The Global Regulation of International Nurse Recruitment and Migration. A Historical-Critical Institutional Ethics of Care Enquiry

Abstract

Since the Second World War, international nurse recruitment has become a high-level political matter in spheres of cross-border global governance. This paper traces the global politics-ethics nexus of this development through a focus on two multilateral agreements that regulate such recruitment: the International Labour Organization Nursing Personnel Recommendation (1977) and the World Health Organization Global Code of Practice on the lnternational Recruitment of Health Personnel (2010). Innovating a global historical-critical institutional ethics of care enquiry to frame and structure the analysis, the paper argues that these global-level agreements have been consistently intentionally permissive of the international recruitment of nurses. International organisations and the international community of state and non-state stakeholders have facilitated these global nurse labour dynamics, not despite two major regulatory initiatives but through them. We find that both multilateral agreements mostly meet the standards of a global ethic of care, but do not do so as far as a critical ethic of care is concerned. The weak global institutional framework, the lack of strong connecting mechanisms in the Global Code to national spheres of governance and law, the absence of lateral links to international legal codes in the areas of social and labour policy, and the failure to address historical (including colonial) legacies underpinning the systematic depletion of national nursing workforces in poorer countries present significant challenges in realising the level of nursing workforce sustainability necessary to achieving the health and health-related SDGs.