Medical Cosmopolitanism: The global extension of justice in healthcare practice.

Abstract

While there is a shortage of healthcare workers in virtually all countries, there currently exists a pronounced inequality in the distribution of healthcare workers, with a high concentration of healthcare workers in high income countries (HIC) and low concentrations in low- and middle- income countries (LMIC). This inequality in the distribution of healthcare workers persists, in spite of the fact that HICs enjoy a much lower disease burden than LMICs This inequality raises medical ethical issues related to what obligations health workers from HICs have to correct these imbalances by working in LMICs. While the biomedical principle of Justice, first formulated by Beauchamp and Childress, advocates for healthcare workers to conduct themselves in a manner that is fair and equitable in light of what is due or owed, it does not elaborate on what sort of obligation this places on healthcare workers from HICs to work in LMICs in a bid fairly distribute the availability of healthcare workers. As such, this paper gives a normative argument for why healthcare workers from HICs have a moral obligation to work in LMICs, a concept we call Medical Cosmopolitanism. Following our positive argument, we debunk prominent objections to the concept of Medical Cosmopolitanism and consider ethical, educational and governmental implications of our findings.