CREUM, Univeristé de Montréal, C.P. 6128 succ. Centre-ville, Montréal, Québec, Canada.
Soc Sci Med. 2009 Aug;69(3):301-4. doi: 10.1016/j.socscimed.2009.03.004. Epub 2009 Mar 19.
This paper demonstrates a working alternative to the accepted ethics of physician migration. A dominant cosmopolitan ethics encourages upward mobility of physicians in a globalized labour force, and this ultimately advances the position of individuals rather than improving public health-care service for vulnerable communities in the global South. Cuba's Escuela Latinoamericana de Medicina (ELAM) challenges this trend as its institutional ethics furnishes graduates with appropriate skills, knowledge and service ethics to deliver quality care in marginalized areas. This paper provides an analysis of how ELAM trains physicians in community-oriented service for marginalized areas in the global South. The principle finding of this analysis is that ELAM exhibits a working alternative to the accepted ethics of physician migration, as it encourages graduates to practice in marginalized communities rather than feed the migration pipeline into the North. Arguably, ELAM serves as an important case study in how a medical school's ethics can work to bring graduates closer to the communities that are in desperate need of their skills and of their compassion.
本文提出了一种有别于传统的、被广泛认可的医师移民伦理观的替代方案。一种主流的世界主义伦理学鼓励医生在全球化的劳动力市场中向上流动，而这最终是为了提升个人的地位，而不是为了改善全球南方弱势社区的公共医疗服务。古巴的拉美医科大学（ELAM）挑战了这一趋势，因为它的机构伦理为毕业生提供了适当的技能、知识和服务伦理，以便在边缘化地区提供高质量的护理。本文分析了 ELAM 如何培训医生为全球南方的边缘化地区提供以社区为导向的服务。这一分析的主要发现是，ELAM 展示了一种有别于传统的医师移民伦理观的替代方案，因为它鼓励毕业生在边缘化社区行医，而不是将他们推向北方的移民管道。可以说，ELAM 是一个重要的案例研究，说明了一所医学院的伦理观如何能够促使毕业生更接近那些迫切需要他们的技能和同情心的社区。
