Medical Brain Drain as Structural Human Rights Violation

The political debate about international medical brain drain is dominated by the human rights language. It is widely thought that affluent nations, by recruiting health-workers from vulnerable regions violate the human right to health of vulnerable populations. It is also argued that developing countries that fail to retain their health workforce violate the right to health of their own citizens. Moreover, the migrating doctors and nurses are seen as implicated in the harm through the compound effect of their personal choice to emigrate. The aim of this paper is to understand in what sense is medical brain drain a human rights violation. Existing accounts suffer from two types of conceptual biases. First, they are locked into a statist paradigm that takes the root causes of medical brain drain to be found within domestic societies and bad government choices. Second, by focusing on the agents (migrants and national governments), they omit the essential role played by structural constraints; namely, international institutions and the background condition of global socio-economic inequality that together significantly limit the range of options available to individual and collective agents. This paper proposes a shift from the agent-centered view towards a structural conception of human rights. The ‘political-institutional turn’ provides an innovative conceptual framework by taking the role of human rights to be an international standard of legitimate political standing and action. What remains unclear is the appropriate judicandum: whether the legitimacy of states, international institutions or the global order should be assessed. This paper aims to specify this theoretical stake in a concrete international political context. It argues that medical brain drain is a structural violation of the human right to health; the result of a complex interplay between individual choices and state action, which are shaped by international institutions in the context of excessive global inequalities.