interest of ethical tourism in the near future. Therefore, I predict that it is only a matter of time before ethical tourism is integrated into the mass tourism model .

In fact, there is a strong argument to suggest that ethical tourism should be part of an attitude towards tourism , rather than a niche product.

So how to we monitor and measure ethical behaviour? What are the guidelines for ethical tourism? Is there a code of conduct?

These are all very important questions. The problem that we have with broad and subjective concepts, such as ethical tourism, is definition and measurement. When is something ethical and who decides?

Unfortunately, there is not one set code of conduct for stakeholders in tourism to work towards. This makes for somewhat murky waters… nonetheless, there are a number of guidelines and codes that are used in different spheres and contexts.

Some examples of codes of conduct used in ethical tourism include:

• Global Code of Ethics for Tourism – United Nations
• Tips for Responsible travellers – World Committee on Tourism Ethics (ECTE)
• Putting Ethics into Practice – Tearfund
• The Countryside Commissions’ Code – UK Government
• Code of Ethics – Conservation International
• Environmental Codes of Conduct for Tourism – United Nations Environment Programme (UNEP)
• Values in Action: WWF’s Core Standards of Performance – World Wildlife Fund (WWF)
• Tour Operators’ Initiative for Sustainable Tourism Development  (TOI)  – United Nations World Tourism Organisation (UNWTO)

The purpose of codes, such as these, is to raise awareness and to educate the tourist.

They do also play an important role in informing other stakeholders of tourism, such as private organisations of Government. Codes of conduct help to explain how it is possible for people to support the management of tourism in a sustainable, and ethical, manner.

Major ethical issues in tourism

There are many many ethical issues within tourism. After all, tourism is one of, if the the , biggest industry in the world- so there are bound to be a diverse range of issues.

Below, I have briefly outlined some of the most common ethical issues in tourism.

There is lots of money to be made in tourism. However, the income is rarely distributed evenly.

More often than not, the vast majority of wealth made from tourism goes to large, Western corporations. Even if we concentrate on an area of tourism that is in the developing world, much of the income from tourism is still swallowed up by international organisations, known as economic leakage .

Inherently, most of the jobs in the travel and tourism industry pay low salaries. Think- the chef in your hotel restaurant, the maids who clean your beds and the theme park ride operator at the fun fair. None of these people are likely to be paid high salaries.

Tourism can also cause other negative economic impacts , such as gentrification (when local people are pushed out of the area that they have traditionally lived in because the cost of living has risen too much). Tourism can encourage theft, gambling and cause people to leave their traditional methods of income generation behind (such as farming) in exchange for tourism.

The sex tourism industry in Thailand is a good example of this, where young girls frequently leave their homes in rural areas to join the sex trade in the city in search of a more prosperous economic outlook.

The tourism industry is known to use and abuse local areas and resources. This is often at the detriment of the local population .

Take golf tourism, for example. Golf courses require a huge amount of water in order to be maintained. In some parts of the world, where there are water shortages, this means that local people may go without essential water needed for cooking, washing etc at the expense of the tourism industry.

Sadly, children are exploited with the tourism industry more often than we care to admit.

Have you ever bought an item from a kid who is a street seller? If the answer is yes, then you are helping to fuel this exploitation…. if the parents know that their kids can make money from tourism, they will continue to keep them out of school and working on the streets.

There are many jobs that kids do that are indirectly linked to the tourism industry too. From working in factories to farm work to begging, to sex tourism.

Similarly, many women are exploited within the tourism industry.

The most obvious example is this is through sex tourism , which is a prominent industry in South East Asia, amongst other parts of the world.

However, there are also many other ways that women are treated unfairly in the tourism industry. Most of the top jobs are done by men and women salaries, on average, are significantly lower around the world than men’s salaries.

As I mentioned before, the sex tourism industry is pretty significant. While many people like to pretend it doesn’t exist, the truth is that this is a multi-million Dollar industry.

However, many people who work in the sex trade do not want to be there. Some are forced into this line of work against their will. Some are only children.

Wildlife tourism has moved towards the forefront of consumer awareness in recent years. People are now largely empathetic of animal rights and welfare.

People are now preferring to visit safari parks over zoos, going to animal sanctuaries and conservation projects and volunteering their time to help, rather than hinder.

Nonetheless, maltreatment of animals does still happen in many contexts around the world; from dolphins in captivity to cat cafes to riding elephants.

It’s ironic really that tourism all too often destroys the environment that it relies on.

For tourism to be ethical, stakeholders need to ensure that any damage to the environment is minimised. This includes a range of aspects such as reducing CO2 emissions to picking up litter to reducing the amount of plastic that we use.

There are many ways that tourism can adversely affect culture .

Authenticity in tourism is often a controversial topic, as is globalisation . Tourists should be mindful of local cultures, religions and customs and try not to offend people during their travels too.

Examples of ethical tourism

So, now that we understand what ethical tourism is, lets look at some examples of ethical tourism in practice. Below, I have outlined some of the major examples of ethical tourism. Please note that this list is not exhaustive and not all of these types of tourism are entirely ethical 100% of the time.

Agritourism, also referred to as agricultural tourism, argotourism or farm tourism is a subset of the rural tourism industry. It focusses on agricultural operations and involves tourist activities based in or around farms. This includes activities such as wine tours, horseback riding, clay bird shooting, animal petting and historical agricultural exhibits.

Charity tourism, also referred to as aid tourism, is a form of travel which centres around charitable activity. It can involve helping those in need directly by joining a  volunteer tourism  programme, for example. It can also involve booking tours and travels or providing financial donations through organisations and tour operators which promote charitable tourism, such as  Tourism Concern ,  Barefoot or the  Travel Foundation .

Community based tourism is a term used to describe holidays that benefit both the traveller and the destination. Community based tourism is based on the premise of collective responsibility, allowing the local community to have an active involvement in the development and management of tourism in the area.It often involves rural, poor and economically marginalised populations, where individuals are given the opportunity to raise money through work as land managers, entrepreneurs, produce and service providers and employees.

Cultural tourism  is the act of travellers visiting particular destinations in order to experience and learn about a particular culture. This can include many activities such as; attending events and festivals, visiting museums and tasting the local food and drinks. Cultural tourism can also be an unintentional part of the tourism experience, whereby cultural immersion (with the local people, their language, customs, cuisine etc) is an inevitable part of a person’s holiday.

Ecotourism is a form of tourism directed at preserving fragile environments and eco-systems. Ecotourism commonly occurs in threatened natural environments, where the intention is to provide conservation. Ecotourism efforts include building tourist facilities that have minimal impact on the natural environment, adopting the use of products such as compost toilets or solar-powered electricity. Ecotourism has become somewhat of a ‘buzz word’ in recent years and is closely related to the concept of  sustainable tourism .

Geotourism is tourism that sustains or enhances the geographical features of a destination. Geotourism adopts the principles of sustainable tourism , with a focus on the synergy of the destination- it aims to bring together all of the elements of geographical character to create a fulfilling and rewarding tourism product. Examples of geo tourism may be holiday homes that are run locally and built with local products (e.g. stones) or local produce being sold to tourists.

Pro-poor tourism is not a sector of the tourism industry per se, rather it is an approach to the industry. Pro-poor tourism, often shortened to PPT, intends to provide net benefits to the poor. These can be economic, social or environmental benefits and can be achieved through a range of means such as taking part in charity tourism or purchasing a holiday package through a charitable operator.

According to the World Tourism Organisation, rural tourism is ‘a type of tourism activity in which the visitor’s experience is related to a wide range of products generally linked to nature-based activities, agriculture, rural lifestyle / culture, angling and sightseeing’. Rural tourism takes place in non-urban areas such as national parks, forests or mountain areas. Popular rural tourism activities include cycling, walking or hiking.

Slow tourism  is based on the concept of speed. It involves travelling for a prolonged period of time at a slow pace, allowing the tourist a deep, authentic and cultural experience. An alternative tourism form, slow travel is typically associated with sustainable practices, taking into consideration the impacts of travel on the environment, society and economy. Slow travel can be undertaken in any destination, but is particularly popular amongst traditional backpacking routes in destinations such as South East Asia, Central America or Australia .

Sustainable tourism , similarly to responsible tourism, relies on the premise of taking care of the environment, society and economy. Sustainable tourism principles intend to minimise the negative impacts of tourism, whilst maximising the positive impacts. As defined in the Bruntland Report, sustainable tourism is ‘development that meets the needs of the present without compromising the ability of future generations to meet their own needs’.

Volunteer tourism  is a type of tourism whereby an individual will travel abroad to a destination that is predominantly considered ‘undeveloped’ or ‘developing’ to offer their support to those in need. According to Steven Wearing, the founder of the concept, a volunteer tourist undertakes holidays that might involve aiding or alleviating the material poverty of some groups in society, the restoration of certain environments or research into aspects of society or environment.

WWOOFING  stands for world wide opportunities on organic farms. It is a form of homestay tourism, whereby the tourist works on the farm in exchange for free board. WWOOFING has grown as an industry in recent years and is particularly popular in Australia, where many international tourists undertake agricultural work in order to extend the duration of their working holiday visa.

Criticisms of ethical tourism

Ethical tourism is all about doing good . Sounds great, doesn’t it? Too good to be true even? Well, perhaps it is…

There are, in actual fact, many criticisms of ethical tourism. Yes, it done well it has some fantastic positive impacts. But all too often this is not the case. The most common criticisms of ethical tourism include; the naivety of tourists, the fact that small-scale projects often can not solve large-scale problems and the subjectivity of the term ethical tourism. In addition to this, some people actually question whether achieving true ethical tourism is even possible!

Many tourists don’t want to exhibit unethical behaviour. The problem is that they simply do not realise that they are doing it!

I remember when I first moved to Thailand to teach English and I leant that it was culturally offensive to show the soles of your feet. I was horrified to learn this, given that I had been sat on the floor in temples and other public places with my legs straight out in front of me- and soles completely on show! This is one example of how tourists are often ignorant to local customs and traditions, and can this easily cause offence, albeit in unintentionally.

Wildlife tourism is another good example. For years, tourists would ride elephants, completely unaware of how much the elephant would suffer in order to provide them with this pleasure. Fortunately, there is now a lot more awareness in this area.

Many examples of ethical tourism, such as volunteer tourism projects or areas which are adopting geotourism principles are small in size. Yes, there are positive impacts to such projects, but they are barely a pin-prick into the bigger problems at hand.

Take pro-poor tourism, for example. There are some fantastic initiatives around the world, however these projects are small. Every little helps, for sure- but they only have a small impact on the wider issue and problems.

What is ethical behaviour?

Part of the problem with ethical tourism is that different people have different perceptions of what is ethical and what is not. In China , for example- it is deemed as perfectly ok to keep animals in small enclosures. Whereas, in much of the Western world, tourists would look upon this in horror.

Perception of ethics vary around the world and between different types of people . And a large part of this is done to education and awareness. If you have never been taught that fois gras is made by force feeding geese to fatten their liver, then you might be perfectly happy to eat it. If you have not seen the documentaries about how plastic is filling our oceans then you may have no problem with using a plastic disposable straw.

The point I am trying to make is that people view ethical tourism and understand ethical tourism in different ways. This includes not only tourists, but also tour operators , travel agents , tour guides, Governments and a range of other tourism industry stakeholders.

The last criticism of ethical tourism that is worthwhile mentioning here is motivation .

Why does someone make a commitment to be an ethical tourist or to promote ethical tourism? Is it because they genuinely care about said ethical issues? Or is it because they are making money from it is some way?

We live in a world where consumerism and commercialisation are key. The capitalist marketplace demands competitive prices, innovative practices, superior marketing and a USP.

One way of achieving these things is for organisations to promote themselves as ethical operators. This enhances their corporate social image and makes them look more appealing to customers. In turn, this increases business and makes the organisation more money.

So, does the organisation who is promoting ethical tourism really care about ethical tourism? Maybe they do care, but I suspect that profit comes before ethics in most instances. Sad, but true.

