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4. In this essay, I will argue that it is legitimate and permissible for states to prevent

the emigration of law-abiding citizens under certain conditions as part of compulsory

service schemes.

Introduction

I will draw on points raised by Luara Ferracioli (Ferracioli 2015) to first justify

restrictions on migration in general even if one accepts a human right to freedom of

movement, then examine some conditions under which it is morally permissible for

states to prevent the emigration of law-abiding citizens based on the work of Gillian

Brock (Brock and Blake 2014) and Kieran Oberman (Oberman 2013) as well as

analyse some empirical data from the emigration of health-care workers in Sub-

Saharan African nations in support of my argument.

I will consider a few concerns regarding the fairness of emigration restrictions by

poor states raised by Michael Blake (Brock and Blake 2014) raise objections to them

and finally conclude this essay.

Justifications for restricting emigration

Since the publication of Joseph Carens’ seminal paper (Carens 1987), there has

been a trend in political philosophy to make a case for open borders based on the

argument that freedom of movement within a state for the fulfilment of basic life

projects such as pursuing careers, maintaining relationships and practice of religion

is a basic human right, and extending that right across borders. (Oberman 2013)

However, since Hohfeld, a distinction between claim rights and liberty rights has

been recognised in political philosophy, with liberty rights guaranteeing freedom or

permission for right-holders and claim rights entailing responsibilities of other parties
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with regard to the right-holder. If freedom of movement across borders were to be

recognised as a fundamental human right, it would be a liberty right.

Why restricting migration in general is not a violation of freedom of movement

It does not necessarily follow that the act of migration is an exercise of this right.

Immigrants do not act as tourists, diplomats or visiting traders who primarily move

around a recipient state temporarily, they settle in the country and exercise claims on

the existing population, such as claims on healthcare, education, and housing as

well as create an economic impact on the existing labour market.

Based on this distinction between the two kinds of rights, Ferracioli grounds the

justification of immigration restrictions on the political autonomy of communities over

self-determination of their domestic socioeconomic arrangements and overrides that

of the desire to expand personal autonomy by migrants who are doing well but who

would like to raise their standards of living. (Ferracioli 2015) For example, my family

and I are under no obligation to buy my neighbours a new car even if we were richer

than they were.

While Ferracioli’s article is focussed on moral justifications for recipient states to

restrict immigration, based on her arguments one can conclude that i) restricting

migration in general does not violate the right to freedom of movement since

migration involves more than just movement, contrary to how Oberman interprets

Article 13 of the Universal Declaration of Human Rights (Oberman 2013), ii) the

political autonomy of countries affected by migration to make their own

socioeconomic arrangements takes precedence over the desire for expansion of

personal autonomy by migrants if they are reasonably well-off.

When it is permissible to restrict emigration

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The most compelling reason to argue for restricting emigration is brain drain – the

migration of skilled workers, most commonly those associated with the heath-care

and education sector, from poorer to more affluent nations. (Oberman 2013)

This is most devastating in cases where emigration of skilled workers cannot be

compensated for through financial remittances or transfer of skills. (Ferracioli 2015)

In Sub-Saharan Africa, an increase in HIV prevalence is correlated with an increase

in the rate at which physicians migrate to OECD countries (Bhargava 2013)

(Bhargava and Docquier 2008). The whole of Africa suffers a quarter of the world’s

disease burden shared amongst 13.8% of its population served only by 1.3 % of its

doctors. (Brock, Global Justice: A Cosmopolitan Account 2009) African countries

spend $500 million a year educating health-care workers who end up working in the

USA, Europe or South Asia. (Serour 2009) Clearly brain drain is an actual problem

affecting many lives in developing nations.

Following on from Oberman’s list of conditions under which recipient states may

legitimately restrict immigration to prevent brain drain (Oberman 2013), Brock has

formulated a similar list of factors under which sender states might restrict

emigration. She suggests two principle schemes to regulate emigration if these

conditions apply: compulsory service and taxation (Brock and Blake 2014). The

former is of more relevance to the original question and in relation to the reality of

brain drain and healthcare in Sub-Saharan Africa so I will not consider taxation in the

following paragraphs.

Compulsory service implies that emigration restriction can be legitimately permissible

Compulsory service in healthcare contexts currently exists in many different forms in

various developed countries, often involving sending service members to

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underserved areas, usually rural, as part of a course of study, as a requirement after

completion of a degree, as a requirement to apply for a licence to practice as part of

that state, and as a requirement for post-graduate training (Brock and Blake 2014).

Compulsory service in healthcare contexts as an alternative to military conscription

still exists in Europe today and is not viewed as a violation of the prohibition on

forced labour by the European Court of Justice nor by the UN.

The nature of compulsory service, especially when involving serving in

geographically remote underserved areas, is naturally accompanied by a restriction

on freedom of movement even within the state, to say nothing of emigration out of

the state, yet it is still regarded as legally permissible in developed states under a

contemporary understanding of human rights. So clearly, even developed states are

allowed to legitimately restrict emigration to some degree under certain conditions

with a modern conception of human rights.

Brock’s factors describe conditions where compulsory service as emigration

restriction is permissible

Briefly summarised, Brock states that a poor, legitimate, developing state might

legitimately deploy skilled workers on compulsory service to restrict emigration if

there are certain necessary background conditions, the state exercises legitimate

power by upholding human rights, the presence of the skilled workers in the country

is vital to remedy the deprivations, the skilled workers hold responsibilities to assist

the nation satisfy its needs and the costs of staying and participating in compulsory

service are not unreasonable.

