Criminalizing the brain drain
Nevertheless, the industrialized world regards itself as having serious doctor, nursing and dental shortages, and part of the solution to the crisis currently involves recruiting from ... the developing world. You don't need a fully articulated theory of justice to see a deep problem here. In fact, it is old news: the brain drain of health professions from developing countries has long been discussed, moral outrage has been expressed, and various professional bodies have issued policies condemning the practice. Not that all this has had much of an impact so far. This week's Lancet, however, has a new twist on the old story. A group of authors have apparently decided enough is enough: they propose that the predatory recruitment of developing world health professionals be considered an international crime.
The idea is laudable, because the gravitas of 'crime' at least matches the seriousness of the issue. But how would it work in practice? It is difficult enough to enforce crimes against humanity, much less crimes against the universal right to health. Can one envision CEOs of recruitment bureaus being hauled off to the Hague and awaiting trial along with Charles Taylor? Besides, the defence lawyers would argue that the recruitment bureaus do not intend to endanger the health of developing nations; they are providing opportunities to skilled individuals who have the right to work where they want. It might be wiser (but not much easier) to press for enforceable national laws -- in abuser countries like Canada, United States, the United Kingdom, Australia and New Zealand -- that pose clear restrictions on the import of health human resources from developing countries, while working on the international front to address the conditions of poverty and neglect that push doctors, nurses and dentists towards greener pastures.