So we have concluded that ethical tourism is subjective and difficult to measure. Does that mean that there is really such a thing as ethical tourism? Can any tourism be entirely and truthfully ethical? what does this actually mean?

Monbiot (1999) makes a valid argument in this regard, stating that; ‘tourism is, by and large, an unethical activity, which allows us to have fun at everyone else’s expense’.  Hickman (2002) further concludes that tourism is inherently a ‘self centred act’. Butcher (2009) takes this one step further by questioning whether ethical tourism is actually a good thing at all, in his chapter entitled ‘Against Ethical Tourism’ in the book Philosophical Issues in Tourism .

Perhaps the answer is that ethical tourism should not be seen as a form of tourism per se , but instead should be approach that is taken in an appropriate way, depending on the specific context. It is certainly not a black and white issue… and is certainly an area worthy of further discussion.

How to be an ethical tourist

I would like to end this article with a practical overview of some of the things that tourists, and other tourism industry stakeholders, can do to exhibit ethical behaviour.

It is extremely difficult (if possible at all) to be 100% ethical for 100% of the time. BUT, there are many things that we CAN do to help to protect and preserve the environment, society and the economy. Keep reading to find out what YOU can do to help.

If you want to be an ethical tourist, you must demonstrate a commitment to reducing any negative impacts on the environment. Some of the things that you can do include:

• Don’t buy animal souvenirs
• Don’t touch animals
• Don’t feed wild animals
• Avoid unethical wildlife tourism
• Don’t drop litter
• Don’t touch coral
• Try slow tourism
• Opt for eco-friendly transportation options
• Turn off the lights
• Try ecotourism
• Avoid plastic
• Don’t waste water
• Stick to main paths

Ethical tourists also have a care and consideration for society and the communities that they interact with as part of their tourist experience. Here are some things that you can do to be an ethical tourist:

• Learn the local language
• Be respectful of local customs and traditions
• Immerse yourself into local life
• Be sensitive
• Don’t give to beggars
• Treat people fairly
• Avoid sex tourism
• Don’t take photos of people without their permission

Lastly, an ethical tourist should be mindful of their economic behaviour. Here are some things that you can do to ensure that you have a positive impact, where possible:

• Avoid multinational chain hotels
• Limit economic leakage where you can
• Avoid all-inclusive holidays
• Leave positive reviews for local businesses
• Consider who you are booking your holiday with
• Haggle fairly
• Ethical tourism involves making responsible and sustainable choices when traveling.
• It is important to respect local cultures, traditions, and customs when visiting a new place.
• Supporting local communities by buying locally-made products and using locally-owned businesses can have a positive impact on the local economy.
• Minimising your carbon footprint by using eco-friendly transportation options and reducing waste can help reduce the impact of tourism on the environment.
• Being mindful of the impact of your visit on the local environment and taking steps to minimize damage, such as not littering or damaging natural habitats, is important.
• Engaging in ethical wildlife tourism, such as visiting sanctuaries and conservation centers, can help support animal welfare and conservation efforts.
• Respecting the privacy and dignity of local people is important when taking photographs or engaging in other tourist activities.
• Supporting ethical tourism organisations and initiatives can help promote sustainable and ethical tourism practices.
• Learning about the history and culture of the destination you are visiting can help you appreciate and respect it more.
• Ultimately, ethical tourism involves making conscious and informed decisions that benefit the destination and its people, while minimising negative impacts on the environment and local communities.

Lastly, lets finish off this article by answering some of the most common questions on this subject.

Ethical tourism refers to tourism that promotes responsible and sustainable practices that benefit the environment and local communities.

How is ethical tourism different from other types of tourism?

Ethical tourism is different from other types of tourism because it places an emphasis on promoting sustainable and ethical practices, while minimising negative impacts on the environment and local communities.

Ethical tourism is important because it helps promote sustainable and ethical practices in the tourism industry, which can benefit both the environment and local communities.

What are some examples of ethical tourism practices?

Examples of ethical tourism practices include supporting local businesses, reducing waste and using eco-friendly transportation options, respecting local cultures and traditions, and engaging in ethical wildlife tourism.

How can tourism negatively impact the environment and local communities?

Tourism can negatively impact the environment and local communities through overdevelopment, pollution, cultural commodification, and economic exploitation.

Can ethical tourism benefit local communities?

Yes, ethical tourism can benefit local communities by supporting local businesses, creating job opportunities, and promoting sustainable practices.

What is responsible tourism?

Responsible tourism is a type of tourism that aims to promote ethical and sustainable practices that benefit local communities and minimise negative impacts on the environment.

Is ethical tourism more expensive than traditional tourism?

Ethical tourism may not necessarily be more expensive than traditional tourism, as it depends on the specific activities and accommodations chosen.

What is the role of governments and tourism organisations in promoting ethical tourism?

Governments and tourism organisations have a role in promoting ethical tourism by creating policies and guidelines that encourage sustainable and ethical practices, and by educating tourists on ethical tourism practices.

How can tourists engage in ethical tourism?

Tourists can engage in ethical tourism by being mindful of their impact on the environment and local communities, supporting local businesses, engaging in ethical wildlife tourism, and respecting local cultures and traditions.

Ethical tourism is a fascinating and important subject that is only going to grow in the coming years. Want to learn more? Check out the resources below:

• What Sustainable Tourism Is + Why It Is The Most Important Consideration Right Now
• The Shocking Truth About Sex tourism
• What is sports tourism and why it is so big?
• What is responsible tourism and why does it matter?

Liked this article? Click to share!

• International edition
• Australia edition
• Europe edition

Integrating ethics into tourism: beyond codes of conduct

As the world's largest service industry, contributing an estimated 5% to worldwide GDP, tourism creates both jobs and wealth but also has clear social and environmental consequences. The industry is therefore faced with a range of increasingly pressing challenges.

Over the last few years, hotel companies have made a determined effort to deal with the impact their business activities have on the environment, particularly by measuring and reducing their carbon and water footprints. Both major international hospitality companies and small businesses recognise that there are tangible benefits in doing this, including real efficiency gains and an improved corporate reputation.

Another closely linked challenge for companies is how to manage the ethical operation of their business. Ethical issues arise in four main areas: the supply chain, the local community (in the tourism destination), the workplace, and customers. There may be concerns about forced labour in the supply chain or exploitation of migrant workers in the workplace for example; or local people may – often rightly – perceive that they have little or no share in the economic benefits of tourism, while bearing a disproportionate burden from environmental degradation.

In 1999, the UN World Tourism Organisation (UNWTO) devised and adopted a global code of ethics for tourism, designed to minimise the negative effects of tourism activity on destinations and local communities, which was officially recognised by the UN in 2001. Now, the UNWTO is holding the first International Congress on Ethics and Tourism (15-16 September 2011, Madrid), arguably the first opportunity to evaluate whether the industry has moved beyond symbolic statements and agreed codes to concrete actions.

Encouragingly, there is evidence that the hotel industry is assuming a proactive, collective approach to human rights and business ethics, incorporating human rights risk mapping, employee training on responsible business, and sustainable local benefits. Major hotel companies have taken significant steps in the past decade to integrate policies on human rights into their stated policies on business conduct and ethics.

How in practice can the global hospitality industry advance ethical and socially responsible tourism? One concrete initiative is the Youth Career Initiative supported by several major international hotel companies. This six-month education programme gives disadvantaged young people aged 18 to 21 hands-on experience, and training in an international hotel. Apart from gaining life and work skills, young participants are empowered to make informed career choices, enabling them to improve their employability and enhance their long-term social and economic opportunities.

Over 420 young people in 11 countries participate in the programme every year in more than 50 leading hotels. The high number (85%) of young people graduating from this scheme to secure employment in the hotel industry or in further education shows that this project effectively tackles key issues of youth unemployment and social exclusion, poverty, and exploitation. In addition, a pilot programme to rehabilitate survivors of human trafficking will be run soon in hotels in Mexico, Brazil and Vietnam.

Among specific initiatives, Marriott International relaunched their business ethics awareness programme last year, which provides employees with the tools to identify potential ethical and compliance issues and raise them with the appropriate leaders within the organisation. This includes a new training video for all new hire inductions, plus quarterly bulletins with updates on tools for prevention. The company recently developed human rights and protection of children training for their security officers and all property-based employees, which is being rolled-out across their global operations.

Another company with a proactive ethical policy is Shangri-La Hotels and Resorts, a Hong Kong-based hotel group operating globally but with half of its properties in China. They launched a supplier code of conduct in 2009 (now externally audited) and conduct site visits to their top 150 suppliers to check employee wages and conditions, health and safety, management systems and environmental practices; they have a group-wide programme linking hotels with a local school or orphanage for five to 10 years, including providing training in hotel skills.

The examples highlighted still represent best practice rather than industry-wide reality. There is much more to be done. A code of ethics and human rights policy is no longer enough: companies need to show practical examples of where they have made a difference through the supply chain, local communities, their workplace, and to their customers' behaviour. Embedding ethics into core business strategy makes good business sense as it potentially enhances a company's profits, management effectiveness, public image and employee relations.

Hospitality companies that do take a long-term view, and marry high ethical standards with practical measures, are likely to prove the winners in a fast-changing industry. The Madrid UNWTO conference should provide an interesting snapshot of whether the industry has really grasped the nature of this challenge.

Francesca Leadlay is programme manager, sustainability, at the International Tourism Partnership , a global programme of the International Business Leaders Forum

This content is brought to you by Guardian Professional . Become a GSB member to get more stories like this direct to your inbox

• Guardian sustainable business
• Sustainable business blog

Comments (…)

Most viewed.

UN Tourism | Bringing the world closer

Global code of ethics for tourism.

• Private Sector Signatories of the Commitment
• Ethics convention
• World Committee on Tourism Ethics (WCTE)
• The Responsible Tourist

Background of the Global Code of Ethics for Tourism

Share this content.

• Share this article on facebook
• Share this article on twitter
• Share this article on linkedin

The Global Code of Ethics for Tourism sets a frame of reference for the responsible and sustainable development of world tourism. It draws inspiration from many similar declarations and industry codes that have come before and it adds new thinking that reflects our changing society at the beginning of the 21st century.

The Global Code of Ethics for Tourism (GCET) is a comprehensive set of principles whose purpose is to guide stakeholders in tourism development: central and local governments, local communities, the tourism industry and its professionals, as well as visitors, both international and domestic.

With international tourism forecast to reach 1.6 billion arrivals by 2020, members of the World Tourism Organization believe that the Global Code of Ethics for Tourism is needed to help minimize the negative impacts of tourism on the environment and on cultural heritage while maximizing the benefits for residents of tourism destinations. The Global Code of Ethics for Tourism is intended to be a living document. Read it. Circulate it widely. Participate in its implementation. Only with your cooperation can we safeguard the future of the tourism industry and expand the sector's contribution to economic prosperity, peace and understanding among all the nations of the world.

The Code was called for in a resolution of the UNWTO General Assembly, meeting in Istanbul, Turkey, in 1997. Over the following two years, a special committee for the preparation of the Code was formed and a draft document was prepared by the Secretary-General and the legal adviser to UNWTO, in consultation with UNWTO Business Council, UNWTO's Regional Commissions, and the UNWTO Executive Council.

The United Nations Commission on Sustainable Development, meeting in New York in April, 1999, endorsed the concept of the Code and requested UNWTO to seek further input from the private sector, non-governmental organizations and labour organizations. Written comments on the Code were received from more than 70 UNWTO Member States and other entities. The resulting 10 point Global Code of Ethics for Tourism - the culmination of an extensive consultative process - was approved unanimously by the UNWTO General Assembly at its meeting in Santiago, Chile, in October 1999, in UNWTO resolution A/RES/406(XIII) .

The United Nations Economic and Social Council (ECOSOC), in its substantive session of July 2001, adopted a draft resolution on the Code of Ethics and called on the UN General Assembly to recognize the document. Official recognition by the UN General Assembly of the Global Code of Ethics for Tourism came on 21 December 2001, through UN resolution A/RES/56/212 , by which it further encouraged the World Tourism Organization to promote an effective follow-up of the Code.

