Abstract
This chapter contextualizes the debates surrounding global migration governance of nursing skills, which have been framed in terms of brain drain and global competition of skills or human capital. The debates have been pushed to consider ethics with regard to supporting the health system of the source countries in the South. High-income countries, especially those which rely on import of health care workers, are called upon to take responsibility for the consequences of active and unethical international recruitment practices. I draw on governmentality and ethics of care scholarship to argue for a critical take on governance and create an opportunity to discuss care as a moral framework, which is displaced in current calls for supposed ethically sound solutions.
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Notes
- 1.
Ronald Skeldon, “Of Skilled Migration, Brain Drains and Policy Responses” International Migration 47, no. 4 (2008), https://doi.org/10.1111/j.1468-2435.2008.00484.x
- 2.
Nicola Yeates, “The globalization of nurse migration: Policy issues and responses,” International Labour Review 149, no. 4 (2011), https://doi.org/10.1111/j.1564-913X.2010.00096.x
- 3.
Skeldon, “Of Skilled Migration, Brain Drains and Policy Responses”.
- 4.
Goodin, “If People were Money…,” in Free movement: Ethical Issues in the Transnational Migration of People and Money, ed. Brian Barry and Robert E. Goodin (London and New York: Routledge, 2015), 16.
- 5.
Frank van Tubergen, Immigrant Integration: A Cross-National Study (New York: LFB Scholarly Publishing LLC, 2006), 85.
- 6.
Jaspertap Singh and V.V. Krishna, “Trends in Brain Drain, Gain and Circulation: Indian Experience of Knowledge Workers,” Science, Technology and Society 20, no. 3 (2015), https://doi.org/10.1177/0971721815597132
- 7.
Singh and Krishna, “Trends in Brain Drain, Gain and Circulation: Indian Experience of Knowledge Workers.”
- 8.
John Connell, Migration and the Globalisation of Health Care: The Health Worker Exodus? (Cheltenham and Northampton: Edward Elgar Publishing, 2010).
- 9.
Connell, Migration and the Globalisation of Health Care: The Health Worker Exodus?
- 10.
Ibid.
- 11.
Timothy Ken Mackey and Bryan Albert Liang, “Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health,” Health Policy 107, no. 1 (2012), https://doi.org/10.1016/j.healthpol.2012.04.006
- 12.
John Connell and Margaret Walton-Roberts, “What about the workers? The missing geographies of health care,” Progress in Human Geography 40, no. 2 (2016), https://doi.org/10.1177/0309132515570513
- 13.
Armando J. Garcia Pires, “Brain Drain And Brain Waste,” Journal of Economic Development 40, no. 1 (2015), http://www.jed.or.kr/full-text/40-1/1.pdf
- 14.
Aisha Lofters et al., ““Brain drain” and “brain waste”: experiences of international medical graduates in Ontario,” Risk management and healthcare policy 7 (2014), https://doi.org/10.2147/RMHP.S60708
- 15.
Connell and Walton-Roberts, “What about the workers? The missing geographies of health care.”
- 16.
Sally Moyce, Rebecca Lash, and Mary Lou de Leon Siantz, “Migration experiences of foreign educated nurses: a systematic review of the literature,” Journal of Transcultural Nursing 27, no. 2 (2016), https://doi.org/10.1177/1043659615569538
- 17.
Skeldon, “Of Skilled Migration, Brain Drains and Policy Responses”.
- 18.
Stephen Castles, “Guestworkers in Europe: A Resurrection?,” International Migration Review 40, no. 4 (2006), https://doi.org/10.1111/j.1747-7379.2006.00042.x
- 19.
Sergio Carrera, Elspeth Guild, and Katharina Eisele, “The Attractiveness of EU Labour Immigration Policy,” in Rethinking the Attractiveness of EU Labour Immigration Policies: Comparative perspectives on the EU, the US, Canada and beyond, ed. Sergio Carrera, Elspeth Guild, and Katharina Eisele (Brussels: Centre for European Policy Studies, 2014).
- 20.
