A question of justice: Assessing nurse migration from a philosophical perspective

Developing World Bioethics

Volumn 11, Issue 1, 2011, Pages 30-39

  Kaelin, Lukas ^a  

^a UNIVERSITY OF VIENNA   (Austria)

Author keywords

Bioethics; Justice; Nurse migration; Philosophy

Indexed keywords

ARTICLE; DEVELOPED COUNTRY; DEVELOPING COUNTRY; ETHICS; FEMALE; HEALTH CARE MANPOWER; HUMAN; INTERNATIONAL COOPERATION; MIGRATION; NURSE; PHILIPPINES; SOCIAL BEHAVIOR; SOCIAL JUSTICE; UNITED STATES;

DEVELOPED COUNTRIES; DEVELOPING COUNTRIES; EMIGRATION AND IMMIGRATION; FEMALE; HEALTH MANPOWER; HUMANS; INTERNATIONALITY; NURSES; PHILIPPINES; SOCIAL JUSTICE; SOCIAL RESPONSIBILITY; UNITED STATES;

EID: 79952745581     PISSN: 14718731     EISSN: 14718847     Source Type: Journal    
DOI: 10.1111/j.1471-8847.2010.00284.x     Document Type: Article

References (42)

1. B.L. Brush & J. SochalskiInternational Nurse Migration: Lessons from the Philippines. Policy Polit Nurs Pract2007 837-46
2. J. Galvez Tan2005The National Nursing Crisis: 7 Strategic Solutions. Quezon City, Philippines: Philippines Center for Investigative Journalism. Available at: [Accessed 11 Jan 2010]; M. Kingma. 2006. Nurses on the Move. Migration and the Global Health Care Economy. Ithaca, NY: Cornell University Press: 29 ff2010
3. J. Buchan & L. Calman2005Summary. The Global Shortage of Registered Nurses. Geneva: International Council of Nurses: 2. Available at2010
4. C.C. Choy2003Empire of Care. Nursing and Migration in Filipino American History. Durham & London: Duke University Press
5. Kingma, op. cit. note 2, p. 19; D.S. Kline. Push and Pull Factors in International Nurse Migration. J Nurs Scholarsh200335107-111
6. World Health Organization (WHO). 2003. International Nurse Mobility. Trends and Policy Implications. Geneva: WHO: 37. Hirschfeld notes that American nursing school have to turn away annually 150,000 qualified applicants due to understaffing. M.J. Hirschfeld. 2008. Globalisation: Good or Bad, for Whom? In The Globalisation of Nursing. V. Tschudin & C. Hancock, eds. Oxford/New York, NY: Radcliffe Publishing200812-24
7. WHO, op. cit. note 642
8. Kingma, op. cit. note 231
9. Choy, op. cit. note 425
10. Kingma, op. cit. note 227
11. Ibid: 27; Hirschfeld, op. cit. note 617
12. Kingma, op. cit. note 2173
13. Brush & Sochalski, op. cit. note 141
14. Kingma, op. cit. note 2173
15. Galvez Tan, op. cit. note 2
16. Kingma, op. cit. note 2179
17. F.M.E. Lorenzo et al. Nurse Migration from a Source Country Perspective: Philippine Country Case Study. Health Serv Res2007421406-1418
18. M.M.B. Asis & F. Baggio2008Introduction: Will Turning Transnational Foster Development in the Philippines? In: Moving Out, Back and Up: International Migration and Development Prospects in the Philippines, M.M.B. Asis & F. Baggio, eds. Quezon City, Philippines: Scalabrini Migration Center1-16
19. Philippine Overseas Employment Administration (POEA). 2006. OFW Global Presence. A Compendium of Overseas Employment Statistics 2006. Mandaluyong City, Philippines: POEA. Available at: [Accessed 11 Jan 2010]; Philippine Overseas Employment Administration (POEA). 2007. 2007 Overseas Employment Statistics. Mandaluyong City, Philippines: POEA. Available at: [Accessed 11 Jan2010
20. Former Secretary of Health, Jaime Z. Galvez Tan points out that for example in 2001 the Philippine Overseas Employment Administration (POEA) reported only 304 nurses moving to the United States. And, he continues: 'This is definitely gross underreporting since the International Union of Nurses reported that close to 10,000 Filipino nurses were directly hired by US based hospitals in 2001 through their nursing job fairs held in various parts of the Philippines.' (Galvez Tan, op. cit. note2001
21. Manila Times. 2007. Editorial: Our Nurses in Japan. The Manila Times Internet Edition 9 January. Available at: [Accessed 10 Jan 2009]; R. Tulfo. 2007. What's Wrong with Sending Nurses to Japan? Philippine Daily Inquirer 16 October. Available at: [Accessed 27 Apr2010
22. R.E. BallDivergent Development, Racialised RightsGlobalised Labour Markets and the Trade of Nurses - The Case of the Philippines. Womens Stud Int Forum200427119-133