Although it is not a legally binding document, Article 10 of the Code provides for a voluntary implementation mechanism through the recognition of the role of the World Committee on Tourism Ethics (WCTE), to which stakeholders may refer, on a voluntary basis, any matters concerning the application and interpretation of the document.

9 most common ethical practices in the hospitality industry

Eva Lacalle

Link copied

Ethical practices in hotels help hoteliers ensure guest and employee satisfaction while protecting the brand's reputation. Fostering an environment based on mutual respect between guests and staff is crucial for ongoing success.

Ethics is the backbone of remarkable hospitality, so let's explore the must-know ethical practices in hotels. We'll also discuss the best ways to adopt an ethical mindset.

Table of contents

What is ethics in hospitality?

Ethics in hospitality refers to a value system that guides all your management decisions. It encompasses the principles, values, and standards your hotel promises to live up to. Be sure to communicate all of these on your website. Remember the golden rule – treat your guests how you want to be treated and consider how your actions affect them.   

Guests need to be able to trust you to have their best interests in mind. The best way to do this is to work from a place of emotional intelligence . That means treating guests with empathy and extending it to your employees and suppliers. Such an approach makes your hotel a pleasant place for anyone visiting.

Nine ethical practices in hotels you should know 

Let's look at the key aspects of ethics in the hospitality industry – from how you treat your staff and guests to the community you operate in and how you advertise. Ethics defines a holistic approach to doing business.

Treating your employees fairly 

Treating your employees fairly is one of the most important ethical commitments in the hospitality industry. Your employees are the face of your business – if you don’t treat them well, you probably won’t treat your guests well. Ensure fair and competitive wages, safe working conditions, and equal opportunities regardless of race, socioeconomic background, and education level.

You should also have zero tolerance for harassment and discrimination. Place diversity and inclusion at the forefront of your staff training. Your organizational culture should encourage and reward people for speaking up when something isn’t going right. Empower your teams to anonymously report issues without fear of losing their jobs.

Customer first 

'The guest is always right' is an ethical premise. After all, your guests are keeping you in business, so treat them with respect, honesty, and fairness. Avoid false advertising, price gauging, or hidden fees. Ensuring transparency across all channels encourages positive guest interactions because it shows your ethical responsibility.  

Data privacy

Nowadays, data privacy and security are ethical and legal obligations, especially in Europe with GDPR . Hotels handle a large amount of sensitive data, so tell your guests what you do with the data and who's managing it. You must safeguard their data and use it with consent in the most transparent way possible.  

Regulatory compliance 

Fulfilling your legal obligations is critically important for your success. Those include labor laws, health and safety standards – such as having fire hydrants on every floor and an exit plan – and other legal requirements. Be sure to keep an eye on changing legislation.

Accessibility

Many governments have created laws to be more inclusive to people with disabilities and motor impairments. This means installing elevators and ramps to ease the use of wheelchairs, as well as ample space to maneuver them around the hotel. Accessible bathrooms are on this list, too. When your hotel can’t meet those requirements, it’s your ethical responsibility to share that clearly on your website.

Read more in our guide to accessibility .

Environmental responsibility  

Climate change shifted our focus back to the environment. As a sector that creates a lot of waste , hospitality must promote environmentally friendly practices that reduce carbon footprint. Hotels can do their part to conserve energy, produce less waste, and reduce, reuse, and recycle, playing positive role models in their local communities.

Community involvement 

Community involvement means actively engaging with the local neighborhood. Your hotel can support the local economy by partnering with local businesses, creating events, and promoting socially responsible initiatives. Why look for outside providers when you have the possibility to foster a strong local community?

Marketing and advertising

Responsible marketing and advertising include accurately portraying your rooms and services, avoiding deceptive advertising, and being culturally sensitive. Marketing campaigns should feature guests from different backgrounds while being socially responsible and truthful.     

Crisis management 

In the face of a crisis, such as a natural disaster or an epidemic, hotels must take responsible actions and prioritize the safety and well-being of their guests and staff. The best way to handle it? Have an action plan in place should such a crisis happen.  

Running a hotel with high ethical standards is a strategic decision that can determine your hotel’s long-term success and competitiveness. Committing to authenticity lets your hotel build strong relationships with guests and keep talent.   

The better the overall experience at your hotel, the better your reputation will be.  

Eva has over a decade of international experience in marketing, communication, events and digital marketing. When she's not at work, she's probably surfing, dancing, or exploring the world.

Hospitality hot takes straight to your inbox

Sign up to our monthly newsletter for industry insights, product news, partner updates and more.

The Nordic Hotel Playbook

Download now

Similar articles

Make it remarkable.

Ready to take the first step towards a more efficient, flexible, guest-centric approach to hospitality?

Cookie management

Here you can manage your preferences regarding cookies:

Essential cookies

Essential cookies enable core functionalities of the website such as marking your data inputs, network management and accessibility.

Functionality cookies

These cookies allow a website to remember choices you have made in the past, like what language and currency you prefer, remember your name and email and automatically fill forms.

Analytical cookies

Analytical cookies help us improve our website by collecting and reporting information on how you use it.

Advertising cookies

Advertising cookies for delivering tailored and customized advertising.

Guest editorial: Innovation in hospitality and tourism: ethical issues and challenges

Journal of Hospitality and Tourism Insights

ISSN : 2514-9792

Article publication date: 26 August 2022

Issue publication date: 26 August 2022

Oskam, J. and De Visser-Amundson, A. (2022), "Guest editorial: Innovation in hospitality and tourism: ethical issues and challenges", Journal of Hospitality and Tourism Insights , Vol. 5 No. 4, pp. 709-712. https://doi.org/10.1108/JHTI-09-2022-341

Emerald Publishing Limited

Copyright © 2022, Emerald Publishing Limited

The UNWTO asserts that “through the direct, spontaneous and non-mediatized contacts it engenders between men and women of different cultures and lifestyles, tourism represents a vital force for peace and a factor of friendship and understanding among the peoples of the world” ( UNWTO, 2001 ). The concept of “hospitality” even more clearly denotes a moral principle ( Derrida, 2000 ; Lashley and Morrison, 2000 ). However, the ethicality of both these activities is not uncontroversial, as tourism, besides driving international friendship, is also associated with ecologically or socially unsustainable developments; hospitality as a moral act toward a visitor without expectation of recompense has become differentiated from conditioned or transactional hospitality.

Our increasing but understudied desire to travel the world ( Oskam, 2020b ) has spurred an overconsumption that contributes to climate change ( Holden, 2017 ; Dogru et al. , 2019 ), alienation of resident communities ( Harvey, 2012 ; Colomb and Novy, 2017 ; Milano et al. , 2019 ; Oskam, 2020a ), food waste ( De Visser-Amundson, 2020 ; Filimonau and Delysia, 2019 ), excessive water consumption ( Garcia et al. , 2022 ), labor exploitation ( Baum et al. , 2020 ) and social inequality ( Kim et al. , 2016 ; Lashley, 2022 ). Growing attention in academic studies and in professional circles for these issues seems to indicate that tourism and hospitality are not generally seen as intrinsically beneficial to mankind. If there was any doubt about the perceived harmfulness of the industry with its growth rate prior to pandemic, evidence was provided by multiple articles advocating that the 2020 COVID standstill be used for a radical change or “reset” of tourism ( Brouder, 2020 ; Gössling et al. , 2020 ; Gössling and Schweiggart, 2022 ; Hall et al. , 2020 ; Niewiadomski, 2020 ; Prideaux et al. , 2020 ; Sigala, 2020 ).

Besides an evident growth of the problems themselves, with the example of climate change symptoms manifesting themselves with increasing frequency around the world, and a greater awareness among scholars and practitioners, the attention to sustainable business and Corporate Social Responsibility is also the consequence of changing social forces. The private and corporate responsibility to act against pollution, injustice and other negative externalities of their economic activities mirrors the inability of public authorities to constrain the dark sides of market forces, either because they operate at a global, supranational level, or because of a withdrawal of public authorities from their regulatory roles. In this sense, the movement to self-regulate and self-constrain is an expression of neoliberal ethics.

What responsibility does the academic community have in these developments? It can be argued that current research practices favor a reproduction of the same ethical concerns and solutions that have emerged in the corporate environment. If we do not want market driven forces to be the sole agents for social good, the challenge is to not just examine ethical thinking and practices as they exist, but rather provide insights into practices that should exist. The first principle of Responsible Business Research suggests in that regard that the purpose of research is to structure the current knowledge of best practices such that it can help shaping and creating better futures. Business research thereby holds an important social role to observe and address negative consequences of firm actions; innovative research must spur companies toward more responsible practices ( Community for Responsible Research in Business and Management, 2017 ).

Innovation, on the other hand, is traditionally defined in terms of commercial purposes, competitiveness or firm performance ( Lelo de Larrea et al. , 2021 ; Schumpeter, 1934 ). Calls for more sustainable tourism, especially when the definition of the concept started to shift from the prolonged viability of a business to the need to avoid alterations or degradations of the human and physical environment ( Butler, 1999 ), marked the incorporation of ethical concerns as drivers of innovation. However, this shift in academic perspective does not imply that innovation and socially responsible practices are always a logical combination. That there is a tension between the two is illustrated by the debates around automation and employment, about economic growth, wealth distribution and the distribution of negative externalities; or, straightforward, by the observation that innovation is an important predictor of CO 2 emissions ( Umar et al. , 2020 ).

This special issue explores the contradictory links between innovation in tourism and hospitality as an antecedent of ethical issues, and ethical issues as a driver of business innovation. It contains five papers covering a diverse range of ethical issues and innovation in hospitality and tourism including Corporate Social Responsibility, gendered perspectives, ethical leadership, food circularity, pricing, and the fundamental debate about ethicality in business. In An exploration of female underrepresentation on executive boards in the Dutch hotel industry through an ethical lens, Lereculey-Peran, Lombarts and Brannon study gender inequality in Dutch hotel industry executive boards through an ethical female stakeholder framework, finding different gendered perspectives on work-family balance and professional ambitions. With their findings, the authors call for “a wider discussion addressing ethical working conditions for all employees”.

The second paper, The mediating effects of green organizational citizenship on the relationship between green transformational leadership and green creativity: evidence from hotels, by Öğretmenoğlu, Akova and Göktepe, uses a ‘green context’ (i.e. environmentally friendly behaviors) with the focus on the effects of ethical leadership on employees’ creativity. More specifically, they demonstrate how employees’ readiness to voluntarily perform environmentally friendly acts on the work floor (defined as green organizational citizenship in the article) influences this relationship.

The third paper considers food waste and the role of consumers’ ethical judgments. It is written by Li Ding and titled The effects of self-efficacy and collective efficacy on customer food waste reduction intention: the mediating role of ethical judgment . Using a restaurant context, the paper shows that consumers’ food waste reduction intentions (FWRI) are positively influenced by their perceived self-efficacy and collective efficacy toward reducing food waste. Importantly, she also finds that these relationships are mediated by the ethical judgment of the study participants. This means consumers’ perception of how ethically a restaurant influences their FWRI through a pathway of both self and collective efficacy (i.e. the belief of how effective one's own actions and actions by society in general against food waste).

So far, the angle has been: what are the outcomes of ethically motivated behavior? The fourth contribution to this special issue ventures into the ethical effects of innovation. Computerized pricing algorithms are an example of innovations that may lead to perhaps unforeseen or unintended ethical consequences. Discriminatory pricing inflicts a harm for which regulatory frameworks are unprepared. In their viewpoint paper on Algorithmic pricing in hospitality and tourism: call for research on ethics, consumer backlash and CSR , Van der Rest, Sears, Kuokkanen and Heidary detect a research gap around the embeddedness of pricing fairness in studies of CSR, arguing that more research is needed on the moral and reputational consequences of algorithmic pricing, and on the development of a consumer impact metrics to be incorporated into the customer-focused sections of CSR reporting standards.