Carrera, Guild, and Eisele, “The Attractiveness of EU Labour Immigration Policy.”
- 21.
Castles, “Guestworkers in Europe: A Resurrection?.”
- 22.
Ibid.
- 23.
Martin Ruhs and Bridget Anderson, “Responding to employers: skills, shortages and sensible immigration policy,” in Europe’s Immigration Challenge: Reconciling Work, Welfare and Mobility, ed. Elena Jurado and Grete Brochmann (London and New York: IB Tauris, 2013).
- 24.
Francis Green, “What is Skill? An Inter-Disciplinary Synthesis “(London: Centre for Learning and Life Chances in Knowledge Economies and Societies, 2011). https://www.llakes.ac.uk/sites/default/files/Green%20-%20What%20is%20Skill%20-%20final.pdf
- 25.
Organisation for Economic Co-operation and Development, International Mobility of the Highly Skilled, Organisation for Economic Co-operation and Development (Paris, 2001).
- 26.
Ruhs and Anderson, “Responding to employers: skills, shortages and sensible immigration policy.”
- 27.
Ibid.
- 28.
Fernando R. Tesón, “Brain Drain,” San Diego Law Review 45, no. 4 (2008): 8.
- 29.
Parvati Raghuram, “Governing the mobility of skills,” in Governing International Labour Migration: Current Issues, Challenges and Dilemmas, ed. Christina Gabrielle and Hélène Pellerin (Oxon and New York: Routledge, 2008).
- 30.
Thomas Faist, “The mobility turn: a new paradigm for the social sciences?,” Ethnic and Racial Studies 36, no. 11 (2013), https://doi.org/10.1080/01419870.2013.812229
- 31.
Faist, “The mobility turn: a new paradigm for the social sciences?.”
- 32.
Faist, “The mobility turn: a new paradigm for the social sciences?,” 1642.
- 33.
Thomas Faist, “Unravelling Migrants as Transnational Agents of Development: A Contribution to the Emerging Field of the Transnational Social Question,” in Unravelling Migrants as Transnational Agents of Development: Social Spaces in between Ghana and Germany, ed. Thomas Faist and Nadine Sieveking (Münster: Lit-Verlag, 2011); Hein de Haas, “The Migration and Development Pendulum: A Critical View on Research and Policy,” International Migration 50, no. 3 (2012), https://doi.org/10.1111/j.1468-2435.2012.00755.x; Skeldon, “Of Skilled Migration, Brain Drains and Policy Responses”.
- 34.
Steffen Angenendt, Michael Clemens, and Meiko Merda, “The WHO global code of practice: a useful guide for recruiting health care professionals? Lessons from Germany and beyond,” SWP Comment 22/2014 (2014).
- 35.
Martin Geiger, “The Transformation of Migration Politics: From Migration Control to Disciplining Mobility,” in Disciplining the Transnational Mobility of People, ed. Martin Geiger and Antoine Pécoud (London: Palgrave Macmillan, 2013).
- 36.
Kenneth Hermele, The Migration and Development Nexus: Looking for a Triple Win (Stockholm: Forum Syd, 2015).
- 37.
Angenendt, Clemens, and Merda, “The WHO global code of practice: a useful guide for recruiting health care professionals? Lessons from Germany and beyond.”
- 38.
Ibid.
- 39.
Ibid.
- 40.
Mireille Kingma, Nurses on the move: Migration and the global health care economy (London: Cornell University Press, 2006).
- 41.
Connell and Walton-Roberts, “What about the workers? The missing geographies of health care.”
- 42.
Ibid.
- 43.
Raghuram, “Governing the mobility of skills.”
- 44.
Raghuram, “Governing the mobility of skills.”
- 45.
Nicola Yeates, “A Dialogue with ‘Global Care Chain’ Analysis: Nurse Migration in the Irish Context,” Feminist Review 77 (2004), https://www.jstor.org/stable/1395901; Nicola Yeates, Globalizing Care Economies and Migrant Workers: Explorations in Global Care Chains (Basingstoke: Palgrave Macmillan, 2009).
- 46.
