Elective surgery with a side of nan

You can now get an all-expense paid trip for yourself and a companion to travel to India and get that procedure taken care of.
http://www.nytimes.com/2008/11/21/health/21abroad.html?_r=1

One of the many any issues that occur to me regarding international ‘medical tourism’ is how this impacts informed consent issues. A search for ‘medical tourism’ turned up the two following medical travel agencies. These are not providers or insurers. From what I can see, you sign your consent in the foreign country after consultation with the foreign doctor.

I wonder if this consent would hold up in the United States? After traveling thousands of miles for the purpose of a surgical procedure, isn’t an individual somewhat captive and under some duress and ‘forced’ to sign a consent? Or is traveling thousands of miles to get a elective surgical procedure a form of consent in and of itself? I have always been focused on health care in the United States and would like to know more about how ethical practices are handled in situations like this.

http://www.medicaltourismsolutions.com/procedures/sample_packages.htm
http://www.medpathgroup.com/