Finally, in A systematic review of ethical issues in hospitality and tourism innovation , the authors give an overview of the state-of-the-art in studies of the overlap of ethical issues and innovation in the hospitality and tourism discipline. The review detects that a methodological bias towards a quantification of the effects of ethical innovations leads to an instrumentalization of the underlying principles; in other words, the dominant question becomes: “what is this ethical behavior good for?” At the same time, the authors argue that the overview would not be complete if the numerous studies that refer to ethical issues without phrasing it in those terms would remain excluded. The imbalances in the study of the topic call for more scholarly attention to future ethical consequences of business innovations in hospitality and tourism.

Baum , T. , Mooney , S.K. , Robinson , R.N. and Solnet , D. ( 2020 ), “ COVID-19’s impact on the hospitality workforce–new crisis or amplification of the norm? ”, International Journal of Contemporary Hospitality Management , Vol. 32 No. 9 , pp. 2813 - 2829 .

Brouder , P. ( 2020 ), “ Reset redux: possible evolutionary pathways towards the transformation of tourism in a COVID-19 world ”, Tourism Geographies , Vol. 22 No. 3 , pp. 484 - 490 .

Butler , R.W. ( 1999 ), “ Sustainable tourism: a state‐of‐the‐art review ”, Tourism Geographies , Vol. 1 No. 1 , pp. 7 - 25 .

Colomb , C. and Novy , J. ( 2017 ), Protest and Resistance in the Tourist City , Routledge , London/New York .

Community for Responsible Research in Business and Management ( 2017 ), “ A vision of responsible research in business and management: striving for useful and credible knowledge ”, Position Paper , Erasmus University , Rotterdam , available at: https://datarepository.eur.nl/articles/preprint/A_Vision_of_Responsible_Research_in_Business_and_Management_Striving_for_Useful_and_Credible_Knowledge/11302577 ( accessed 27 April 2022 ).

De Visser-Amundson , A. ( 2020 ), “ A multi-stakeholder partnership to fight food waste in the hospitality industry: a contribution to the United Nations Sustainable Development Goals 12 and 17 ”, Journal of Sustainable Tourism . doi: 10.1080/09669582.2020.1849232 .

Derrida , J. ( 2000 ), Of Hospitality , Stanford University , Stanford .

Dogru , T. , Marchio , E.A. , Bulut , U. and Suess , C. ( 2019 ), “ Climate change: vulnerability and resilience of tourism and the entire economy ”, Tourism Management , Vol. 72 , pp. 292 - 305 .

Filimonau , V. and Delysia , A. ( 2019 ), “ Food waste management in hospitality operations: a critical review ”, Tourism Management , Vol. 71 , pp. 234 - 245 .

Garcia , C. , Deyà-Tortella , B. , Lorenzo-Lacruz , J. , Morán-Tejeda , E. , Rodríguez-Lozano , P. and Tirado , D. ( 2022 ), “ Zero tourism due to COVID-19: an opportunity to assess water consumption associated to tourism ”, Journal of Sustainable Tourism . doi: 10.1080/09669582.2022.2079652 .

Gössling , S. and Schweiggart , N. ( 2022 ), “ Two years of COVID-19 and tourism: what we learned, and what we should have learned ”, Journal of Sustainable Tourism , Vol. 30 No. 4 , pp. 915 - 931 , doi: 10.1080/09669582.2022.2029872 .

Gössling , S. , Scott , D. and Hall , C.M. ( 2020 ), “ Pandemics, tourism and global change: a rapid assessment of COVID-19 ”, Journal of Sustainable Tourism , Vol. 29 No. 1 , pp. 1 - 20 , doi: 10.1080/09669582.2020.1758708 .

Hall , C.M. , Scott , D. and Gössling , S. ( 2020 ), “ Pandemics, transformations and tourism: be careful what you wish for ”, Tourism Geographies , Vol. 22 No. 3 , pp. 577 - 598 .

Harvey , D. ( 2012 ), Rebel Cities: from the Right to the City to the Urban Revolution , Verso Books , London/New York .

Holden , A. ( 2017 ), “ Mass tourism and the environment: issues and dilemmas ”, in Harrison , D. and Sharpley , R. (Eds), Mass Tourism in a Small World , CABI , Wallingford, OH , pp. 75 - 84 .

Kim , N. , Song , H. and Pyun , J.H. ( 2016 ), “ The relationship among tourism, poverty, and economic development in developing countries: a panel data regression analysis ”, Tourism Economics , Vol. 22 No. 6 , pp. 1174 - 1190 .

Lashley , C. (Ed.) ( 2022 ), in Prejudice and Discrimination in Hotels, Restaurants and Bars , Routledge , London .

Lashley , C. and Morrison , A. (Eds) ( 2000 ), In Search of Hospitality. Theoretical Perspectives and Debates , Butterworth-Heinemann , Oxford .

Lelo de Larrea , G. , Altin , M. , Koseoglu , M.A. and Okumus , F. ( 2021 ), “ An integrative systematic review of innovation research in hospitality and tourism ”, Tourism Management Perspectives , Vol. 37 , 100789 .

Milano , C. , Cheer , J.M. and Novelli , M. ( 2019 ), Overtourism: Excesses, Discontents and Measures in Travel and Tourism , CABI .

Niewiadomski , P. ( 2020 ), “ COVID-19: from temporary de-globalisation to a re-discovery of tourism? ”, Tourism Geographies , Vol. 22 No. 3 , pp. 651 - 656 .

Oskam , J. ( 2020a ), The Overtourism Debate: NIMBY, Nuisance, Commodification , Emerald , Bingley .

Oskam , J. ( 2020b ), “ The will to travel ”, in Oskam , J. (Ed.), The Overtourism Debate: NIMBY, Nuisance, Commodification , Emerald , Bingley , pp. 43 - 58 .

Prideaux , B. , Thompson , M. and Pabel , A. ( 2020 ), “ Lessons from COVID-19 can prepare global tourism for the economic transformation needed to combat climate change ”, Tourism Geographies , Vol. 22 No. 3 , pp. 667 - 678 .

Schumpeter , J.A. ( 1934 ), The Theory of Economic Development; an Inquiry into Profits, Capital, Credit, Interest, and the Business Cycle , Harvard University Press , Cambridge, MA .

Sigala , M. ( 2020 ), “ Tourism and COVID-19: impacts and implications for advancing and resetting industry and research ”, Journal of Business Research , Vol. 117 , pp. 312 - 321 .

Umar , M. , Ji , X. , Kirikkaleli , D. and Xu , Q. ( 2020 ), “ COP21 Roadmap: do innovation, financial development, and transportation infrastructure matter for environmental sustainability in China? ”, Journal of Environmental Management , Vol. 271 , 111026 .

UNWTO ( 2001 ), Global Code of Ethics for Tourism , United Nations , New York (accessed 16 June 2022) .

Related articles

We’re listening — tell us what you think, something didn’t work….

Report bugs here

All feedback is valuable

Please share your general feedback

Join us on our journey

Platform update page.

Visit emeraldpublishing.com/platformupdate to discover the latest news and updates

Questions & More Information

Answers to the most commonly asked questions here

Ethical issues in tourism and hospitality during the pandemic: Expert panel

The Canadian Centre for Ethics & Corporate Policy presents a panel on ‘Ethical Issues in Tourism and Hospitality During the Pandemic.’

On Tuesday, February 15, 2022, from 1:00-2:00 p.m., the Canadian Centre for Ethics & Corporate Policy will present a panel of leaders in the Tourism and Hospitality sector to discuss ‘Ethical Issues in Tourism and Hospitality During the Pandemic.’ The COVID-19 pandemic has highlighted a number of ethical issues for these industries, including: - The health and safety of front-line hospitality and tourism workers, including mental health concerns. - Fair compensation of hospitality and tourism workers for additional risks and responsibilities. - COVID precautions (health) for customers of hotels and restaurants. - Customers cancelling reservations have expected refunds to be full and swift, which has not always happened. - Front-line workers may have been asked to enforce COVID-related restrictions on customer behaviour. - Job security for front-line workers as a challenge, as restaurants and hotels shift gears, adapted, and in many cases closed either temporarily or permanently. - The changing role of “gig economy” workers in these industries - Vaccination policies and other precautions when government policy & public-health guidance has varied.

Register for this webinar HERE .

Trending Now

Susie grynol resigns from hac, appointed vp at marriott international.

The Hotel Association of Canada (HAC) has announced the resignation of Susie Grynol from her position as president and CEO, effective June 3rd, 2024

Distinguished women leaders within the Canadian hotel sector

To commemorate International Women’s Day 2024, Choice Hotels Canada presents the remarkable journeys of four distinguished women leaders within the Canadian hotel sector. Their stories of resilience, innovation, and…

Introducing TOOR Hotel, a new urban boutique hotel

Canadian hotelier, Sukhdev Toor has announced details about the first TOOR Hotel, a distinct lifestyle hotel and residence coming very soon to downtown Toronto.

Marriott International appoints new senior leaders to Canadian team

Marriott International has appointed Susie Grynol and Keri Robinson to its Canadian senior leadership team.

Keeping hotel industry professionals, from franchisees to operations managers to executives to suppliers, in the know with the latest stories and developments every week.

Subscribe for free to receive STAY news.

Click through the PLOS taxonomy to find articles in your field.

For more information about PLOS Subject Areas, click here .

Loading metrics

Open Access

Peer-reviewed

Research Article

Roboethics of tourism and hospitality industry: A systematic review

Roles Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing

Affiliation Belt and Road International School, Guilin Tourism University, Guilin, Guangxi, China

Roles Resources, Software, Validation

Affiliation International Hospitality Management, Taylor’s University, Subang Jaya, Malaysia

Roles Data curation, Investigation, Validation, Visualization

Affiliation College of Business and Economics, The Australian National University, Canberra, Australia

Roles Conceptualization, Formal analysis, Funding acquisition, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations School of Hospitality Management, Guilin Tourism University, Guilin, Guangxi, China, School of Hospitality, Tourism and Events, Taylor’s University, Subang Jaya, Malaysia

• Jinsheng Jason Zhu, 
• Zhiyong Liu, 
• Tairan Huang, 
• Xue Shirley Guo

• Published: June 30, 2023
• https://doi.org/10.1371/journal.pone.0287439
• Reader Comments

This study aims to give a comprehensive analysis of customers’ acceptance and use of AI gadgets and its relevant ethical issues in the tourism and hospitality business in the era of the Internet of Things. Adopting a PRISMA methodology for Systematic Reviews and Meta-Analyses, the present research reviews how tourism and hospitality scholars have conducted research on AI technology in the field of tourism and the hospitality industry. Most of the journal articles related to AI issues published in Web of Science, ScienceDirect.com and the journal websites were considered in this review. The results of this research offer a better understanding of AI implementation with roboethics to investigate AI-related issues in the tourism and hospitality industry. In addition, it provides decision-makers in the hotel industry with practical references on service innovation, participation in the design of AI devices and AI device applications, meeting customer needs, and optimising customer experience. The theoretical implications and practical interpretations are further identified.

Citation: Zhu JJ, Liu Z, Huang T, Guo XS (2023) Roboethics of tourism and hospitality industry: A systematic review. PLoS ONE 18(6): e0287439. https://doi.org/10.1371/journal.pone.0287439

Editor: Tomo Popovic, University of Donja Gorica, MONTENEGRO

Received: December 21, 2022; Accepted: June 6, 2023; Published: June 30, 2023

Copyright: © 2023 Zhu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper.

Funding: The corresponding author has been participating in research projects with the title of ‘The Factors Influencing Customers' Use of Smart Devices in Guangxi Hotel Industry in the Post-epidemic Era’ supported by Guilin Tourism University in Guangxi, China. The project No. is S202211837095. This article is part of academic achievements of first-class universities and disciplines in tourism management discipline (project) in Guangxi, China. The corresponding author has also been participating in research projects supported by Guilin Tourism University-China ASEAN Research Centre. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Many individuals believe that Industry 4.0 might be characterized by the increased adoption of networking technologies and intelligent automation in current organizations. An innovation paradigm for the advancement of technology seems to be developing [ 1 , 2 ], one that incorporates automated machine learning [ 3 , 4 ], deep learning [ 5 , 6 ], nanodevices [ 7 , 8 ], quantum physics [ 9 – 11 ], and self-driving automobiles [ 12 ]. As a result of developments such as technology and time/space compression [ 13 , 14 ], how we communicate and cooperate in the future will be different. It is projected that both the capabilities and performance of artificial intelligence (AI) will continue to develop in the coming years, making it one of the technologies that are considered cutting-edge [ 15 , 16 ].

