Emmy Noether-Group on Bioethics and Political Philosophy and Centre of Advanced Study in Bioeth-ics, University of Münster, Germany;
Swiss Med Wkly. 2013 Oct 25;143:w13845. doi: 10.4414/smw.2013.13845. eCollection 2013.
Health-worker migration, commonly called "medical brain drain", refers to the mass migration of trained and skilled health professionals (doctors, nurses, midwives) from low-income to high-income countries. This is currently leaving a significant number of poor countries, particularly in sub-Saharan Africa, with critical staff shortages in the healthcare sector. A broad consensus exists that, where medical brain drain exacerbates such shortages, it is unethical, and this review presents the main arguments underpinning this view. Notwithstanding the general agreement, which policies are justifiable on ethical grounds to tackle brain drain and how best to go about implementing them remains controversial. The review offers a discussion of the specific ethical issues that have to be taken into account when deciding which policy measures to prioritise and suggests a strategy of policy implementation to address medical brain drain as a matter of urgency.
卫生工作者迁移，通常被称为“医学人才流失”，是指受过培训和熟练的卫生专业人员（医生、护士、助产士）从低收入国家向高收入国家大规模迁移。这使得许多贫穷国家，特别是撒哈拉以南非洲地区，医疗保健部门的关键人员严重短缺。人们普遍认为，在医学人才流失加剧这种短缺的情况下，这种行为是不道德的，本综述提出了支持这一观点的主要论据。尽管存在普遍共识，但在伦理上哪些政策是合理的，可以用来解决人才流失问题，以及如何最好地实施这些政策，仍然存在争议。本综述讨论了在决定优先考虑哪些政策措施时必须考虑的具体伦理问题，并提出了一项紧急解决医学人才流失问题的政策实施策略。
