Physician brain drain: Can nothing be done?
Public Health Ethics 1 (2):180-192 (2008)
| Abstract | The Harvard University Program in Ethics and Health, 651 Huntington Avenue, 6th floor c/o HSPH, François Xavier Bagnoud Building Boston, MA 02115, USA. Email: Nir_Eyal{at}hms.harvard.edu ' + u + '@' + d + ' '//--> Abstract Access to medicines, vaccination and care in resource-poor settings is threatened by the emigration of physicians and other health workers. In entire regions of the developing world, low physician density exacerbates child and maternal mortality and hinders treatment of HIV/AIDS. This article invites philosophers to help identify ethical and effective responses to medical brain drain. It reviews existing proposals and their limitations. It makes a case that, in resource-poor countries, ‘locally relevant medical training’—teaching primarily locally endemic diseases and practice in scarcity conditions, training in rural communities and admitting rural students preferentially—could help improve retention. Locally relevant training would arguably diminish medical brain drain in five ways. It would (i) make graduates less attractive for Western employers, (ii) align graduates’ expectations with actual practice, diminishing ‘burn-out’, (iii) enhance the professional prestige of local practice, (iv) hold rotations in, and recruit applicants from, rural areas, which is known to improve retention there, and (v) create local career development options that attract practitioners to stay. Such educational reform may raise worries about poor-quality care, breach of the freedom of education and occupation, breach of the freedom of movement, unequal distribution of opportunities among students, hypocrisy and resistance from influential actors. We address these worries. CiteULike Connotea Del.icio.us What's this? | |||||||||
| Keywords | No keywords specified (fix it) | |||||||||
| Categories | ||||||||||
| Options |
|
|||||||||
Download options| PhilPapers Archive |
Upload a copy of this paper Check publisher's policy on self-archival Papers currently archived: 5,711 |
| External links |
 |
| Through your library | Configure |
Similar books and articlesBjørn Hofmann, Anne Myhr & Søren Holm (2013). Scientific Dishonesty—a Nationwide Survey of Doctoral Students in Norway. BMC Medical Ethics 14 (1):1-9.
Jessica Price & Agnes Binagwaho (2010). From Medical Rationing to Rationalizing the Use of Human Resources for Aids Care and Treatment in Africa: A Case for Task Shifting. Developing World Bioethics 10 (2):99-103.
Ross W. I. Kessel (1983). Changing Access to Hospital Care: Altered Values at the Academic Health Center. Theoretical Medicine and Bioethics 4 (2).
Rosemarie Tong (2001). Just Caring About Women's and Children's Health: Some Feminist Perspectives. Journal of Medicine and Philosophy 26 (2):147 – 162.
Allen E. Buchanan (1987). The Profit Motive in Medicine. Journal of Medicine and Philosophy 12 (1).
Doug Seale (2011). Patrick J. Carr and Maria J. Kafalas, Hollowing Out the Middle: The Rural Brain Drain and What It Means for America. Journal of Agricultural and Environmental Ethics 24 (5):535-543.
András Miklós (2009). Public Health and the Rights of States. Public Health Ethics 2 (2).
Iain Brassington (2012). What's Wrong with the Brain Drain (?). Developing World Bioethics 12 (3):113-120.
Ruth Groenhout (2012). The “Brain Drain” Problem: Migrating Medical Professionals and Global Health Care. International Journal of Feminist Approaches to Bioethics 5 (1).
Analytics
Monthly downloads |
Added to index2009-12-21Total downloads20 ( #61,609 of 551,007 )Recent downloads (6 months)1 ( #63,425 of 551,007 )How can I increase my downloads? |
My notes
Discussion