AI was predicted by practitioners in the hotel business professionals that its application can enhance both the quality of services provided and the experiences provided to customers. They had high hopes that the AI they had implemented would be beneficial to their management and operations. Despite the fact that a growing number of hospitality organisations have adopted AI devices [ 17 , 18 ], customers’ interest in and use of AI gadgets is lower than anticipated [ 19 , 20 ]. Acceptance by users is the determining factor in the successful adoption of any brand-new technology [ 21 ]. To avoid losing money on AI investments and make the most of the opportunities presented by its use, experts in the hospitality industry need to investigate the factors that influence the acceptance and use of AI devices by customers [ 22 ].

To minimise unnecessary AI investments and maximise the potential benefits of AI incorporation, hospitality professionals should investigate factors that influence the acceptance and use of AI devices by customers. As more and more applications are found for artificial intelligence, researchers have begun paying a lot more attention to AI’s underlying difficulties. Initially, AI research was carried out by engineers, who mostly concentrated their efforts on AI design challenges [ 23 ]. These concerns included AI appearance, mapping, picture recognition, and other similar topics. A social science flavour has only recently been added to artificial intelligence research, which focuses on human-AI interaction, user perceptions, and acceptance of AI devices as service providers. This is a relatively new development, as social science researchers have only recently begun entering the field [ 24 – 29 ]. Research into artificial intelligence is still in its immaturity as a direct result of the comparatively short history of AI deployment. In artificial intelligence studies with a social science perspective, a significant amount of emphasis is focused on doing conceptual and descriptive research [ 27 ]. The development of a theoretical framework for the use of AI devices and the decision-making process was the primary emphasis of this research [ 30 , 31 ]. These studies analysed previous work done in the field of artificial intelligence device implementation literature (such as research on service robots), with the objectives of providing an explanation for the phenomenon of AI adoption and identifying suitable future study fields [ 32 ]. The preponderance of research conducted to understand the phenomena of AI adoption has been conducted from the service provider’s perspective. These studies have mostly examined the usage and effects of AI devices on the operation and administration of service providers, including cost reduction [ 33 ], investments [ 34 ], workforce management [ 35 , 36 ], as well as work environments [ 37 , 38 ]. These results should be taken with an amount of caution since there hasn’t been a great deal of study on how people react to and employ AI devices.

Research methodology adopted

By focussing on a larger number of tourist and hospitality journals, the purpose of this investigation was to find a way around the constraint previously mentioned. Preferred Reporting Items for Systematic Reviews and Meta-Analyses, or PRISMA for short, is a further addition to this research endeavour [ 39 ]. In the field of medicine, this specific approach to systematic practice is extensively well-known and respected [ 40 ]. However, scholars and academics in the tourism industry rarely use it, except for some outstanding literature [ 41 , 42 ]. In particular, this study investigates whether or not the PRISMA checklist items have been used in any systematic reviews that have been carried out in the field of tourism and hospitality by assessing the items on the checklist. Because of this, the author’s awareness of the methods that tourism academics use when doing systematic reviews has been one of the major contributions as a result of this study. This study will provide researchers with criteria for performing a suitable-practice systematic review and pave the route for the authors to use PRISMA in the current study. Importantly, this paper provides a complete analysis of the systematic evaluations that have been published in journals dealing with hospitality and tourism themes (see Fig 1 below). This underrepresentation of the tourism and hospitality themes was the primary impetus for the decision of delving into a such research topic. This current comprehensive analysis of review papers in this paper provides more illumination on a variety of domains of roboethics knowledge as an outcome of the research endeavour.

• PPT PowerPoint slide
• PNG larger image
• TIFF original image

(Source: the authors’ own elaboration) (Keywords: human / computer / interaction / hospitality / tourism / ethics, each of the words shown in different research endeavour).

https://doi.org/10.1371/journal.pone.0287439.g001

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines [ 43 , 44 ]. The author conducted a detailed search for previously published systematic reviews that were included in hospitality and tourism journals. Using a dataset produced from this summary, this study was analysed to determine the level of quality of systematic reviews conducted in the hospitality and tourist industry. In the current study, the PRISMA reporting checklist parts that are utilized to carry out systematic reviews in the social sciences are broken down, and more explanation is provided [ 39 , 45 , 46 ]. A protocol was prepared in advance to record the analytic process and inclusion criteria for the primary dataset [ 47 – 49 ]. Web of Science, ScienceDirect.com and the journal websites were used to search for articles published in tourism and hospitality journals of high quality that had reviews in their titles, abstracts, and/or keywords relating to a systematic review, tourism, hospitality, AI, robot, ethic(s) and human-computer interaction (see Fig 2 below for its keyword co-occurrence frequency outcome). The paper selection criteria are listed as follows.

• Selected data must be related to robot ethics-themed articles and reviews on the tourism and hospitality industry.
• Sources other than the English language have been excluded in the systematic review of the current paper.
• Papers not related to human-robot interactions are excluded.
• There is no time limit for the selected papers in the current study.

(Source: our elaboration from the VOSviewer software).

https://doi.org/10.1371/journal.pone.0287439.g002

For instance, since August 2022, the investigation has been continuing until the formal draught of the manuscript has been produced. The information that was found in the identified entries’ previously released articles was transferred to a database created in Microsoft Excel. The evaluation of the title and abstract was completed independently by the first author and the corresponding author of the current paper. Subsequently, the whole content of the selected papers was scrutinised in light of the qualification requirements. In particular, the author looked at studies that found relevant material by exploring several sources using a set of phrases that had already been determined.

Accordingly, the allocation of scientific publications per publishing year was subsequently constructed. Fig 3 depicts the progression of academic output on the specified subject across the whole period of time between 1987–2022. In the early phases of implementation, there were very few publications. From 1987 through 2017, a small number of papers were recorded annually, except for the year 2011, when three pieces were published. In the years between 2018 and 2022, the quantity of chosen topics grew rapidly and substantially. Regarding 2022, it needs to be understood that it is continuing, therefore, the 20-article data shown is not conclusive. Therefore, the increasing tendency of previous years and the substantial number of papers will continue to exhibit a culminating tendency of expansion. Human-computer interaction and robotethics concerns in the tourist and hospitality industry have attracted a growing amount of attention in recent years, as shown by a rising trend identifying the last few years as being increasingly more productive and diversified.

(Source: Authors’ elaboration).

https://doi.org/10.1371/journal.pone.0287439.g003

Researchers’ attention to AI adoption

The term artificial intelligence (AI) is used to describe computer programmes that simulate human intelligence in judgment by combining complex software and hardware components with massive data [ 50 ]. Alternately, artificial intelligence (AI) can be understood as the capacity of a system to accurately interpret sensory stimuli, acquire new knowledge, and apply such knowledge learned to accomplish original objectives in an adaptive approach [ 51 ]. As more and more applications are found for artificial intelligence, researchers have begun paying a lot more attention to AI’s underlying difficulties [ 52 – 55 ]. Research on artificial intelligence (AI) was first carried out by engineers, who primarily focused their efforts on AI design challenges such as the appearance of AI, cartography, visual identification, and other similar topics [ 23 , 55 ]. A sociology flavour has only recently been incorporated into computational intelligence, which concentrates on human and AI interplay, perceived utility, as well as the acquiescence of AI technologies as service suppliers. This is a relatively new development, as sociologists have only barely started entering the domain [ 20 , 27 , 28 ]. AI research is ongoing in its early stages as a result of the relatively shorter history of AI implementation in human history. The artificial intelligence research that took a social science perspective placed a strong emphasis on theoretical and implementation studies that are geared toward conceiving how AI devices are employed and how decisions are made [ 56 , 57 ]. They described the phenomenon of AI interaction with AI-facilitated systems and proposed future research fields [ 58 , 59 ]. These studies have focused primarily on the use of AI devices and the effects these devices have had on the management and operation of the service provider’s business, such as cost-benefit balancing [ 60 ], operational functions [ 61 ], job opportunities [ 62 , 63 ], staff competencies enhancing [ 64 ], and facility designs [ 65 – 67 ], among others. The bulk of research conducted to understand the phenomena of AI adoption has been conducted from the service provider’s perspective, while these findings should be taken with a smidgen of scepticism since there has not been a great deal of study on how people react to and employ AI devices. There are three distinct ways that ethics might be interpreted in the robotics discipline [ 68 , 69 ], which include the moral codes that are programmed in robotics, the ethics of individuals who build while using robots, and the morality of how people interact with automatons. The works of literature pertaining to robot ethics in service would be included in the systematic review in order to further delve into these ethical themes concerning the service business, particularly in the tourism and hospitality industry.

AI applications in service areas

Despite the fact that conventional interactions between consumers and human employees continue to be the norm, artificial intelligence has gained prominence in recent years [ 70 ]. Artificial intelligence enables robotics to tackle issues in a manner equal to that of humans by incorporating human characteristics into complex algorithms. Consequently, using deep learning algorithms, artificial intelligence systems may be able to assist companies in creating customised offers based on prior client requests and preferences. AI is permeating several businesses, notably the service industries, because of its profit-enhancing potential and technical developments. As artificial intelligence technology has advanced and digital marketing has become more important, businesses in a wide variety of service industries, such as healthcare coverage, financial services, general merchandise, healthcare, youth development, commuting, tourist activities, and hotel management, have integrated AI devices into their service provision and operational processes [ 71 , 72 ]. The devices with AI technologies can provide services in various ways. Opinion mining [ 73 ], which is propelled by AI technologies such as natural language processing, has the potential to discover and automatically assess the perspectives of travellers on the qualities of items sold in the tourism industry. Chatbots and messaging that are driven by AI are being used by firms that provide Smart Support to enhance both functional and technical support operations [ 74 , 75 ]. Recommender systems that are powered by artificial intelligence are used to provide visitors with a list of activities that are tailored to their preferences and requirements [ 76 ]. Robots and service automation techniques such as delivery robots, chatbots, robot-concierges, and self-service kiosks have been utilized to enhance corporate performance and customer service in the hotel business [ 77 , 78 ]. It has begun to get substantial attention as a result of the growth in the number of AI-powered solutions that are used in the service delivery process.

Ethics issues of AI and roboethics

Lin et al. [ 79 ] outline the increasing presence of robotics in humanity, from safety to sexuality, and examine the myriad of ethical and societal difficulties. In the study, Lin classifies these issues into three key areas, such as security and faults, laws and ethics, and the interplay of social relationships. Malle [ 80 ] gives a framework that specifies what a normatively competent automaton would entail, which is commonly referred to as computer morality, in an attempt to more effectively merge the morals of robot operation in society. In the meantime, examine a variety of ethical concerns that reflect the deployment, utilization, and therapeutic interventions of such ethical androids in social structures. Such a topic is typically referred to as robot ethics. Meanwhile, Vanderelst and Winfield [ 81 ] present a strategy for programming robots with ethical conduct based on the simulation theory of cognition. As a philosophical study, it gives a theoretical perspective; nevertheless, no practical proposals are provided addressing which robots should bear responsibility in which situations or how rules for the responsible use of robots need to be created. The best approach to robot ethics, according to Asaro [ 69 ], is one that covers all of the ethical difficulties involved with robot ethics, and in order to do so, it must consider that robots are serving in a societal-technical system. Danaher [ 82 ] attempts to illustrate and expand the concept that robot processing is a guideline to the ethics of robotics by using prior work on robotic morality as a basis. Following these, Burton et al. [ 83 ] continue to give AI instructors and programmers case studies and linkages to service providers and service resources. While expressing and agreeing on ethical concepts for robots is essential, it is simply the beginning of comprehending the social structure of robotic ethics [ 84 , 85 ]. Comparisons with the field of robot ethics shed light on some of the limitations of theories, including the fact that they are at times much too comprehensive and theoretical to interpret ethics in practice. In what is intended to be a quasi-examination, compare and contrast a wide range of ethical standards by highlighting both their similarities and their differences [ 86 ]. To get an understanding of the role that checklists play in AI ethics. It is important to concentrate on fairness while engaging in an iterative design process with a few AI practitioners. Siau and Wang [ 87 ] investigate the ethics of artificial intelligence by analysing AI ethics in modern times. Their principal innovation is a theoretical analysis of the field at a higher-level abstraction, in which they offer core concepts, outline methodology, and discuss critical concerns in AI ethics.

