246311 Health worker migrations: Re-thinking the meaning of community and the grounding of responsibility

Tuesday, November 1, 2011: 5:15 PM

Lisa Eckenwiler, PhD , Director of Health Care Ethics, George Mason University, Fairfax, VA
Given the unprecedented migration rates of health personnel to affluent, English- speaking countries in the global North (chiefly the US), the loss, in turn, in low-income countries of public investment in education and training, and of urgently needed health personnel, we are compelled to ask how we, the beneficiaries of this migration, should reason about responsibilities. In particular, I consider how we ought to conceptualize “community” and understand its scope in the context of global health personnel shortages. Do we have responsibilities to distant communities that serve as sources for our own public health system? If so, what are they, what is their basis, and how shall we assign them? How, in addition, should we regard and treat migrant health professionals and paraprofessionals in our own communities? How might we revise conceptualizations of citizenship in order to recognize the contributions to our communities of migrant health personnel? While prevailing accounts of global justice ground it in our shared humanity or participation in injustice, I will suggest that additional insights on global responsibilities (their basis and content) can be gleaned from scrutinizing our status as “ecological subjects”, that is, beings whose identities, communities, and habitats are relational, indeed, mutually constitutive.

Learning Areas:
Ethics, professional and legal requirements
Public health or related public policy

Learning Objectives:
1) Describe the major ethical concerns raised by health worker migration; 2) Identify the limitations and ethical implications of prevailing conceptions of community; and 3) Describe existing and innovative approaches to grounding and assigning responsibilities to various stakeholder communities affected by health worker migration.

Keywords: Health Care Workers, Migrant Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an academic working in ethics in public health, with a current research focus on health worker migration and global health inequalities
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.