The role of structural ethics in restraining "Japa" among clinicians

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Ikechukwu Monday Osebor

Globally, inequity is ingrained in every sector, and healthcare is no exception. The need for medical justice is not only for patients but also for medical personnel. Structural injustice is the denial of infrastructure and the avoidance of responsibilities. The underrepresentation, marginalization, inadequate working environment, poor remuneration, fatigue, overstress, and economic adversity are structural injustices. The structural injustice becomes a source of worry for the clinicians, coupled with the challenges of treating 4000 patients per doctor in Nigeria. Despite the efforts of governments to stop Japa, it has persisted. The moral implication of Japa include dreadful medical standards, withdrawal of medical services, indiscriminate deaths of patients caused by push and pull factors. The Japa syndrome may be good and healthy for economic reasons, but it has done more harm than good. Using the method of philosophical analysis, this study maintains that structural injustice is the major cause of Japa among clinicians and has provided rigid foundations for the classical management of the health sector. This study suggested the application and implementation of structural ethics to overhaul structural injustice and reduce the shortage of medical personnel in Nigeria.

Paraules clau
Japa, Doctors, Structural Ethics, Death, Medical injustice

Article Details

Com citar
Monday Osebor, Ikechukwu. «The role of structural ethics in restraining “Japa” among clinicians». Ramon Llull Journal of Applied Ethics, 2024, núm. 15, doi:10.60940/rljaev1n15Id428072.
Referències

Ahmed O. (2023). Japa: Nigeria now has 1 doctor for every 4,000 patients, the College of Surgeons laments. https://gazettengr.com/japa-nigeria-now-has-1-doctor-to-4000-patients-college-of-surgeons-laments/

Apte, Vaman Shivaram (1890). A Practical Sanskrit-English Dictionary, p. 447

Ashley, Thomas (2006) Chakra Mantras: Liberate Your Spiritual Genius Through Chanting (1 ed.) San Francisco: Farrand Weiser Books, p. 11. ISBN 9781578633678.

Arzroomchilar, E. (2022). "Structural Ethics" as a Framework to Study the Moral Role of Non-Humans Techné: Research in Philosophy and Technology

Jenny, C., and Committee on Child Abuse and Neglect (2007) Recognizing and responding to medical neglect Pediatrics, 120(6), 1385–1389.

Assembly, U. G. (1948). Universal declaration of human rights UN General Assembly, 302(2), 14–25

Astor, A., Akhtar, T., Matallana, M. A., Muthuswamy, V., Olowu, F. A., Tallo, V., & Lie, R. K. (2005). Physician migration: views from professionals in Colombia, Nigeria, India, Pakistan, and the Philippines Social science and medicine, 61 (12), 249–2500.

Bernard Dayo (n-d): How "Japa" Became the Nigerian Buzzword for Emigration https://www.okayafrica.com/emigration-in-nigeria-japa/

Boboc, C., Vasile, V., and Ghiţă, S. (2011). Migration of Physicians: Causes and Effects in CEE Countries In: Zhou, M. (eds.) Education and Management ISAEBD 2011. Communications in Computer and Information Science, vol. 210 Springer, Berlin, Heidelberg https://doi.org/10.1007/978-3-642-23065-3_74

Botezat, A., and Ramos, R. (2020). Physicians' brain drain: a gravity model of migration flows Global Health 16, 7 https://doi.org/10.1186/s12992-019-0536-0

Brey, P. (2013). From moral agents to moral factors: The structural ethics approach In The moral status of technical artifacts (pp. 125–142). Dordrecht: Springer Netherlands

Brey, P. A. E. (2014). From moral agents to moral factors: the structural ethics approach In P. Kroes and P. P. C. C. Verbeek (Eds.), The Moral Status of Technical Artifacts (pp. 124–142), (Philosophy of Engineering and Technology, Vol. 17, No. 17) Springer. https://doi.org/10.1007/978-94-007-7914-3_8

Chinagorom U (2023). Japa is good for Nigeria—Peter Obi https://www.premiumtimesng.com/news/more-news/606160-japa-is-good-for-nigeria-peter-obi.htm

Chinagorom, U. (2023). 'Japa' is good for Nigeria, says Peter Obi. https://www.premiumtimesng.com/news/more-news/606160-japa-is-good-for-nigeria-peter-obi.html

Daisy, C., and Eric, C. (2020). COVID-19 Lockdowns: A Public Mental Health Ethics Perspective Asian Bioethics Review, 2020 https://doi.org/10.1007/s41649-020-00144-0

