South African Journal of Philosophy = Suid-Afrikaanse Tydskrif vir Wysbegeerte - latest Issue

How should we respond to losses associated with the brain drain in our unjust world? As we write this introduction, the situation in South Africa continues to be concerning. Thuli Madonsela, the former Public Protector, has released an influential report concerning state capture and corruption. The “Fees Must Fall” movement has succeeded in shutting down many universities. Sixty-three per cent of young children growing up in South Africa today live in poverty, with woefully inadequate sanitation, access to nutrition, healthcare and provision for other basic needs (Pretorius 2016). Reforms on many fronts seem warranted. While people of good faith might well disagree about what is needed and how to prioritise improvements, it would probably be hard to find many citizens who think South Africa today is a place where justice has been achieved.

This paper explores and adds to Gillian Brock and Michael Blake’s debate on health worker migration. Brock argues for a limited right of states to restrict the migration of health workers beyond their borders. She offers a range of reasons to support this argument based broadly on her account of global justice. In the context of health worker migration, she supports her argument more specifically by linking health workers’ obligations to duties of reciprocity and not imposing costs on their compatriots. In this paper, I seek to support her argument by offering solidarity, as developed in the literature on public health ethics, as a ground for the obligations of health workers to their compatriots and a limited right of states to restrict their movements. On a narrow view of reciprocity, health workers are obligated to repay their communities for the benefits that they have received during their childhoods and training. Solidarity augments this view by arguing that all persons also have positive obligations to take public actions to address injustices. This complementary ground for restrictions on the movements of health workers helps to address Blake’s critiques of communitarianism and reciprocity as justifying state restrictions.

In this paper I consider Gillian Brock’s and Michael Blake’s discussion of emigration in Debating Brain Drain in relation to the particular case of South Africa, and explore whether skilled white people have a duty to remain in the country. Focusing on the role of community in this debate, I argue that communities and allegiances in South Africa are still too divided and antagonistic for them to play the duty-grounding role that Brock requires.

In this paper, I argue that one permissible solution to the problem of brain drain from less developed countries is to level a tax on the money skilled emigrant workers earn within more developed countries. Contrary to both Brock and Blake, this tax may be levelled even if it was not announced to the emigrants in advance of their training in their home country, and even if they never explicitly agreed to accept that tax as a condition on that training. This is because the emigrants are still political members within their home country – though their membership fades away gradually with time spent in their new country – and can thus be subjected to the burdens of political membership, including redistributive taxation.

This paper proposes two shifts in our approach to the brain drain crisis. First, it argues for a collective view. Since the moral wrong of the brain drain is inherently collective, we can best understand our consequent duties through a collective lens. Second, the paper argues that we ought to explore explicitly the duties of citizens of source states. These citizens systematically bear the burdens of labour migration, giving us good reason to search for normative guidelines for how best to understand and distribute these burdens. Drawing on these two shifts, the paper argues that the obligations of citizens of source states are best understood as individual shares of a collective duty to uphold the functioning of their state. The content of this duty is deeply shaped by background injustice and so ought to be understood as a duty to “take up the slack”. As such, individuals’ shares are differentiated to respect the diversity of individual circumstance and, where formal policy is required, it ought to be democratically determined.

This paper joins the thorny debates on the “brain drain”. It first examines some of the core issues and debates around international migration and the asymmetry in the arguments that defend the right to restrict entry but are critical of any attempts to rein in exit. It then argues that the empirical evidence on this issue is contingent on multiple factors, which weakens the case for universal recommendations. Instead, the paper lays out a form of “partial cosmopolitanism” that attempts to balance an individual’s freedom to exit with the larger social good in two distinctive ways: first, by allowing some grains of sand in the wheels of skilled migration flows through contingent contracts in higher education; and second, enhanced temporary migration that encourages greater international mobility but with temporal curbs. The paper concludes by suggesting that in an era of international migration, welfare considerations need to account for both people within territorially bounded countries and territorially unbounded nations.

In my contribution to this brain drain debate sparked by Brock and Blake’s book, Debating Brain Drain, I respond only to Brock’s position, and raise three objections which I suggest complicate the picture that she sketches. First, I take issue with the way in which she frames the moral question, namely by limiting her focus to what home countries may legitimately do to address the problems associated with the brain drain. I argue that the way in which she frames the question has important ideological consequences, because she does not adequately account for the larger context, in particular, by leaving out the moral obligations of the host countries who are the main beneficiaries of the brain drain. My second objection is rooted in the distinction between technical knowledge and practical knowledge found in the work of Habermas – an important distinction which gets obscured in Brock’s analysis in precisely the kind of ideological ways that Habermas was concerned about. She namely attempts to solve what are mainly practical (political) problems through purely instrumental, technical means. Several distortions accompany this fundamental confusion. My third point of critique has to do with the problem that an ethics of care (an ethics of responsibility and obligation) encounters within a liberal paradigm strongly shaped by an ethics of rights. Drawing on the work of Kroeger-Mappes, I argue that Brock arbitrarily singles out a group of people and holds them to an ethics of care which is strictly supererogatory within her own liberal paradigm.

