Adopting an ethical approach to migration health policy, practice and research

Abstract

Migration health is affected by decision making at levels ranging from global to local, both within and beyond the health sector. These decisions impact seeking, entitlements, service delivery, policy making and knowledge production on migration health. It is key that ethical challenges faced by decision makers are recognised and addressed in research and data, clinical practice and policy making on migration health. An ethical approach can provide methods to identify ethical issues, frameworks for systematising information and suggesting ethically acceptable solutions, and guidance on procedural concerns and legitimate decision making processes. By unpacking dilemmas, conflicts of interests and values at stake, an ethical approach is relevant for all who make decisions about migration health policy and practice. Adopting an ethical approach to migration health benefits governments, organisations, policy makers, health workers, data managers, researchers and migrants themselves. First, it highlights the inherent normative questions and trade-offs at stake in migration health. Second, it assists decision makers in deciding what is the ethically justifiable thing to do through an ‘all things considered’ approach. Third, ethical frameworks and technical guidance set normative and practical standards for decision makers facing ethical questions – from ‘bedside rationing’ to collection of big data or in policy making – that can ensure that migrants’ interests are considered. Fourth, there is a need for greater transparency and accountability in decision making, as well as meaningful participation of migrant groups. An ethical approach connects to public health, economic and human rights arguments and highlights the urgent need to mainstream concerns for migrants in global and national health responses.

Migration health ethics in Southeast Asia: a scoping review

“…The health and well-being of migrants are impacted by a complex range of global and local factors, both within and beyond the health sector. Therefore, an ethical approach to policy making, research and clinical practice can provide means to identify ethical issues, frameworks for systematising information and catalyse the formulation of ethically acceptable solutions ( Onarheim et al, 2021 ). The systematic unpacking of dilemmas, values, and conflicts of interest equips decision-makers in migration health with analytic tools and guidance in dealing with challenges in policy making and practice.…”

“…The systematic unpacking of dilemmas, values, and conflicts of interest equips decision-makers in migration health with analytic tools and guidance in dealing with challenges in policy making and practice. Ethical scrutiny and procedural guidance can also assist in highlighting policies and practices that are at variance with fundamental principles of medical ethics, public health and human rights ( Onarheim et al, 2021 ).…”

“…It is an “interdisciplinary field populated by scholars, teachers, and clinical practitioners from a wide variety of traditional disciplines, such as philosophy, religious studies, law, medicine, nursing, social work, public health, the medical humanities (literature and history), and social sciences (politics, sociology, economics, anthropology)” ( University of Virginia, 2023 ). Onarheim et al (2021) highlighted myriad ethical dilemmas faced by key stakeholders in migration health, which include health workers, regional and international policymakers, data managers and researchers, and migrants themselves, which suggests that bioethics is inextricably linked to almost all aspects of migration health.…”

“…Research on migration health ethics can also be transformative – bringing disempowered voices into focus and providing a platform that offers solutions to pertinent issues surrounding migrant health ( Zion, 2019 ). It is imperative to not only recognise ethical challenges in migration health, but also to document the issues while systematically formulating sustainable ethical solutions to research, clinical practice and policymaking on migration health ( Onarheim et al, 2021 ).…”

Inclusief hr-beleid voor arbeidsmigranten hard nodig

“…Om deze en andere redenen pleiten verscheidene experts en organisaties (o.a. WHO, 2014;ILO, 2020;Onarheim, 2021) bijvoorbeeld voor het toekennen van gelijke rechten op gezondheidszorgvoorzieningen voor migranten in een werkland, ook al is de verblijfstatus vanwege de (tijdelijke) duur van het verblijf mogelijk onduidelijk. Voor gezondheidswerkers kan het ingewikkeld zijn de juiste behandeling en verzorging te waarborgen (mede vanwege bovengenoemde taalproblemen of andere barrières zoals de financiering of het gebrek aan eenduidige regelgeving).…”