Different views on AI adoption in the tourism and hospitality industry

As a result of the growing prevalence of artificial intelligence (AI) technologies and artificial intelligence gadgets within the hospitality sector, the customer and provider possess distinct points of view regarding the utilization of AI [ 75 , 88 – 90 ]. From the point of view of service suppliers, artificial intelligence gadgets have the potential to enhance businesses’ productivity, effectiveness, and security reduced expenses, improve quality service, facilitate a sustainable workforce with synergic collaboration between human staff and AI-given service, and enhance employee satisfaction, thereby improving employees’ overarching well-being of all stakeholders in the tourism and hospitality businesses [ 91 , 92 ]. Although some enterprises are aware that the initial investment necessary for AI technologies may be rather significant, they are nonetheless excited to incorporate these technologies within hospitality businesses [ 17 , 93 ]. According to the uncanny valley theory [ 94 , 95 ], which is a graphic depiction of the relationship between human people’s affinity and AI devices’ realism (i.e. similarity to humans), the devices’ realism increases as the degrees of human individuals’ affinity and acceptance for AI devices increase. In other words, the greater the capacity of people to accept and identify with AI gadgets, the more realistic they look.

Clients might well have conflicting opinions about the adoption and usage of AI gadgets in the hotel industry. On the one hand, some current existing researches suggest that AI gadgets may increase consumers’ perceptions of service excellence and reliability, hence increasing their acceptance of their usage in accommodation facilities [ 96 , 97 ]. The usage of AI in the hospitality business may change the way that visitors evaluate and appreciate the services offered by hotels [ 23 , 98 ]. It is indeed possible that AI devices will improve customers’ experiences. Customers are willing to accept and make use of AI devices in the hotel business [ 99 ]. On the other hand, however, the level of acceptance and use differs depending on the service that AI gadgets deliver. Not every customer is exhilarated by anticipating the bright future of AI devices. There is still a major crowd of customers, who continually show strong resistance to accepting and using AI devices in the hospitality industry. Customers who use AI gadgets express feeling isolated while using adopting computer-mediated communications as a consequence of the reduced opportunity for social connection, which ultimately results in their decision to forego the utilization of high-tech devices [ 100 ]. Customers perceive that the hospitality industry should place more of an emphasis on human value as opposed to robotic value [ 101 , 102 ]. In particular, they believe that luxury hotels and hotels that do employ robotic services should place a greater emphasis on the experience guests have while staying at their properties.

Moreover, the perceived human-likeness perceived intelligence and perceived danger including privacy, safety, and security problems might influence consumers’ adoption and usage of AI gadgets in the hotel industry [ 103 ]. Some users believe that the humanlike characteristics of AI products might undermine their human identity [ 104 ]. When the level of realism of AI devices hits a certain limit, the affinity connecting humans and AI gadgets will decline substantially, resulting in unexpected feelings, or even perceptions of risks [ 105 , 106 ]. Customers may be hesitant to adopt AI technology because of anxiety that humans may lose their individuality to humanoids, causing hotel technology resistance [ 107 – 109 ]. Many consumers who are unwilling to accept and employ AI technologies are also concerned about their privacy [ 110 ]. AI devices equipped with machine intelligence are regarded as an effective method for increasing the customer experience, since they utilize significant consumer data to anticipate their needs and tailor their services. Customers are reluctant to share or expose their personal information with hospitality service suppliers. When customers discover that service providers surreptitiously collect, store, and use their personal information, they may feel increasingly less secure. For instance, some customers may disapprove if a hotel monitors everything they do throughout their stay, including what customers watch on television and what people eat [ 111 ]. Individuals may feel worried about their privacy being violated, despite the fact that such information would be used to produce better-tailored customer service. Tourism and hospitality businesses and their clients will be affected by security breaches.

Tensions in roboethics in the tourism and hospitality industry robot-adoptions

Customers’ perceptions of the adoption and utilization of AI gadgets vary from optimism over the enhancement of their experience to the anxiety of an automated society [ 15 , 112 ]. In addition, existing technology acceptance theories have been used to investigate the acceptability of AI gadgets by consumers and their employment in service settings [ 113 – 115 ]. Because these theories were designed to explain the acceptance and usage of non-intelligent technology gadgets, several researchers suggested that they may not be suitable to investigate consumers’ acceptance and use behaviour in the setting of AI devices [ 116 , 117 ]. Since AI devices have unique intelligent natures that are significantly different from non-intelligent technologies devices such as humanlike mindsets that require fewer customers’ learning to operate the devices, which makes the ease of use as core constructs in traditional technology acceptance models irrelevant to explain the drivers of customers’ acceptance and use of AI devices [ 118 ].

In addition, the previous study has investigated the acceptance and use of AI devices by customers in a variety of service settings [ 119 , 120 ]. According to the findings of previous studies, the varying degrees of services and the nature of utilitarianism and hedonism may vary from one service to another [ 121 , 122 ]. This difference has the potential to have a significant impact on the expectations of consumers and the hotel products the consumers intend to purchase. Customers in the hospitality business seem to have higher expectations of hedonic value (that is, enjoyable and unique experiences) than those in other service industries. Additionally, in comparison to other types of organizations, the hospitality sector has far more frequent interactions between customers and employees [ 123 ].

Roboethics in tourism and hospitality amid the COVID-19

Coronavirus disease 2019 (abbreviated as COVID-19) is swiftly disseminated over the globe through human pathogens [ 124 – 126 ]. The pandemic has prompted a massive worldwide public health push to reduce social interactions and increase clear distance. Numerous ideas demonstrate that unpredictability and poor consistency not only endanger people’s choices of physical health, but also their mental health, particularly in the psychological and cognitive domains (see Fig 4 for the keyword co-occurrence map). After a crisis, customers’ conduct will alter [ 127 – 129 ]. Previously, researchers have observed that customers’ acceptance and use of AI devices in the hospitality business are not promising due to the customers’ desire for personalized amenities with actual staff members [ 130 – 132 ]. History demonstrates that technological innovation and advancement may aid in disaster or crisis management [ 133 ]. For instance, robots were used in the 2011 Fukushima nuclear plant disaster [ 134 ]. In three major areas, including health treatment, logistics, and reconnaissance, robotics may aid the pandemic [ 135 ]. In hospitals, airports, transportation systems, recreation and scenic areas, hotels, restaurants, and communities in general, AI devices such as robots, autonomous vehicles, and drones have played a significant role in managing the potential spread of COVID-19 [ 136 , 137 ]. They are responsible for delivering items, disinfecting and sterilizing public spaces, detecting or measuring body temperature, providing safety or security, and comforting and entertaining patients and customers [ 133 ]. The quick growth of robots, automation, and artificial intelligence (AI) is anticipated to impact and revolutionize many facets of the hotel and service sectors, particularly after COVID-19.

(Source: our elaboration).

https://doi.org/10.1371/journal.pone.0287439.g004

When the COVID-19 pandemic is still underway, the public has also been made aware of the advantages that AI gadgets may provide in terms of facilitating the preservation of social distance and minimizing the danger of infection. During the COVID-19 public health disaster, it is probable that hotel consumers may be increasingly keen to utilize AI devices [ 138 , 139 ]. Customers may utilize self-service technology to check in or check out, get service information through chatbots, enjoy hotel amenities offered by service robots, and modify the room’s amenities via smart systems. In light of the fact that the production of the vaccine has not yet reached full maturity, there is an urgent need to conduct an empirical study to determine how customers’ perceptions of the threat posed by COVID-19 affect their willingness to accept and utilize AI devices in the hospitality industry. Due to the extremely infectious nature of COVID-19, maintaining a safe social distance between individuals has proved to be an effective method of preventing viral infections [ 140 , 141 ]. The pandemic has prompted a massive worldwide public health push to preserve social distance by reducing direct human-to-human contact and high physical distances. These practices of social distance have had a significant influence on businesses that depend heavily on human connection, such as hospitality and tourism, which are suffering severely during this era [ 142 , 143 ].

Discussion and conclusion

This study employed a systematic review following the PRISMA guidelines to provide a comprehensive knowledge of AI adoption in the hospitality industry and its relevant ethical issues. According to the PRISMA guidelines, the inclusion criteria and data collection process are explained. The present research examined 89 relevant research articles from prestigious databases such as Web of Science and ScienceDirect.com, as well as journal websites. The paper presents a keyword co-occurrence map and the number of published papers per publishing year to provide an overview of the AI research papers’ landscape in hospitality. The study identified six research domains related to the publication themes, highlighting the advantages and complexities of AI technology in the hospitality industry. It summarizes the applications of AI in service areas and discusses different views on AI adoption from the perspectives of service providers and customers in the tourism and hospitality industry. Furthermore, it also references various studies that have explored the ethical implications of AI in the hospitality industry. The ethical issues related to AI adoption such as resistance by employees, competition with rivals, and legal issues are identified. which are essential and not frequently raised in publications. The paper contributes to the existing literature by providing a comprehensive analysis of AI adoption in the hospitality industry and emphasizing the need for further research in understanding the roboethics issues for AI adoption. The insights gained from this study can help hospitality professionals make informed decisions regarding AI investments and ensure the optimal utilization of AI technologies in their operations.

Theoretical implications

The literature review included in this study suggests that the tourism and hospitality-related publications have developed in terms of not only a rise in volume but also a growing diversity of topics. However, significant research gaps and under-researched areas in the tourism industry were also revealed. Future studies should investigate more complicated smart environments in which robots interact simultaneously with other robots and people, as they become more autonomous and interconnected with the Internet of Things (IoT). In addition, interdisciplinary research collaborations are required to provide more robust and widespread research on AI technology. Future studies on human concerns should include replication studies to examine the effects of robots on the tourism and hospitality experience and the attitudes, requirements, and hopes/fears of staff. The integration of robots into the behaviours of customers and service staff in the tourism and hospitality industry should be examined concerning morality and ethics.

Practical implications

This research provides managers and marketers in the hotel industry with essential information to establish appropriate AI device investment and adoption strategies. It aids in increasing their understanding of consumers’ motivations for utilizing AI devices, proposing business strategies for planning, operating, and marketing their businesses, and enhancing customer experience using AI devices. It also enables hotel managers to strike a balance between the increased value-added requests of consumers, the technological advancement of the business, and the high danger of disease transmission.

Limitations

The present research has two limitations. First, the theoretical framework and research findings used in this study are restricted to the present era. Second, the data collection approach will consist of conducting a systematic review of a larger base of hotel research to determine their acceptance and usage of AI devices based on their views. Thus, the findings may vary significantly if the sample consists of actual hotel guests who have stayed in specific hotels that offer service through AI gadgets.

Future research implications

As AI technology rapidly advances, customers’ adoption and usage of AI products may alter drastically in the near future. Therefore, it will be important to develop a theoretical framework that encompasses the nature of AI variables in the future to predict the factors that impact consumer acceptance and use of AI devices and the relevant ethical issues that AI created should be laid stress by future research.