According to the brain drain argument, there are good reasons for states to limit the exit of their skilled workers (more specifically, healthcare workers), because of the negative impacts this type of migration has for other members of the community from which they migrate. Some theorists criticise this argument as illiberal, while others support it and ground a duty to stay of the skilled workers on rather vague concepts like patriotic virtue, or the legitimate expectations of their state and co-citizens. In this article, on the contrary, we suggest that the liberal conception of states’ legitimate political authority demands, and not just permits, that developing states from which migration of skilled workers occurs set up contractual mechanisms. These mechanisms will ensure that state-funded training in the health sector is provided against a commitment on the part of future professionals to reciprocate with their services for the benefits obtained. If one of the conditions for the state to maintain legitimate political authority is to provide basic services such as healthcare to its subjects (while respecting at the same time their autonomy and freedom), then this is what developing states affected by the brain drain ought to do. What we call the authority-based approach to the brain drain also helps to clarify the obligations that other states have not to interfere with these contractual mechanisms when they exist, and not to profit from their absence. Inspired by FIFA’s legal instruments of training compensation and solidarity mechanism for the transfer of players, we conclude by suggesting a plausible global policy to complement this authority-based approach.

The problem of brain drain, the movement of skilled citizens of developing countries to developed ones, arises largely because of seriously unequal life prospects in different countries. Hence, there is something profoundly wrong with the brain drain, something that calls for a moral response. Brock and Blake offer such a response by debating the ethical rights and responsibilities of skilled professionals, and of the societies in which they live, from the perspective of moral liberalism. The aim of my paper is to develop a response to some of their arguments from the perspective of moral communitarianism, with particular reference to the work of one of its classical proponents in African philosophy, Kwame Gyekye.

I argue in this paper that the proposals developed by Gillian Brock in Debating the Brain Drain: May Governments Restrict Emigration? should not only be applied to so-called “highly skilled” emigrants. I contend that Brock’s proposals, in order to be implemented justly, must be re-framed such that they are inclusive of so-called “low-skilled” or “unskilled” migrants. I argue for a more inclusive understanding of the “brain drain” in immigration policy – one that can make use of Brock’s important proposals in an expanded fashion – and I provide an account of what this more inclusive understanding should look like.

In Debating Brain Drain, Gillian Brock and Michael Blake both draw on a liberal moral-political foundation to address the issue, but they come to different conclusions about it. Despite the commonly held value of free and equal persons having a dignity that grounds human rights, Brock concludes that many medical professionals who leave a developing country soon after having received training there are wrong to do so (if they do not provide compensation) and that the state may place some limits on their ability to exit, whereas Blake infers that there is neither any wrongdoing on their part, nor rightful restrictions placed on them. In this article, rather than sort out which has the better interpretation of what liberalism entails, I consider the medical brain drain in the light of an alternative normative framework, one informed by ideals of communion salient in the sub-Saharan moral tradition. I argue that a principle of prizing communal relationships more naturally entails Brock’s conclusions than does her appeal to liberalism.

The paper provides a critical perspective on recent contributions to the economics literature, and associated philosophical arguments, that downplay negative effects of skilled migration on developing countries. The assertion that such migration incentivises investment in human capital is shown to rely on shaky theoretical foundations and weak empirical evidence. The associated economic literature suggesting a net positive effect of brain drain is at odds with literatures on the positive effects of human capital and education on economic growth. The manner in which net effects are determined also demonstrates that such contributions are utilitarian in nature. Identifying those who are the worst affected by brain drain, as well as the possible decision of a citizen placed behind the veil of ignorance, supports the view that opposing barriers to brain drain is inconsistent with a Rawlsian social welfare function. The  undermining of institutions by skilled emigration is a fundamental consideration neglected by the economics literature without justification and, again, contradicts literatures on growth and institutions within economics. The economic theory of education can also be shown to support the view that depriving governments of the power to limit migration undermines states’ ability to resolve market failures. A number of other issues are identified that deserve greater consideration, including reflexivity in research on brain drain, the political economy of skilled migration and the philosophical status of nation-states. Despite unreliable econometric evidence, there is sufficient basis and justification to act. The paper concludes by briefly sketching possible actions under different degrees of international cooperation.

This paper contributes to the discussion of the ethics of brain drain against the background of the book Debating Brain Drain co-authored by Gillian Brock and Michael Blake. Whereas Gillian Brock argued in this book that a plausible response of global justice would, under certain conditions, permit that developing countries impose taxes or demand compulsory service from their professionals who emigrate, Michael Blake rejects such claims in his defence of the right to emigrate. Extending this debate to the context of reverse immigration, I attempt in this paper to establish if the arguments provided by both scholars are capable of accounting for the cogency or otherwise of preference in reverse immigration. My proposal is that the arguments provided by both Brock and Blake require further contextualisation to make them capable of deciding the question of preference in reverse immigration.

This article uses Plato’s Crito as a lens through which to consider the question of whether a South African citizen should emigrate from South Africa. While this question is not exactly parallel to that of whether the condemned Socrates should flee Athens, it has much more to do with justice than is commonly thought. For in order for one to know whether one has an overall duty to remain in or leave South Africa, one must determine what one owes to one’s country and compatriots, one’s community, one’s family, and oneself.

In this essay, which forms part of a symposium on the brain drain, I respond to the arguments of several critics. I defend my proposals concerning how to address problems associated with high levels of skilled migration, especially in the face of concerns about identity, community and obligation in an unjust world.

I have previously argued that liberal states are limited in the means by which they can respond to the emigration of skilled professionals. In particular, the right to leave is a right of sufficient strength that it must be defended even when its suspension would create more robust institutions for those in the state of origin. Against this, four critics offer arguments in favour of positions which – like those of Gillian Brock – would allow states more leeway in their legitimate policy options. These critics offer arguments from legitimate authority; from solidarity; from burden-sharing under non-ideal circumstances; and from gradualism in both the acquisition and dissolution of membership. In this paper, I defend my original view against these objections. I am grateful to these critics, as well as the other authors who have written in this volume.