Coercion in the Fight Against Medical Brain Drain

  • Nir Eyal
  • Samia A. Hurst


Several contributions in this book tell of doctors’ increasing emigration from developing countries where they are in critical shortage, especially from the underserved rural and public sectors of countries in sub-Saharan Africa (SSA) and South Asia. They point out the severe harm from that migration to some of the world’s poorest and sickest populations who have no other doctors to turn to, and gain little from their emigration. Since significant harm to the badly off is bad, decline in that migration is usually a good development. But how to strive to achieve it?


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  1. Benatar, S. R. (2007), ‘An Examination of Ethical Aspects of Migration and Recruitment of Health Care Professionals from Developing Countries’, Clinical Ethics, 2(1), 2–7.CrossRefGoogle Scholar
  2. Cappuccio, F. P. and Lockley, S. W. (2008), ‘Safety and the Flying Doctor’, BMJ, 336, 218.CrossRefGoogle Scholar
  3. Cohen, G. A. (1979), ‘Capitalism, Freedom and the Proletariat’, in A. Ryan, The Idea of Freedom: Essays in Honour of Isaiah Berlin, Oxford: Oxford University Press, pp. 7–25.Google Scholar
  4. De Albornoz, S. C. (2006), ‘On a Mission: How Cuba Uses its Doctors Abroad’, BMJ, 333(7566), 464.CrossRefGoogle Scholar
  5. De Vos, P. and Van der Stuyft, P. (2006), ‘Cuba’s International Cooperative Efforts in Health’, BMJ, 333(7568), 603.CrossRefGoogle Scholar
  6. Dovlo, D. (2005), ‘Wastage in the Health Workforce: Some Perspectives from African Countries’, Human Resources for Health, 3, 6.CrossRefGoogle Scholar
  7. Dovlo, D. and Nyonator, F. (2003), ‘Migration by Graduates of the University of Ghana Medical School: A Preliminary Rapid Appraisal’, Human Resources Development Journal, 3(1), 40–51.Google Scholar
  8. Dworkin, R. (2000), Sovereign Virtue, Cambridge: Harvard University Press.Google Scholar
  9. Dwyer, J. (2007), ‘What’s Wrong With the Global Migration of Health Care Professionals? Individual Rights and International Justice’, Hastings Cent Rep, 37(5), 36–43.CrossRefGoogle Scholar
  10. Eyal, N. (2003), Distributing Respect, University of Oxford, doctoral dissertation.Google Scholar
  11. Eyal, N. (2008), ‘Utilitarianism and coercion’, Notizie di Politeia, 24(90), 108–123.Google Scholar
  12. Eyal, N. (draft), ‘Medical Tourism: From Brain Drain to Brain Gain’, in progress.Google Scholar
  13. Eyal, N. and Bärnighausen, T. (draft), ‘Conditioning Medical Scholarships on Long, Future Service: A Defence’, in progress.Google Scholar
  14. Eyal, N. and Hurst, S. A. (2008), ‘Physician Brain Drain: Can Nothing be Done?’ Public Health Ethics, 1(2), 180–92.CrossRefGoogle Scholar
  15. Fabre, C. (2006), Whose Body is it Anyway?: Justice and the Integrity of the Person, Oxford: Oxford University Press.CrossRefGoogle Scholar
  16. Field, C. and Reed, G. (2006), ¡Salud! (Film).Google Scholar
  17. Fried, C. (1983), ‘Distributive Justice’, Social Philosophy and Policy, 1, 45–59.CrossRefGoogle Scholar
  18. González López-Valcárcel, B. and Barber Pérez, P. (2008), ‘Difficulties, Pitfalls and Stereotypes in Physician Workforce Planning’ (original in Spanish), Gac Sanit, 22(5), 393–5.CrossRefGoogle Scholar
  19. Hayek, F. A. (1982), Law, Legislation, and Liberty, London: Routledge.Google Scholar
  20. Hayek, F. V. (1960), The Constitution of Liberty, Chicago: University of Chicago Press.Google Scholar
  21. Hunt, P. (2005), The Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, Commission on Human Rights.Google Scholar