Arlie Russell Hochschild, “Global Care Chains and Emotional Surplus Value,” in On The Edge: Living with Global Capitalism, ed. Will Hutton and Anthony Giddens (London: Jonathan Cape, 2000).
- 47.
Helma Lutz, “Care migration: The connectivity between care chains, care circulation and transnational social inequality,” Current Sociology 66, no. 4 (2018), https://doi.org/10.1177/0011392118765213
- 48.
See Rhacel Salazar Parreñas, Children of Global Migration: Transnational Families and Gendered Woes (Stanford: Stanford University Press, 2005).
- 49.
Yeates, “The globalization of nurse migration: Policy issues and responses,” 437.
- 50.
Yeates, “The globalization of nurse migration: Policy issues and responses.”
- 51.
Sarah Dyer, Linda McDowell, and Adina Batnitzky, “Emotional labour/body work: The caring labours of migrants in the UK’s National Health Service,” Geoforum 39, no. 6 (2008), https://doi.org/10.1016/j.geoforum.2008.08.005
- 52.
Yeates, “The globalization of nurse migration: Policy issues and responses,” 428.
- 53.
Lisa Eckenwiler, “Care worker migration, global health equity, and ethical place-making,” Women’s Studies International Forum 47, B (2014): 213, https://doi.org/10.1016/j.wsif.2014.04.003
- 54.
Iris Marion Young, “Responsibility and global justice: A social connection model,” Social Philosophy and Policy 23, no. 1 (2006): 114, https://doi.org/10.1017/S0265052506060043
- 55.
See Eckenwiler, “Care worker migration, global health equity, and ethical place-making.”
- 56.
Yeates, “The globalization of nurse migration: Policy issues and responses.”
- 57.
Sirpa Wrede, “Nursing: globalization of a female-gendered profession,” in The Palgrave handbook of gender and healthcare, ed. Ellen Kuhlmann and Ellen Annandale (Basingstoke: Palgrave Macmillan, 2010).
- 58.
Eckenwiler, “Care worker migration, global health equity, and ethical place-making.”
- 59.
Mackey and Liang, “Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health.”
- 60.
Paul H. Troy, Laura A. Wyness, and Eilish McAuliffe, “Nurses’ experiences of recruitment and migration from developing countries: a phenomenological approach,” Human Resources for Health 5, no. 15 (2007), https://doi.org/10.1186/1478-4491-5-15
- 61.
Allyn L. Taylor and Lawrence O. Gostin, “International recruitment of health personnel,” The Lancet 375, no. 9727 (2010), https://doi.org/10.1016/S0140-6736(10)60596-X
- 62.
Kingma, Nurses on the move: Migration and the global health care economy.
- 63.
Alex Sager, “Brain drain, health and global justice,” in The International Migration of Health Workers. Ethics, Rights and Justice, ed. Rebecca S. Shah (London: Palgrave Macmillan, 2010).
- 64.
Mackey and Liang, “Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health.”
- 65.
Yeates, “The globalization of nurse migration: Policy issues and responses.”
- 66.
Tim Martineau and Annie Willetts, “The health workforce: Managing the crisis ethical international recruitment of health professionals: will codes of practice protect developing country health systems?,” Health policy 75, no. 3 (2006), https://doi.org/10.1016/j.healthpol.2005.04.012; A. Christine Delucas, “Foreign nurse recruitment: Global risk,” Nursing ethics 21, no. 1 (2014), https://doi.org/10.1177/0969733013486798
- 67.
Mackey and Liang, “Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health.”
- 68.
Kingma, Nurses on the move: Migration and the global health care economy, 7.
- 69.
Delucas, “Foreign nurse recruitment: Global risk.”
- 70.
Nicholas Blake, “Nursing migration: issues of equity and balance,” Australian Nursing Journal 18, no. 3 (2010).
- 71.
Mackey and Liang, “Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health.”
- 72.
Ibid.
- 73.
Mary Robinson and Peggy Clark, “Forging solutions to health worker migration,” The Lancet 371, no. 9613 (2008), https://doi.org/10.1016/S0140-6736(08)60310-4
- 74.
