Karan Abraar, DeUgarte Daniel, Barry Michele
Associate clinical professor of surgery and co-director of the Global Health Education Programs at the University of California, Los Angeles (UCLA), Center for World Health.
Senior associate dean for global health and director of the Center for Innovation in Global Health at Stanford University in Stanford, California.
AMA J Ethics. 2016 Jul 1;18(7):665-75. doi: 10.1001/journalofethics.2016.18.7.ecas1-1607.
The movement of health care workers from countries with resource scarcity and immense need ("source" countries) to areas of resource abundance and greater personal opportunity ("destination" countries) presents a complex set of decisions and relationships that affect the development of international health care systems. We explore the extent to which ethical quandaries arising from this movement are the responsibility of the said actors and the implications of these ethical quandaries for patients, governments, and physicians through the case of Dr. R, a surgeon from Nigeria who is considering working in the United States, where he is being trained to help develop surgical capacity in his country. We suggest how Dr. R, the United States, and Nigeria all contribute to "brain drain" in different but complementary ways.
医护人员从资源稀缺且需求巨大的国家（“来源”国）流向资源丰富且个人机会更多的地区（“目的地”国），这带来了一系列复杂的决策与关系，影响着国际医疗体系的发展。我们通过R医生的案例来探讨这种人员流动引发的伦理困境在多大程度上应由上述行为主体负责，以及这些伦理困境对患者、政府和医生的影响。R医生是一名来自尼日利亚的外科医生，他正在美国接受培训，以便回国后帮助提升本国的外科手术能力，同时他也在考虑在美国工作。我们指出R医生、美国和尼日利亚如何以不同但相辅相成的方式促成了“人才外流”。
