There is a global shortage of nurses that affects healthcare delivery, which will be exacerbated with the increasing demand for healthcare professionals by the aging population. The growing shortage requires an ethical exploration on the issue of nurse migration. In this article, we discuss how migration respects the autonomy of nurses, increases cultural diversity, and leads to improved patient satisfaction and health outcomes. We also discuss the potential for negative impacts on public health infrastructures, lack of respect for cultural diversity, (...) and ethical concerns related to autonomy and justice, including coercion and discrimination. This analysis is written from a rights-based ethics approach by referring to rights held by nurses and patient populations. Nurse migration highlights conflicts between nurses and between nurses and healthcare systems. Increased awareness of ethical challenges surrounding nurse migration must be addressed to enhance the well-being of nurses and patient populations. (shrink)

I am very grateful to the five commentators for taking the time to respond to my article ‘The Active Recruitment of Health Workers: A Defense’.1 I have learned a great deal from each of their commentaries, and I am sorry to say that I will be unable to address all their important comments and criticisms in detail. In this response, I will focus on replying to the commentators’ major objections.In my paper, I suggested that the emigration of health workers from (...) poor countries might not have harmful effects on health outcomes in general, or may only have relatively small negative effects in a wide range of cases. Several commentators challenge my analysis. Carwyn Rhys Hooper suggests that it is prima facie plausible that the emigration of health workers causes harm, and that there is insufficient evidence to reject this claim.2 Gilian Brock3 and Iain Bassington4 argue that my paper failed to consider the full range of possible harms that the active recruitment of health workers brings about. These commentators are correct in that we need more evidence about the effects of migration, and that it may be too soon to arrive at the all-things-considered judgment that the emigration of health workers does not generally enable serious harm.Nonetheless, I believe that the active recruitment of health workers is still permissible. For one thing, I am less confident than Brock that the empirical research on skilled migration clearly establishes that the migration of skilled professionals causes harm to sending countries. There is a sizable body of empirical research that is inconsistent with many of Brock's claims. It is not obvious that the emigration of skilled workers depletes human capital in the sending country.5 ,6 In fact, there is evidence that the opportunity to emigrate …. (shrink)