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International Migration of Doctors: Need to follow the Commonwealth Code

Posted by plosmedicine on 31 Mar 2009 at 00:02 GMT

Position: Professor of Psychiatry
Institution: Memorial University of Newfoundland, St. John's, A1B 3V6, Canada
Submitted Date: November 28, 2006
Published Date: November 29, 2006
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

The issue will remain hot and to some extent unresolved. The following aspects need attention.

1) The Human Rights perspective:

The human rights declaration, article 3 states "Everyone has a right to life, liberty and security of person". Article 13 states "Everyone has the right to leave any country, including his own, and to return to his country". Article 23: "Everyone has the right to work, to free choice of employment, to just and favorable conditions of work and to protection against unemployment". Article 25: "Everyone has the right to a standard of living adequate for health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services". With these declarations, are the governments of such countries taking some steps to preserve the individual human rights? Among the fundamental rights, security has assumed tremendous importance. Personal communication by the writer indicated that majority of doctors were prepared to stay in the Pakistan provided they get assurance of personal safety. The UN makes policies for global implementation and makes sure to help the developing countries to strengthen their capacity in terms of health care and other machinery but their help does not reach to the right corner. The W.H.O. and UN should also measure and monitor the problems of growing insecurity in these countries which lead to loss of the heath work force instead of just monitoring the life expectancy, infant mortality, poverty line, and demographic indicators etc. The US-UN has tremendous impact on developing countries, then why they cannot force these nations to curb violence, avoid political upheavals, respect human rights, wipe corruption and promote all favorable factors that can contribute to conducive environment which would lead to global social well-being, retention of health workers and respect for human rights. Without these steps, no country has any right to prevent their health workers to migrate for the sake of their individual human rights. Any effort in doing this will account towards gross human rights violation by the concerned state in particular and United Nations Organization in general.

") Ethical issues

Whether recruitment by developed countries is ethical is a big question. Harsh reality with the developed countries like Canada and Australia who are in acute shortage of psychiatrists and general family physicians in areas of need and for developing countries which as a whole in need for national services cannot be addressed easily. The balance cannot be achieved effectively and fully but mutual redressal is possible if the developed countries pay compensation to source countries for their loss of trained personnel, invest in enhancing the training and skills development in the countries exporting skilled doctors and follow the Commonwealth Code. This Code of Practice for the International Recruitment of Health Workers is intended to provide governments with a framework within which international recruitment should take place. It is sensitive to the needs of the recipient countries and the migratory rights of individual health professionals. It also does not propose that governments should limit or hinder the freedom of individuals to choose where they wish to live and work. In conclusion, it will be against human rights and ethical principles to stop the international migration of doctors but the gravity of problem can be sorted out by the adherence and application of Commonwealth Code in its true sense and spirit.


1-United Nations. Universal Declaration of Human Rights, 1948-1998, the fiftieth anniversary, adopted and proclaimed by General Assembly resolution 217 A(III) of 10 December, 1948.
2- Gadit, A., Khalid, N. Human rights and international recruitment of psychiatrists: dilemma for developing countries. J Pak Med Assoc. 2006, vol 56, no. 10, p:474-6.

No competing interests declared.