The Ethics of Bilateral Labor Agreements for Nurses : Perspectives from the Philippines

Abstract: The dissertation "The Ethics of Bilateral Labor Agreement for Global Nurses - Perspectives from the Philippines" is written in the research area of ​​applied ethics and examines ethical aspects of labor migration in the specific area of ​​healthcare, with the Philippines as an example. The central questions for the dissertation are the ethical issues of nurse migration in the Philippine context. These ethical concerns give rise to how the responsibility for such migration governance should be understood and designed. More specifically, the issue of responsibility is discussed in relation to the Philippine Government, and its counterpart foreign governments, for their use of the bilateral labor agreement (BLA) as a policy measure to manage the migration of nurses.The thesis draws on from empirical studies of Filipino nurses’ massive emigration and how this mobility affects individuals and the Philippine society. Historical description of the emergence of healthcare professionals as export products in the Philippines is also consulted. The country’s colonial history is described, and its relevance to today’s migration pattern is analyzed. Based upon the empirical data on past and present Filipino health worker emigration, identified ethical implications are examined. Among these are the rights of individuals and the division of responsibilities between origin and destination countries in order to address the ethical implications the BLAs give rise to. In the theoretical part of the work, key elements from John Rawls’ theories of justice (1971, 1993, 2001) are used to identify conditions of a crafting public policy that, ideally, should be met in agreement with the members of a liberal society. Thereafter, the ideal model of a BLA is constructed based on the main principles of justice. The model is used to examine the extent to which, if at all, the existing BLAs between the Philippines and countries like Japan and Germany can be considered as ethically defensible instruments for managing the emigration of nurses. Finally, a discussion on how such agreements should be designed to be ethically defensible is offered.