Monday, June 05, 2006

Taking nurses from the poor for the rich

A small provision in a recent immigration bill passed by the US Senate removes the limit placed on the number of nurses who can immigrate and work in the United States. The provision is meant to alleviate the nurse shortage in the United States, where more than approximately 100,000 nurses are needed. As the baby boomers grow older, and in need of care, the demand for nurses will only rise. From a certain restricted perspective, the provision is merely a way of making supply match US domestic demand. According to Bruce Morrison, a lobbyist for American Hospital Association and a former Democratic congressman, "[T]here is no reason to cap the number of nurses coming in when there's a nationwide shortage, because you need people immediately."

Other perspectives on the meaning of the provision have been coming in lately. This week's editorial in The Lancet criticizes the provision as unjust, both in its effects on health care systems in the developing world and its role in maintaining the status quo of underpaying nurses in the United States. The shortage of nurses in developing countries is exponentially greater than that of the United States, and 'in-sourcing' nurses from resource-poor countries just perpetuates the domestic trend of underpaying nursing staff. It is a painful irony that the same Senate that sponsors US-funded global initiatives against HIV/AIDS, tuberculosis and malaria is willing to support a provision that will help to undercut those efforts. As Holly Burkhalter of Physicians for Human Rights puts it: "We're pouring water in a bucket with a hole in it, and we drilled the hole."

Ethical culture in Chinese biomedical research

The Christian Science Monitor has an interesting piece on ethics in current Chinese medical research. The most valuable insight is the authors' recognition that ethical problems -- in China or elsewhere -- do not stem primarily from the bad character of individual scientists, but rather problematic structural factors within local scientific practice. In the case of Chinese science, the problems mainly arise from the strong incentives tied to scientific success, and the weakness of formal mechanisms to deal with the scientific misconduct that such incentives inevitably encourage.