The Volokh Conspiracy - The Road to Serfdom:

Here's what an article in this week's issue of The Lancet suggested. (Note that this was covered in the New York Times; The Lancet is a very prominent medical publication.)

Although the active recruitment of health workers from developing countries may lack the heinous intent of other crimes covered under international law, the resulting dilapidation of health infrastructure contributes to a measurable and foreseeable public-health crisis. There is now substantial evidence of state and organisational involvement in active recruitment of health workers from developing to developed nations.

There is no doubt that this situation is a very important violation of the human rights of people in Africa. In recent years, international law has developed the notion of international crime to strengthen the accountability of individuals for serious violations. One indication of the gravity of acts and that they deserve treatment as international crimes that has been developed by the International Criminal Court is that they create social alarm. Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm: the practice should, therefore, be viewed as an international crime. [Emphasis added.]

What a way of looking at the world -- though of course nothing remotely new. Your country needs your medical services. Therefore, it's wrong for others to steal you away from your country, since you're the country's property. In fact, this theft is an international crime.

That's what the logic amounts to, it seems to me, though of course for all the best of intentions. The proposal doesn't just call on rich organizations (or even rich countries) to fund medicine in poorer countries, or to teach those countries how to provide medicine more effectively, or to reduce regulatory barriers to good medical care in those countries. Rather, it tries to use international criminal law in a way that blocks people from moving towards a better life for themselves and their families (including their families back home, whom they can support through remittances) -- to keep people where they supposedly belong, in the place that's entitled to their services and to coercive government action aimed at preventing the loss of those services.

Now it's true that the proposal doesn't (yet) cover "passive" recruitment, which is to say simply hiring someone who comes from a country that needs the person more than you do. The article reports: "We, of course, recognise that while there is a right to health for everyone, there are also health-workers' rights to consider. Health workers should have freedom of movement and choice of where they live and work, just as any workers should."

But surely this "active recruitment" doesn't consist of sitting on people's doorsteps and nagging them until they break down and agree to move to a richer country. The health workers who move in response to the active recruitment are exercising their freedom of movement and choice of where they live and work. The active recruitment simply informs them about where the opportunities are, plus helps them lift barriers to the exercise of their rights (legal barriers, by providing "legal assistance with immigration," and economic barriers, by providing "guaranteed earnings, and moving expenses"). It makes no sense to say "of course, we recognise your rights to freedom of movement and choice of where you live and work; we'll just make it an international crime for people to lift legal, economic, and informational barriers to your exercise of those rights."

And the logic of the proposal surely casts into doubt even the health-workers' right to move entirely on their own. After all, the rationale is that "Without immediate actions to discourage migration, the health consequences for Africa are dire," and "Current international treaties and commitments are severely compromised if we are unwilling to adhere to their principles and prevent obvious harms to poor people." The consequences are "dire" and the "harms to poor people" present even if the health workers emigrate without outside "entic[ement]," for instance when they learn about opportunities and get legal and economic help from relatives or friends rather than from recruitment agencies.

Once you take the view that it's an "international crime" to urge or to help someone exercise his rights, you've undermined his practical ability to exercise his rights, and you've also gone a long way towards denying his moral entitlement to those rights. That is the road to serfdom, with each medical professional being the property of the lord of his manor (the local government, though of course speaking on behalf of the people).

Thanks to Michael McNeil for the pointer.

	[Eugene Volokh, February 25, 2008 at 12:47pm] Trackbacks The Road to Serfdom: Here's what an article in this week's issue of The Lancet suggested. (Note that this was covered in the New York Times; The Lancet is a very prominent medical publication.) Although the active recruitment of health workers from developing countries may lack the heinous intent of other crimes covered under international law, the resulting dilapidation of health infrastructure contributes to a measurable and foreseeable public-health crisis. There is now substantial evidence of state and organisational involvement in active recruitment of health workers from developing to developed nations. There is no doubt that this situation is a very important violation of the human rights of people in Africa. In recent years, international law has developed the notion of international crime to strengthen the accountability of individuals for serious violations. One indication of the gravity of acts and that they deserve treatment as international crimes that has been developed by the International Criminal Court is that they create social alarm. Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm: the practice should, therefore, be viewed as an international crime. [Emphasis added.] What a way of looking at the world -- though of course nothing remotely new. Your country needs your medical services. Therefore, it's wrong for others to steal you away from your country, since you're the country's property. In fact, this theft is an international crime. That's what the logic amounts to, it seems to me, though of course for all the best of intentions. The proposal doesn't just call on rich organizations (or even rich countries) to fund medicine in poorer countries, or to teach those countries how to provide medicine more effectively, or to reduce regulatory barriers to good medical care in those countries. Rather, it tries to use international criminal law in a way that blocks people from moving towards a better life for themselves and their families (including their families back home, whom they can support through remittances) -- to keep people where they supposedly belong, in the place that's entitled to their services and to coercive government action aimed at preventing the loss of those services. Now it's true that the proposal doesn't (yet) cover "passive" recruitment, which is to say simply hiring someone who comes from a country that needs the person more than you do. The article reports: "We, of course, recognise that while there is a right to health for everyone, there are also health-workers' rights to consider. Health workers should have freedom of movement and choice of where they live and work, just as any workers should." But surely this "active recruitment" doesn't consist of sitting on people's doorsteps and nagging them until they break down and agree to move to a richer country. The health workers who move in response to the active recruitment are exercising their freedom of movement and choice of where they live and work. The active recruitment simply informs them about where the opportunities are, plus helps them lift barriers to the exercise of their rights (legal barriers, by providing "legal assistance with immigration," and economic barriers, by providing "guaranteed earnings, and moving expenses"). It makes no sense to say "of course, we recognise your rights to freedom of movement and choice of where you live and work; we'll just make it an international crime for people to lift legal, economic, and informational barriers to your exercise of those rights." And the logic of the proposal surely casts into doubt even the health-workers' right to move entirely on their own. After all, the rationale is that "Without immediate actions to discourage migration, the health consequences for Africa are dire," and "Current international treaties and commitments are severely compromised if we are unwilling to adhere to their principles and prevent obvious harms to poor people." The consequences are "dire" and the "harms to poor people" present even if the health workers emigrate without outside "entic[ement]," for instance when they learn about opportunities and get legal and economic help from relatives or friends rather than from recruitment agencies. Once you take the view that it's an "international crime" to urge or to help someone exercise his rights, you've undermined his practical ability to exercise his rights, and you've also gone a long way towards denying his moral entitlement to those rights. That is the road to serfdom, with each medical professional being the property of the lord of his manor (the local government, though of course speaking on behalf of the people). Thanks to Michael McNeil for the pointer.