Kingma, Nurses on the move: Migration and the global health care economy.
- 75.
Yeates, “The globalization of nurse migration: Policy issues and responses.”
- 76.
Ibid.
- 77.
James Buchan and Delanyo Dovlo, International Recruitment of Health Workers to the UK: A Report for DFID, DFID Health Systems Resource Centre (London, 2004), http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.159.3006&rep=rep1&type=pdf
- 78.
The eight instruments chosen for the analysis are the DOH guidance on international nursing recruitment; DOH Code of practice for NHS employers involved in the recruitment of healthcare professionals; DOHC guidance for best practice on the recruitment of overseas nurses and midwives; ICN Position statement ethical nurse recruitment; IHA/VOICES/RNHA Supervised practice programme for internationally qualified nurses Independent sector recommendations; a code of practice for the international recruitment of health care professionals (WONCA); Royal college of nurses guidance on nursing recruitment; Commonwealth code of practice for international recruitment of health professionals (draft) and companion document (draft). Martineau and Willetts, “The health workforce: Managing the crisis ethical international recruitment of health professionals: will codes of practice protect developing country health systems?,” 362.
- 79.
Martineau and Willetts, “The health workforce: Managing the crisis ethical international recruitment of health professionals: will codes of practice protect developing country health systems?.”
- 80.
Ibid.
- 81.
Martineau and Willetts, “The health workforce: Managing the crisis ethical international recruitment of health professionals: will codes of practice protect developing country health systems?,” 366.
- 82.
Robinson and Clark, “Forging solutions to health worker migration.”
- 83.
Alex Sager, “Reframing the Brain Drain,” Critical Review of International Social and Political Philosophy 17, no. 5 (2014).
- 84.
Sager, “Reframing the Brain Drain.”
- 85.
Parvati Raghuram, “Caring about ‘brain drain’ migration in a postcolonial world,” Geoforum 40, no. 1 (2009), https://doi.org/10.1016/j.geoforum.2008.03.005
- 86.
Raghuram, “Caring about ‘brain drain’ migration in a postcolonial world,” 18.
- 87.
Raghuram, “Caring about ‘brain drain’ migration in a postcolonial world.”
- 88.
Michel Foucault, Power, ed. James D. Faubion, vol. 3, Essential Works of Foucault 1954–1984, (New York: The New Press, 2000), 341.
- 89.
Sara Kalm, “Liberalizing movements? The political rationality of global migration management,” in The Politics of International Migration Management, ed. Martin Geiger and Antoine Pécoud (Basingstoke: Palgrave Macmillan, 2010).
- 90.
Kalm, “Liberalizing movements? The political rationality of global migration management.”
- 91.
Rahel Kunz, “Mobilising diasporas: A governmentality analysis of the case of Mexico,” Working Paper Series “Glocal Governance and Democracy” (2008). http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.613.3099&rep=rep1&type=pdf
- 92.
Alan Hunt, Regulating the Social, Centre for Criminology (Toronto, 1994), 50.
- 93.
Kalm, “Liberalizing movements? The political rationality of global migration management.”
- 94.
Ibid.
- 95.
Michel Foucault, Ethics. Subjectivity and Truth, ed. Paul Rabinow, vol. 1, The Essential Works of Foucault 1954–1984, (New York: The New Press, 1997).
- 96.
Mitchell Dean, Governmentality: Power and Rule in Modern Society (London: Sage, 1999), 12.
- 97.
Dean, Governmentality: Power and Rule in Modern Society, 16.
- 98.
Kalm, “Liberalizing movements? The political rationality of global migration management.”
- 99.
Ibid.
- 100.
Nicholas J. Kiersey, Doug Stokes, and Jason R. Weidner, “Introduction,” in Foucault and International Relations: New Critical Engagements, ed. Nicholas J. Kiersey and Doug Stokes (London and New York: Routledge, 2011); Dean, Governmentality: Power and Rule in Modern Society.
- 101.