Fasanmade, O. A., & Dagogo-Jack, S. (2015). Diabetes care in Nigeria Annals of Global Health, 81(6), 821–829

Gallagher, A. (2001). Human rights and the new UN protocols on trafficking and migrant smuggling: A preliminary analysis Hum. Rts. Q., 23, 975.

urban dictionary (n-d) https://www.urbandictionary.com/define.php?term=Japa

Hagopian, A., Ofosu, A., Fatusi, A., Biritwum, R., Essel, A., Hart, L. G., & Watts, C. (2005). The flight of physicians from West Africa: views of African physicians and implications for policy Social science and medicine, 61(8), 1750–1760.

Ignatius I (2023). Japa: NMA Opposes Five-Year Compulsory Practice, Says 'That Is Not The Solution.' https://www.channelstv.com/2023/04/12/japa-nma-opposes-five-year-compulsory-service-says-that-is-not-the-solution/

Jude, B. (2022). Ethical Issues in Business https://study.com/learn/lesson/ethical-issues-in-business-types-handling-examples.html

Katharina B. (2023). The Countries Experiencing Doctor Brain Drain: Healthcare in India https://www.statista.com/chart/29667/doctor-brain-drain/

Madaio, M., Blodgett, S. L., Mayfield, E., & Dixon-Román, E. (2022). Beyond "fairness": structural justice lenses on AI for education In The ethics of artificial intelligence in education (pp. 203-239). Routledge.

Monday I.O. (2020). Reintroduction of native-centric education for children in COVID-19 Lockdown Sri Lanka Journal of Child Health, 2020; 49(3): 308–309.

Monday, I (2020). "The Ethics of Organ Farming". Turkish Journal of Bioethics, Vol. 7, No. 4, 183–186

Monday, I.O. (2020). "The Relevance of Deep Ecological Principles in Aquatic Crisis: A Philosophical Perspective," Bangladesh Journal of Bioethics, 11 (2020), p. 35–41. https://doi.org/10.3329/bioethics.v11i2.50392

Monday, IO (2020). Ethics Of Cognitive Restructuring: Rehabilitation Of Rape Victims And Offenders Voices In Bioethics, 6. DOI Https://Doi.Org/10.7916/Vib.V6i.7223

Moore, T. (2004). Ethics. In High Dependency Nursing Care (pp. 120–130). Routledge.

Ogaboh, A. A., Udom, H. T., & Eke, I. T. (2020). Why brain drain in the Nigerian health sector. Asian J Appl Sci, 8.

Onah, C. K., Azuogu, B. N., Ochie, C. N., Akpa, C. O., Okeke, K. C., Okpunwa, A. O., & Ugwu, G. O. (2022). Physician emigration from Nigeria and the associated factors: the implications for safeguarding the Nigerian health system Human Resources for Health, 20(1), 85

Oyetoun, O. (2022): 5 Reasons Why Every Nigerian Under 45 Should Japa https://businesselitesafrica.com/2022/10/12/5-reasons-why-every-nigerian-under-45-should-japa/

Patrick O. (2023) Japan: 2,000 doctors left Nigeria in 2022, says NARD https://punchng.com/japa-2000-doctors-left-nigeria-2022-says-nard/

Pécoud, A., & De Guchteneire, P. (2006). International migration, border controls, and human rights: Assessing the relevance of a right to mobility Journal of Borderlands Studies, 21(1), 69–86

Peter, S. (n-d) Moral Philosophy Encyclopedia Britannica 2019, Available from: https://www.britannica.com/topic/ethics-philosophy

Saad, J.M., and Prochaska, J.O. (2020). A philosophy of health: life as reality, health as a universal value Palgrave Commun. 6(1):45. doi: 10.1057/s41599-020-0420-9. Epub 2020 Mar 18. PMID: 32226633; PMCID: PMC7097380.

Séchet, R., & Vasilcu, D. (2015). Physicians' migration from Romania to France: a brain drain into Europe? Cybergeo: European Journal of Geography

World Bank (2010) Migration and Remittances Factbook 2011 The World Bank

Szcs, E. Geers, R. Jezierski, T. Sossidou, N., and Broom, D. (2021). "Animal Welfare in Different Human Cultures, Traditions, and Religious Faiths". Asian-Australas J Anim Sci, 25: p. 1499–1506. Available at doi: 10.5713/ajas.2012.r.02.

Young, I. M. (1990). Justice and the politics of difference Princeton University Press