• View Article
• Google Scholar
• 5. Goodfellow I, Bengio Y, Courville A. Deep learning. MIT press; 2016.
• PubMed/NCBI
• 9. Le Bellac M. Quantum physics. Cambridge University Press; 2011.
• 10. Piron C. On the foundations of quantum physics. In: Quantum mechanics, determinism, causality, and particles. Springer; 1976. p. 105–16.
• 11. Zeilinger A. Experiment and the foundations of quantum physics. In: More Things in Heaven and Earth. Springer; 1999. p. 482–98.
• 13. Giddens A. The Consequences of Modernity. Redwood City: Stanford University Press; 1990. 204 p.
• 15. Barrat J. Our final invention: Artificial intelligence and the end of the human era. Macmillan; 2013.
• 29. Tussyadiah IP, Park S. Consumer Evaluation of Hotel Service Robots. In: Stangl B, Pesonen J, editors. Information and Communication Technologies in Tourism 2018. Cham: Springer International Publishing; 2018. p. 308–20.
• 45. Galeazzi C, Sacchetti A, Cisbani A, Babini G. The PRISMA program. In: IGARSS 2008–2008 IEEE International Geoscience and Remote Sensing Symposium. IEEE; 2008. p. IV–105.
• 60. Geary T, Danks D. Balancing the benefits of autonomous vehicles. In: Proceedings of the 2019 AAAI/ACM Conference on AI, Ethics, and Society. 2019. p. 181–6.
• 64. Barykin S, Borovkov A, Rozhdestvenskiy O, Tarshin A, Yadykin V. Staff competence and training for digital industry. In: IOP Conference Series: Materials Science and Engineering. IOP Publishing; 2020. p. 012106.
• 69. Asaro P, Wallach W. Introduction: The Emergence of Robot Ethics and Machine Ethics. In: Machine Ethics and Robot Ethics. Routledge; 2020. p. 1–15.
• 77. Kaliappen N, Hassan A. Digital Trends in Asian Hotel Industry. In: Technology Application in Tourism in Asia. Springer; 2022. p. 147–63.
• 84. Whittlestone J, Nyrup R, Alexandrova A, Cave S. The role and limits of principles in AI ethics: towards a focus on tensions. In: Proceedings of the 2019 AAAI/ACM Conference on AI, Ethics, and Society. 2019. p. 195–200.
• 86. Madaio MA, Stark L, Wortman Vaughan J, Wallach H. Co-designing checklists to understand organizational challenges and opportunities around fairness in AI. In: Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems. 2020. p. 1–14.
• 92. Kopacek P, Hersh M. Roboethics. In: Ethical Engineering for International Development and Environmental Sustainability. Springer; 2015. p. 65–102.
• 94. Bartneck C, Kanda T, Ishiguro H, Hagita N. My robotic doppelgänger-A critical look at the uncanny valley. In: RO-MAN 2009-The 18th IEEE international symposium on robot and human interactive communication. IEEE; 2009. p. 269–76.
• 103. Tussyadiah IP, Zach FJ, Wang J. Attitudes Toward Autonomous on Demand Mobility System: The Case of Self-Driving Taxi. In: Schegg R, Stangl B, editors. Information and Communication Technologies in Tourism 2017. Cham: Springer International Publishing; 2017. p. 755–66.
• 110. Mercan S, Akkaya K, Cain L, Thomas J. Security, privacy and ethical concerns of IoT implementations in hospitality domain. In: 2020 International Conferences on Internet of Things (iThings) and IEEE Green Computing and Communications (GreenCom) and IEEE Cyber, Physical and Social Computing (CPSCom) and IEEE Smart Data (SmartData) and IEEE Congress on Cybermatics (Cybermatics). IEEE; 2020. p. 198–203.
• 111. Chung MJY, Cakmak M. “How was Your Stay?”: Exploring the Use of Robots for Gathering Customer Feedback in the Hospitality Industry. In: 2018 27th IEEE International Symposium on Robot and Human Interactive Communication (RO-MAN). IEEE; 2018. p. 947–54.
• 112. Crews JE. Robonomics: Prepare today for the jobless economy of tomorrow. CreateSpace Independent Publishing Platform; 2016.
• 143. Teti M, Schatz E, Liebenberg L. Methods in the time of COVID-19: the vital role of qualitative inquiries. Vol. 19, International Journal of Qualitative Methods. SAGE Publications Sage CA: Los Angeles, CA; 2020. p. 1609406920920962.

share this!

April 11, 2024

This article has been reviewed according to Science X's editorial process and policies . Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

trusted source

written by researcher(s)

Elephant tourism often involves cruelty. Here are steps toward more humane, animal-friendly excursions

by Michelle Szydlowski, The Conversation

Suju Kali is a 50-year-old elephant in Nepal who has been carrying tourists for over 30 years. Like many elephants I encounter through my research , Suju Kali exhibits anxiety and can be aggressive toward strangers. She suffers from emotional trauma as a result of prolonged, commercial human contact.

Like Suju Kali, many animals are trapped within the tourism industry . Some venues have no oversight and little concern for animal or tourist safety. Between 120,000 and 340,000 animals are used globally in a variety of wildlife tourism attractions, including endangered species like elephants. Over a quarter of the world's endangered elephants reside in captivity with little oversight.

Wildlife tourism—which involves viewing wildlife such as primates or birds in conservation areas, feeding or touching captive or "rehabilitated" wildlife in facilities, and bathing or riding animals like elephants—is tricky business . I know this because I am a researcher studying human relationships with elephants in both tourism and conservation settings within Southeast Asia.

These types of experiences have long been an extremely popular and profitable part of the tourism market . But now, many travel-related organizations are urging people not to participate in, or calling for an outright ban on, interactive wildlife experiences .

Tourism vendors have started marketing more "ethical options" for consumers. Some are attempting to truly improve the health and welfare of wildlife, and some are transitioning captive wildlife into touch-free, non-riding or lower-stress environments. In other places, organizations are attempting to implement standards of care or create manuals that outline good practices for animal husbandry.

This marketing, academics argue, is often simply " greenwashing ," applying marketing labels to make consumers feel better about their choices without making any real changes. Worse, research shows that some programs marketing themselves as ethical tourism may instead be widening economic gaps and harming both humans and other species that they are meant to protect.

No quick fix

For example, rather than tourist dollars trickling down to local struggling families as intended by local governments , many tourism venues are owned by nonresidents, meaning the profits do not stay in the area . Likewise, only a small number of residents can afford to own tourism venues, and venues do not provide employment for locals from lower income groups.

This economic gap is especially obvious in Nepalese elephant stables: Venue owners continue to make money off elephants, while elephant caregivers continue to work 17 hours a day for about US$21 a month; tourists are led to believe they are " promoting sustainability ."

Yet, there are no easy answers, especially for elephants working in tourism. Moving them to sanctuaries is difficult because with no governmental or global welfare oversight, elephants may end up in worse conditions.

Many kindhearted souls who want to "help" elephants know little about their biology and mental health needs, or what it takes to keep them healthy. Also, feeding large animals like Suju Kali is pricey, costing around $19,000 yearly . So without profits from riding or other income, owners—or would-be rescuers—can't maintain elephants. Releasing captive elephants to the jungle is not a choice—many have never learned to live in the wild, so they cannot survive on their own.

Hurting local people

Part of the problem lies with governments, as many have marketed tourism as a way to fund conservation projects. For example in Nepal, a percentage of ticket sales from elephant rides are given to community groups to use for forest preservation and support for local families.

Increasing demand for wildlife-based tourism may increase traffic in the area and thus put pressure on local governments to further limit local people's access to forest resources.

This may also lead to increased demands on local communities , as was the case in Nepal. In the 1970s, the Nepalese government removed local people from their lands in what is now Chitwan National Park as part of increasing "conservation efforts" and changed the protected area's boundaries. Indigenous "Tharu," or people of the forest, were forced to abandon their villages and land. While some were offered access to " buffer zones " in the 1990s, many remain poor and landless today.

In addition, more and more desirable land surrounding conservation areas in Nepal is being developed for tourist-based businesses such as hotels, restaurants and shops, pushing local poor people farther away from central village areas and the associated tourism income.

Some activists would like humans to simply release all wildlife back into the wild, but there are multiple issues with that. Elephant habitats throughout Southeast Asia have been transformed into croplands, cities or train tracks for human use. Other problems arise from the fact that tourism elephants have never learned how to be elephants in their natural elements, as they were separated from their herds at an early age.

So tourism may be vital to providing food, care and shelter to captive elephants for the rest of their lives and providing jobs for those who really need them. Because elephants can live beyond 60 years, this can be a large commitment.

How to be an ethical tourist

To protect elephants, tourists should check out reviews and photos from any venue they want to visit, and look for clues that animal welfare might be impacted, such as tourists allowed to feed, hold or ride captive wildlife animals. Look for healthy animals, which means doing research on what "healthy" animals of that species should look like.

If a venue lists no-touch demonstrations—"unnatural" behaviors that don't mimic what an elephant might do of their own accord, such as sitting on a ball or riding a bike, or other performances—remember that the behind-the-scenes training used to achieve these behaviors can be violent, traumatic or coercive .

Another way to help people and elephant is to to use small, local companies to book your adventures in your area of interest, rather than paying large, international tourism agencies. Look for locally owned hotels, and wait to book excursions until you arrive so you can use local service providers. Book homestay programs and attend cultural events led by community members; talk to tourists and locals you meet in the target town to get their opinions, and use local guides who provide wildlife viewing opportunities while maintaining distance from animals .

Or tourists can ask to visit venues that are certified by international humane animal organizations and that do not allow contact with wildlife. Or they can opt for guided hikes, canoe or kayak experiences, and other environmentally friendly options.

While these suggestions will not guarantee that your excursion is animal-friendly, they will help decrease your impact on wildlife , support local families and encourage venues to stop using elephants as entertainment. Those are good first steps.

Provided by The Conversation

Explore further

Feedback to editors

New method could allow multi-robot teams to autonomously and reliably explore other planets

Virgin Galactic completes final spaceflight before two-year pause

6 hours ago

Study finds fresh water and key conditions for life appeared on Earth a half-billion years earlier than thought

21 hours ago

Saturday Citations: Praising dogs; the evolution of brown fat; how SSRIs relieve depression. Plus: Boeing's Starliner

Jun 8, 2024

Nonreciprocal quantum batteries exhibit remarkable capacities and efficiency

New method optimizes lithium extraction from seawater and groundwater

Rare 7-foot fish washed ashore on Oregon's coast garners worldwide attention

Jun 7, 2024

California wildfire pollution killed 52,000 in a decade: study

Quantum chemistry and simulation help characterize coordination complex of elusive element 61

A protein that enables smell in ants—and stops cell death

Relevant physicsforums posts, insulin resistance and external insulin, how do fetuses breathe in the womb.

22 hours ago

COVID Virus Lives Longer with Higher CO2 In the Air

Universal wing- and fin-beat frequency scaling.

Jun 5, 2024

A DNA Animation

May 29, 2024

Probability, genetic disorder related

May 28, 2024

More from Biology and Medical

Related Stories

Wildlife tourism may negatively affect African elephants' behavior

Mar 20, 2019

Thailand leads the pack for Asia's abused tourist elephants

Jul 6, 2017

Elephant tweets highlight divide on conservation issues

Aug 12, 2022

Small 'fortress' parks aren't the answer for Africa's savannah elephants. They need room to roam

Jan 27, 2024

Kenya drought kills more than 200 elephants

Nov 4, 2022

Tougher penalties to protect Sri Lanka elephants after mass deaths

Oct 1, 2019

Recommended for you

DNA in the feces of snow leopards shows alpine cats eat plants

Tree hidey-holes key to helping slow declines of small mammals

Study adds new sea cucumber species to the research toolbox

Scientists 'read' the messages in chemical clues left by coral reef inhabitants

Let us know if there is a problem with our content.

Use this form if you have come across a typo, inaccuracy or would like to send an edit request for the content on this page. For general inquiries, please use our contact form . For general feedback, use the public comments section below (please adhere to guidelines ).

Please select the most appropriate category to facilitate processing of your request

Thank you for taking time to provide your feedback to the editors.

Your feedback is important to us. However, we do not guarantee individual replies due to the high volume of messages.