Dispositif has been translated to English publications as “apparatus.” One way Foucault defines dispositif is through its elements as “thoroughly heterogenous ensemble consisting of discourses, institutions, architectural forms, regulatory decisions, laws, administrative measures, scientific statements, philosophical, moral and philanthropic propositions–in short, the said as much as the unsaid…The apparatus itself is the system of relations that can be established between these elements.” Foucault also denotes dispositif as a configuration, the primary purpose of which is that of acting in response to an urgent need at a given historical instance. See Michel Foucault, Power Knowledge: Selected Interviews and Other Writings, 1972–1977 ed. Colin Gordon (Pantheon Books, 1980).
- 102.
Kiersey, Stokes, and Weidner, “Introduction.”
- 103.
Kalm, “Liberalizing movements? The political rationality of global migration management.”
- 104.
Kiersey, Stokes, and Weidner, “Introduction,” xix.
- 105.
Michel Foucault, “Governmentality,” in The Foucault Effect: Studies in Governmentality, ed. Graham Burchell, Colin Gordon, and Peter Miller (Chicago: University of Chicago Press, 1991).
- 106.
Jason R. Weidner, “Nation Branding, Technologies of the Self, and the Political Subject of the Nation-State” (Annual Meeting of the International Studies Association, Global Governance: Political Authority in Transition, Montreal, 2011); Kalm, “Liberalizing movements? The political rationality of global migration management.”
- 107.
Martin Geiger and Antoine Pécoud, “The Politics of International Migration Management,” in The Politics of International Migration Management, ed. Martin Geiger and Antoine Pécoud (Basingstoke: Palgrave Macmillan, 2010).
- 108.
Geiger and Pécoud, “The Politics of International Migration Management.”
- 109.
Kalm, “Liberalizing movements? The political rationality of global migration management.”
- 110.
Ibid.
- 111.
Antoine Pécoud, “Informing Migrants to Manage Migration? An Analysis of IOM’s Information Campaigns,” in The Politics of International Migration Management ed. Martin Geiger and Antoine Pécoud (Basingstoke: Palgrave Macmillan, 2010).
- 112.
Kalm, “Liberalizing movements? The political rationality of global migration management.”
- 113.
Ibid.
- 114.
Michel Foucault, Security, Territory, Population: Lectures at the Collège de France, 1977–78., ed. Michel Senellart, trans. Graham Burchell (Basingstoke: Palgrave Macmillan, 2007).
- 115.
Foucault, Security, Territory, Population: Lectures at the Collège de France, 1977–78., 18.
- 116.
Claudia Aradau and Tobias Blanke, “Governing circulation,” in Security and Global Governmentality: Globalization, Governance and the State, ed. Miguel de Larrinaga and Marc G. Doucet (London: Routledge, 2010).
- 117.
Anne-Marie D’Aoust, “Circulation of Desire: The Security Governance of the International ‘Mail-Order Brides’ Industry,” in Security and Global Governmentality: Globalization, Governance, and the State, ed. Miguel de Larrinaga and Marc G. Doucet (London: Routledge, 2010).
- 118.
Marian Barnes et al., “Conclusion: renewal and transformation – The importance of an ethics of care,” in Ethics of Care: Critical Advances in International Perspective, ed. Marian Barnes et al. (Bristol: Policy Press 2015), 243.
- 119.
Teodora Manea, “Care for carers: care in the context of medical migration,” in Ethics of Care: Critical Advances in International Perspective, ed. Marian Barnes et al. (Bristol: Policy Press, 2015).
- 120.
Manea, “Care for carers: care in the context of medical migration,” 218.
- 121.
Manea, “Care for carers: care in the context of medical migration.”; L. A. Eckenwiler, “Care Worker Migration and Transnational Justice,” Public Health Ethics 2, no. 2 (Jul 2009), https://doi.org/10.1093/phe/php015, Go to ISI://WOS:000208221600006.
- 122.
Manea, “Care for carers: care in the context of medical migration.”
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Mosuela, C.C. (2020). Migrating Nursing Skills: Governmentality and Ethics of Care. In: Recuperating The Global Migration of Nurses. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-44580-5_2
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