  22. IOM (2008), Resident Duty Hours: Enhancing Sleep, Supervision, and Safety, The National Academies Press: Washington.Google Scholar
  23. Kalantri, S. P. (2007), ‘Getting Doctors to the Villages: Will Compulsion Work?’ Indian J Med Ethics, 4(4), 152–3.Google Scholar
  24. Kamm, F. (2007), Intricate Ethics: Rights, Responsibilities and Permissible Harm, Oxford: Oxford University Press.CrossRefGoogle Scholar
  25. Kupfer, L., Hofman, K., Jarawan, R., McDermott, J., Bridbord, K. (2004), ‘Roundtable: Strategies to Discourage Brain Drain’, Bull World Health Organization, 82(8), 616–19.Google Scholar
  26. Makasa, E. (2005), ‘Africa’s Medical Brain Drain: Why I Want to Stay in Africa’, BMJ, 331(7519), 780.CrossRefGoogle Scholar
  27. Masembe, V. (2008), ‘Health Workforce Migration Community Practice’, Health Worker Migration Community of Practice e-Discussion, available online at [accessed 15 December 2008].
  28. Mullan, F. (2008), ‘Medical Education & Health Equity: An Opportunity For The New Administration’, Health Affairs blog, available online at[accessed 18 December 2008].
  29. Nelson, D. and Taher, A. (2007), ‘Doctors Quit Dirty NHS for India’, The Times, 16 December.Google Scholar
  30. Norwegian Medical Association, (2005), ‘Undergraduate Medical Education and the Residency Requirements for Permanent Licence’, available online at [accessed 20 December 2008].
  31. Nozick, R. (1969), ‘Coercion’, in S. Morgenbesser, P. Suppes, and M. White (Eds) Philosophy, Science, and Method: Essays in Honor of Ernest Nagel, New York: St Martin’s Press, pp. 440–72.Google Scholar
  32. Nozick, R. (1986), Anarchy, State, and Utopia, Oxford: Oxford University Press.Google Scholar
  33. Otsuka, M. (2005), Libertarianism without Inequality, Oxford: Oxford University Press.Google Scholar
  34. Physicians for Human Rights (2004), ‘An Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa’, available online at [accessed 20 December 2008].
  35. Shivakumar, S. (2007), ‘Why Medicos Balk at Rural Service?’ Merinews, available online at [accessed 18 December 2008].
  36. Thomson, J. (1971), ‘A Defense of Abortion’, Philosophy and Public Affairs, 1(1), 47–66.Google Scholar
  37. Travis, A. (2008), ‘200,000 Jobs Barred to Non-European Migrants’, The Guardian, available online at [accessed 18 December 2008].
  38. Vallentyne, P., Steiner, H., and Otsuka, M. (2005), ‘Why Left-Libertarianism Isn’t Incoherent, Indeterminate, or Irrelevant: A Reply to Fried’, Philosophy and Public Affairs, 33(3), 210–22.Google Scholar
  39. Wertheimer, A. (1987), Coercion, Princeton: Princeton University Press.Google Scholar
  40. Williams, B. (1973), ‘The Idea of Equality’, in Problems of the Self, Cambridge: Cambridge University Press: pp. 230–49.CrossRefGoogle Scholar
  41. WHO Realizing Rights, Global Policy Advisory Council Secretariat, Health Worker Migration Initiative (2009), ‘Honouring the Human Rights to Health and Freedom of Movement’, 7 May 2009, available online at [accessed 31 December 2009].
  42. WHO Secretariat (2009), International Recruitment of Health Personnel: Draft Global Code of Practice. Executive Board, 126th Session. Provisional agenda item 4.5 (EB126/8), 4 December 2008, available online at [accessed December 31 2009].

Copyright information

© Nir Eyal and Samia A. Hurst 2010

Authors and Affiliations

  • Nir Eyal
  • Samia A. Hurst

There are no affiliations available

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