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Is active recruitment of health workers really not guilty of enabling harm or facilitating wrongdoing?
  1. Gillian Brock
  1. Correspondence to Dr Gillian Brock, Philosophy Department, University of Auckland, Arts 2, Room 322, 18 Symonds Street, Auckland 1142, New Zealand; g.brock{at}

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Hidalgo1 argues that, contrary to widespread belief, active recruitment of health workers ‘generally refrains from enabling harm or facilitating wrongdoing’. In this commentary, I argue that the case is not yet convincing. There are a number of problems with the argument, only some of which I can sketch here. These include:

  1. Hidalgo gives an insufficient account of the relevant harms that are inflicted when healthcare workers emigrate. Relatedly, he does not take account of the underlying causes of migration and what might assist in remedying the situation. He thus fails to catalogue a wide range of losses that are born when health workers emigrate from developing countries and fails to appreciate how his recommendations undermine some of the constructive initiatives that might assist poor, developing countries.

  2. Hidalgo misrepresents the situation in developing countries, incorrectly describing government funding of tertiary education as some kind of gift, rather than an investment in creating important human capital to provide for citizens’ needs, which can mean that fair returns on investment are quite justified. With the correct descriptions in place, the grounding for various duties to reciprocate is rendered secure.

  3. There are some important problems with the empirical studies cited such that they do not provide support for Hidalgo's argument.

I begin with the case for (1). There are large disparities in life prospects between developing and developed countries. Indeed, this wide disparity is one of the main reasons healthcare workers want to leave in the first place. If that is the main reason healthcare workers seek to exit, it is not insignificant what would address the causal, underlying problems. How do we promote prosperity in developing countries? A lively debate on this topic flourishes. However, one factor that has widespread support from all sides of the debate is that the quality of …

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  • Funding None.

  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • i For a summary of relevant issues concerning the debates about causes of prosperity and the importance of institutions see reference 2, chapter 5.

  • ii For an excellent, accessible treatment see reference 3.

  • iii See Kapur and McHale3 for an excellent overview.

  • iv Kapur and McHale,3 p. 162.

  • v Gillian Brock,2 Chapter 8.

  • vi For more on these arguments see Brock.2

  • vii For more on these arguments see reference 5.

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