Global Health, Justice and the Brain Drain

1
Global Health, Justice and the Brain Drain
Moral responsibility and ethical policies in the
international migration of health-workers

• Rebecca Shah
• Keele University, UK

2
Medical Brain Drain

• The facts
• The problems
• The conference
• This paper
• Health-workers
• Low-income source countries
• High-income receiving countries
• The international community

3
Health-worker options

• Should I stay or should I go?
• Personal costs of staying
• Costs to others of going
• General moral obligations to stay
• Special moral obligations to stay
• But too much moral responsibility?
• Sharing the moral burden

4
Low-income source countries

• Human rights responsibilities
• Local innovation
• Embrace the brain drain
• But insufficient without pro-poor policies
• Prohibit emigration
• Absolute prohibition unconscionable
• Temporary limitations acceptable
• Train intermediate-level workers
• Double standards?
• Train with local focus

5
High-income receiving countries

• Active, passive, and indirect moral
  responsibility
• Duties of justice and assistance
• Immigration control?
• Not active not prohibitive not enough?
• Ethical recruitment
• Compensation
• Partnership not charity
• Joined-up policies

6
International community

• Deep global causal factors
• Global ethical code
• Centralised compensation funds
• Centralised HRH
• Cyclical migration
• Cooperation and power
• Research and information

7
Conclusions

• Ethics as well as effectiveness
• Must share moral responsibility
• Must integrate policy-responses
• Commitment to global justice
• Programme and abstracts
• http//www.in-spire.org/events.html