E-mail the story

Your email address is used only to let the recipient know who sent the email. Neither your address nor the recipient's address will be used for any other purpose. The information you enter will appear in your e-mail message and is not retained by Phys.org in any form.

Newsletter sign up

Get weekly and/or daily updates delivered to your inbox. You can unsubscribe at any time and we'll never share your details to third parties.

More information Privacy policy

Donate and enjoy an ad-free experience

We keep our content available to everyone. Consider supporting Science X's mission by getting a premium account.

E-mail newsletter

• - Google Chrome

Intended for healthcare professionals

• Access provided by Google Indexer
• My email alerts
• BMA member login
• Username * Password * Forgot your log in details? Need to activate BMA Member Log In Log in via OpenAthens Log in via your institution

Search form

• Advanced search
• Search responses
• Search blogs
• News & Views
• Medical tourism...

Medical tourism facilitators walk a tightrope between ethics and business

• Related content
• Peer review
• Charu Bahri , freelance journalist
• Rajasthan, India
• charubahri{at}gmail.com

A new market of intermediary fixers for medical tourists say that they can lower the risks associated with seeking treatment overseas. Charu Bahri asks what these facilitators do—and who oversees them?

When Marie Gopaul,* a 71 year old Mauritian, needed a hip replacement she and her family had concerns about doing it locally. “Doctors told me that the outcomes of robotic hip replacement are the best,” says Marie’s son Louis.* “In Mauritius many hip replacement patients who are operated on conventionally struggle to walk postoperatively.”

Because robotic surgeries weren’t available in Mauritius the family decided to pay for Marie to have surgery abroad—becoming one of the hundreds of thousands of patients who choose to become medical tourists in a market projected to grow from US$24.14bn (£19bn; €22.24bn) in 2023 to $93.38bn by 2030. 1 They settled on India, and for assistance in choosing a doctor and a hospital Louis approached an online medical tourism facilitator recommended by his friends.

Medical tourism facilitators manage and coordinate all activities related to the care of patients and their treatments while travelling abroad, such as visa applications, hotel stays, and airport transfers, although patients normally pay separately for flights. 2 They function as intermediaries between medical tourists (some also work with domestic patients) and a wide network of hospitals.

Brokers or middlemen first emerged in the medical tourism market in India around 2010. They faced resistance from the leading Indian hospital chains, which tried to get them banned with assistance from the Federation of Indian Chambers of Commerce and Industry. 3 But the intermediaries proved steadfast, and eventually India’s leading health standards body, the National Accreditation Board for Hospitals and Healthcare Providers (NABH), officially recognised them under the title medical value travel facilitators.

The NABH introduced “empanelment,” 4 a form of accreditation where inspectors evaluate a facilitator’s services and grant empanelment status if they pass. But empanelment isn’t synonymous with regulation. There are still documented instances 5 6 of domestic patients filing a medical negligence complaint with the police or speaking out on social media against an empanelled facilitator. And, when treatments fail, the NABH has no role to play.

The absence of stricter regulation, as well as concerns over the veracity of information displayed on facilitators’ websites and whether they follow ethical guidelines, 7 has led some critics to warn that facilitators “highly emphasise benefits while downplaying the risks.” 8

Facilitators say that they help prospective patients understand their options. “It’s difficult to choose the right doctor when they all claim to be the best, especially when you don’t speak the local language,” says Louis, when asked why he didn’t approach a hospital directly. “What clinched it for me this time was the facilitator’s counsellor telling me that she would choose the same renowned orthopaedic doctor in Delhi for her own mother.”

Through facilitators patients can get access to treatment options at different price points, something a single hospital can’t deliver. Abhik Moitra, director at HBG Medical Assistance, a leading Indian facilitator, says, “We can offer a Whipple procedure [pancreaticoduodenectomy to remove cancerous tumours from the head of the pancreas] at $12 000 at a top hospital in a leading metro, or at $8000-$9000 in a smaller city.”

Facilitators in India have told The BMJ that they’re conscious of the hospitals they work with, preferring those accredited by the Joint Commission International and the NABH. They also look for hospitals that demonstrate a managerial commitment to international patients and those that have invested in cutting edge technology.

Beyond physical amenities, medical tourism facilitators can support patients’ more personal needs, such as language barriers and settling in. In emerging markets especially, they “ease exposure in unfamiliar settings by dealing with medical and tourism providers.” 9 Louis believes that medical tourists who don’t speak the local language “tend to get fleeced” without a service provider.

Benjamin Hunter, lecturer at the University of Glasgow and an expert on the global healthcare economy, says, “Desperate people, unfamiliar settings, and commercialised healthcare are a recipe for exploitation. Facilitators can ameliorate some of this—or exacerbate it.”

Critics argue that facilitatory service providers work within an absent or limited regulatory framework 10 that limits their responsibility if things go wrong. Treatment failures can burden the patient, as well as public health services in the patient’s home country. 11 For that reason the UK, among others, has drawn up guidelines for prospective medical tourists. 12

The UK’s NHS guidelines on going abroad for medical treatment 13 include a strong recommendation for patients to consider continuity of care and inquire about any compensation for negligence. This can vary by provider. Some Lithuanian hospitals, for instance, promise free further treatment if anything goes wrong, 14 whereas one Lithuanian private hospital, Nordorthopaedics, told The BMJ that only a part of the cost would be waived if the patient needed further intervention.

Likewise, using a facilitator in India doesn’t necessarily add any guarantees. Pankaj Chandna, cofounder of Vaidam.com, a leading facilitator in India, agrees that “a few patients need revision surgery” but says that his company “tries to support such patients as much as possible to alleviate their mental trauma and financial burden.”

Chandna’s company runs a programme called Vaidam Reconnect, “to stay in touch with patients and assign a case manager to those who need further assistance.” He says that recently a patient from Sierra Leone needed corrective surgery after an operation. “Our partner hospital waived the surgical fee and 70% of the medical charges,” says Chandna.

Heidi Kaspar of the Department of Health Professions at the Bern University of Applied Sciences in Switzerland has introduced the notion of “therapeutic itineraries” in medical tourism because she sees medical journeys as “circular movements” rather than “singular and straightforward trips from A to B.”

“Numerous uncertainties [and] inadequate diagnostics at home complicate treatment abroad, prolong the stays of patients, and require family caregivers to return home in order to arrange funding or to organise absence at home,” she says. “On top of this, aftercare and unpredictable illness trajectories when back home lead to replicate journeys.”

Conflicts of interest

Perhaps the biggest concerns about facilitators are their fairness and competence 15 when choosing appropriate doctors and hospitals—and the possibility of pushing unnecessary treatment 16 that’s not in the best interest of patients, just to make a sale.

Facilitators The BMJ spoke to in India said that they don’t charge patients, but they do earn a facilitation fee or marketing fee from the hospitals that treat their referred patients. These payment arrangements differ by hospital. “Some agreements cover outpatient consultations, others only hospital admissions,” says Moitra. Some agreements extend to covering marketing expenses, including outreach programmes where medical value travel facilitators can help advertise hospitals open to private referrals by arranging consultation programmes in partner hospitals in target countries.

Such arrangements stem from the “cut system” in the Indian healthcare sector that the government has yet to legislate against. 17 18 Hunter says, “Opaque commissions breed mistrust, but ultimately facilitators are only one component in a bigger system, and exploitation is not unique to medical travel: the problem is profit driven healthcare.”

Other countries in the region have stricter rules to combat this. Asia’s leading medical tourism destination is Singapore, and its health ministry doesn’t allow doctors and hospitals to pay for referrals, says Nakul Singh, who represents Mount Elizabeth Hospital in India and manages India operations at IHH Healthcare’s Singapore division. Singaporean hospitals open representative offices in overseas target countries to counsel patients, he adds.

Last year around half a million medical tourists entered India, and the central government launched a campaign, Heal in India, to boost medical tourism. Prasanna Saligram, a public health researcher with the People’s Health Movement India, believes that the number isn’t yet high enough to push the government for further regulations, particularly as it “has so many larger issues to address.” He points to the disparity between the cost of healthcare in public and private hospitals.

“Our health sector regulatory framework is very weak,” he explains. “The Indian healthcare story is about ‘globalised’ and ‘marginalised’ patients. Private hospitals thrive on the globalised Indian, high net worth individuals, and medical tourists are just the cherry on top, while poorer people struggle to access healthcare.”

Facilitator driven outreach

Santosh Shetty is chief executive officer of Kokilaben Dhirubhai Ambani Hospital in Mumbai. His hospital is one that works with facilitators, whose services he appreciates when they work within an organised framework and in the patient’s best interests.

“Facilitators with a strong network and presence in the target geographies can help get the necessary licences and permissions for events and can guide local patients,” says Shetty. “Their offices can sometimes also serve as a local centre, which is very reassuring to patients and can overcome language barriers.”

He says that facilitators referred 20-25% of his hospital’s 2600 international patients in 2023. “While we have a dedicated international patient department, our global reach is amplified through credible facilitators,” says Shetty.

“Credible” is the key word. While Louis was appreciative of the facilitator’s team (one of 26 companies empanelled with the NABH 4 ) and the surgeon, he wasn’t blind to gaps in the service. “Our stay in a one star hotel left a lot to be desired,” he says. “I know you get what you pay for, but we could have been better guided on that front.”

In the hospital, says Louis, his mother had a long wait before the first consultation despite having an appointment, and he was charged 65 rupees (about 60p) for every cup of tea he ordered while his mother was in the intensive care unit. “When you’re paying more than double the cost of treatment in your home country you expect better service,” he says. (The hip replacement cost him $6500, which compares with $2500 at a private clinic in Mauritius.)

Nevertheless, the family got what they wanted: Marie had her surgery in January 2024. “The doctor delivered exactly as he had promised,” says Louis. “He had said that Mother would be walking independently a fortnight after being operated on, and she was.”

*Names of patients and their families have been changed.

Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

Provenance and peer review: Commissioned; not externally peer reviewed.

• ↵ Fortune Business Insights. The global medical tourism market size is projected to grow from $24.14 billion in 2023 to $93.38 billion by 2030, at a CAGR of 21.3% over the forecast period. Oct 2023. https://www.fortunebusinessinsights.com/industry-reports/medical-tourism-market-100681
• ↵ National Accreditation Board for Hospitals & Healthcare Providers. Medical value travel facilitator empanelment programme. https://nabh.co/medical-value-travel-facilitator-mvtf/
• ↵ National Accreditation Board for Hospitals & Healthcare Providers. Certified MVTF. https://nabh.co/accreditedmvtf/
• ↵ Ahluwalia H. How Pristyn Care is misleading hospitals and patients. Morning Context 2024 Jan 17. https://themorningcontext.com/internet/how-pristyn-care-is-misleading-hospitals-and-patients
• ↵ Raghavan R. Inside the chaos at Pristyn Care. Mint 2023 Aug 31. https://www.livemint.com/companies/news/inside-the-chaos-at-pristyn-care-11693337299658.html
• Wright KB ,
• O’Connor M ,
• Wombacher K
• Hanefeld J ,
• Horsfall D ,
• ↵ NHS. Going abroad for medical treatment. Reviewed 13 Oct 2023. https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/going-abroad-for-medical-treatment/
• ↵ Das S, Ungoed-Thomas J. “It’s not medical tourism, it’s desperation”: rising number of Britons resort to treatment abroad. Guardian 2023 Jan 21. https://www.theguardian.com/society/2023/jan/21/not-medical-tourism-desperation-britons-resort-treatment-abroad
• Crooks VA ,
• Kingsbury P ,
• ↵ Debroy S. 6 years on, bill against “cut practice” in medical sector back in spotlight. Times of India 2023 Apr 9. https://timesofindia.indiatimes.com/city/mumbai/6-years-on-bill-against-cut-practice-in-medical-sector-back-in-spotlight/articleshow/99350484.cms
• ↵ Nagral S, Nundy S. We need to end “cut” practice in Indian healthcare. BMJ Opinion 2017 Jul 17. https://blogs.bmj.com/bmj/2017/07/07/we-need-to-end-cut-practice-in-indian-healthcare/