The background conditions include: 1) Evidence suggesting skilled citizens of a

country can supply important services for which there are severe shortages and their
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departure would gravely undermine efforts to meet citizens’ needs, 2) Governments

has invested in training skilled workers to meet the needs of the population and to

promote beneficial development, 3) Governments having informed students in the

relevant skills of the expectation that they will have to serve to meet these needs

during the course of or at the completion of their training and having made it an

explicit condition of the students’ acceptance of training, 4) Losses from the

departure of skilled workers are not compensated by benefits resulting from it.

The responsibilities of skilled workers to assist the nation is predicated on a few

considerations: 1) Governments having expended scarce resources to build human

capital to provide for citizens’ needs and thus being entitled to a return on their

investment 2) If skilled workers emigrate, they prevent governments from getting

their rightful return on investment 3) Citizens having benefited from their residence

while not having contributed back to the country for those past benefits takes

advantages of other citizens unfairly. All these considerations are based on the

skilled workers having a fair obligation to compensate the state for their training.

While Brock identifies her focus as poor developing legitimate states, even

developed countries like Canada, Singapore, Norway and Japan employ compulsory

service programmes in healthcare, particularly in rural areas which are underserved.

(Frehywot and Mullan 2010) The same factors apply in their case, although not to

the same degree as trained medical professionals would have in Sub-Saharan

Africa.

In other words, the same arguments which are accepted regarding the costs to the

state of training skilled medical workers in developed countries and the unfairness of

them leaving without having compensated for their training should apply even more
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so to developing nations where the needs of the population are even more severe

and where there is much greater dearth of skilled medical professionals caused by

brain drain.

Blake’s objections to restricting emigration

Blake has a few objections to the arguments by Brock and Oberman on restricting

migration to prevent brain drain. I will examine his argument against skilled workers

being obligated to contribute more than less skilled workers and his argument that

even temporary “suspension of the right to exit is impermissible”. (Brock and Blake

2014)

Blake says that inequalities are not necessarily the results of injustice. Inequalities in

sexual attraction and talents are not regarded as unjust and it is easier, and unequal,

to be successful as a painter in New York compared to Kansas but not unjust. He

states the duties of building just institutions, such as that of healthcare provision in

developing countries, should be spread equally across the world’s population with no

individual receiving more than another just because of talent or skill. He gives the

example of a village whose crops are in danger of being eaten by mountain goats, all

the villagers take equal turns watching the goats but one villager is particularly skilled

at it. He argues that it is unfair to make the skilled villager spend more time than the

other villagers watching for goats.

There are a few ways in which this argument is inadequate, I will discuss two.

First of all, as Brock remarks, there is no reason to assign chores equally if

specialised skills are required, such as in the case of medical, engineering or nursing

work. Who would want a waiter to perform brain surgery on him out of a peculiar

desire for equal distribution?

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Secondly, the mountain goat example is not an accurate parallel to the situation of

skilled workers emigrating from developing countries. To make it more accurate, we

must say that mountain goat watching is a valuable, specialized skill trained at great

cost to a poor village where goats are overwhelming the villagers, with children dying

due to hunger caused by the damage the goats bring. The villager skilled at goat-

watching wants to emigrate to a rich village far away which is far less affected by

goats. It certainly would be within the bounds of fairness to restrict his emigration.

On his argument that even temporary “suspension of the right to exit is

impermissible”, he states that a temporary suspension of any human right violates it,

is illegitimate and impermissible – for instance, a temporary suspension of the right

to leave a religious group can never be justified. (Brock and Blake 2014)

Here, I would like to bring up Ferracioli’s reasoning again. Migration is not only, or

even mainly, the exercise of the right to freedom of movement, it exerts claims on

the recipient country and discharges claims and responsibilities on and towards the

country of origin. A doctor on compulsory service could very well travel to different

countries as a tourist and in so doing exercise his right to freedom; emigration from

his homeland is quite a different thing.

Conclusion

I started this essay by drawing on Ferracioli’s arguments for the justification of

restricted immigration by recipient states and generalizing them to migration in

general. Next, I brought up the deleterious effects of brain drain on developing Sub-

Saharan African countries of as a compelling case for preventing emigration by

states. Then I described compulsory service programmes as a way to combat brain

drain by restricting emigration to some degree, based on certain conditions. I then

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described a list of such conditions formulated by Brock, brought up some objections

by Blake and pointed out some flaws in his objections.

Thus, I believe I have adequately argued for how states can permissibly prevent

emigration, and in particular, brain drain, under the provision of certain conditions

through compulsory service programmes.

2027 words

Bibliography
Bhargava, Alok. 2013. "Physician emigration, population health and public policies." Journal of
Medical Ethics 616-618.

Bhargava, Alok, and Frederic Docquier. 2008. "HIV Pandemic, Medical Brain Drain, and Economic
Development in Sub-Saharan Africa." World Bank Econ Review 345-366.

Brock, Gillian. 2009. In Global Justice: A Cosmopolitan Account, 200. Oxford: Oxford University Press.

Brock, Gillian, and Michael Blake. 2014. Debating Brain Drain: May Governments Restrict
Emigration? Oxford University Press.

Carens, Joseph. 1987. "Aliens and Citizens: The Case for Open Borders." The Review of Politics 251-
273.

Ferracioli, Luara. 2015. "Immigration, self-determination, and the brain drain." Review of
International Studies 99-115.

Frehywot, Seble, and Fitzhugh Mullan. 2010. "Compulsory service programmes for recruiting health
workers in remote and rural areas: do they work?" Bulletin of the World Health Organization
364-370.

Oberman, Kieran. 2013. "Can Brain Drain Justify Immigration Restrictions?" Ethics.

Serour, Gamal. 2009. "Healthcare Workers and the Brain Drain." International Journal of Gynecology
and Obstetrics 175-178.