23. Galvez Tan, op. cit. note 2
24. M.E. Perrin et al.Nurse Migration and its Implications for Philippine Hospitals. Int Nurs Rev200754219-226
25. A. Geller2007Filipino Doc Picks Life as Nurse in U.S. The Washington Post 7 January. Available at: [Accessed 27 Apr2010
26. A lot of the public discussion being waged around this emigration took place in the context of nationalism. On the one hand it was considered a sell-out if the most skilled leave the country, mainly by the country's leading newspaper. On the other hand, it was pointed out that given the wretched condition of the country, to leave it is the only possibility to secure one's family a better life (P.N. Abinales & D.J. Amoroso. 2005. State and Society in the Philippines. New York, NY/ Oxford, UK: Rowman and Littlefield Publishers: 299 f.). It was later noted by the Philippine Daily Inquirer, not without a sort of delayed satisfaction, that abroad there is 'no greener pasture' as the country's 'top notcher' resigned his job due to unsatisfactory living conditions, but was quick to find a new one (G. Lirio. 2006. No Greener Pasture for Top notcher. Philippine Daily Inquirer 4 September. Available at: [Accessed 27 Apr 2010
27. Lorenzo, op. cit. note 221414
28. J. Rawls1999A Theory of Justice, (Revised Edition). Cambridge, MA: Belknap Press
29. The assumption Rawls works on is that people understand and define themselves in absolute terms rather than relative to the rest of society. In reality one might as well prefer being slightly worse off, if the rich neighbour is on the same level as oneself. However, Rawls works on the assumption that people in the original position, behind the veil of ignorance, are mutually disinterested. In defence of Rawls, one also has to point out that behind the veil of ignorance we can reasonably expect people to choose to live in a society where, absolutely speaking, all people are better off even though there is some amount of inequality, which however still allows everyone to successfully aspire for a socially and economically higher position
30. J. Rawls2001Justice as Fairness. A restatement. Cambridge, MA: Belknap Press
31. On a personal note, people in objectively wretched conditions, such as city slum-dwellers in Manila, who can access neither health care nor basic education for their children, would easily trade some of their basic liberties for the benefits of social and economic equality. Their economic and social position does not allow them to be equal members of society and so they end up being deprived not only of social participation but ultimately also of their basic rights. For a concrete account of this deprivation, this inability to articulate their demands, see: A.M.G. Rodriguez. The Mass Raises Its Ugly Head: When the Margins Speak with Their Own Voices. The Loyola Schools Review: School of Humanities200877-99
32. Rawls, op. cit. note 3715
33. To what extent the theoretical, postulated pluralism of Western society is indeed actualized is another question. The rhetorical commitment is not necessarily followed by a pluralistic practice, as discussions about minarets in Switzerland, about non-Christian religious instruction in Austria and gay-marriages in the United States show, to name just a few examples.
34. R. Nozick1974. Anarchy, State, and Utopia. Oxford, UK: Basic Books
35. M. Walzer1983. Spheres of Justice. A Defense of Pluralism and Equality. New York, NY: Basic Books
36. J.S. Mill & J. Bentham1987Utilitarianism and Other Essays, Alan Ryan, ed. London, UK: Penguin Books
37. J. DerridaDeconstruction and the Possibility of Justice. Cardozo Law Rev 1990; 11: No. 5-6. For a discussion of Derrida's take on justice see: L. Kaelin. 2008. The Intrinsic Violence of Rights: Derrida and Hegel. Available at: [Accessed 11 Jan2010
38. C. Geertz.1973Thick Description: Toward an Interpretive Theory of Culture. In: The Interpretation of Cultures. Selected Essays. C Geertz. New York, NY: Basic Books3-30
39. M. Walzer1994Thick and Thin. Moral Argument at Home and Abroad. South Bend, IN: University of Notre Dame Press
40. Galvez Tan, op. cit. note 2
41. Rawls, op. cit. note 4675
42. Walzer, op. cit. note 565