Table 1

Ethical questions faced by decision makers on migration health

Decision makersExamples of ethical questions
Health workers; in national health systems, non-governmental organisations, private health providers.
  • Should a health worker register and report sensitive health information (eg, HIV status), when a visa/working permit may depend on health status?

  • Should a health worker provide information about potential cancer treatment options when these options are not available to the migrant (eg, in refugee camp)?

  • Should non-governmental or civil society organisations provide care to undocumented migrants if it encourages governments to evade their human rights obligations to provide it?

Policy makers
  • International level; intergovernmental or regional organisations, donor agencies, civil society organisations, funding bodies.

  • National/federal level; central authorities, local/municipal authorities, service providers, professional bodies, educational institutions, health insurers, accreditation agencies, civil society organisations, private enterprise, advocacy groups.6

  • Should temporary labour migrants have equal access to all health services, including high-cost care like stem-cell therapy, organ transplants and comprehensive drug abuse therapy?

  • Should all international migrants, irrespective of their legal status, be included in national COVID-19 vaccination programmes?

  • What is the responsibility of sending countries as opposed to receiving ones for ensuring health protection for international labour migrants?

  • What are the roles of national and international actors in protecting undocumented migrants’ health?

  • To what extent and in which ways should health services target migrant groups?

Data managers and researchers; data collectors, researchers, research ethics bodies, participants.
  • Are there migration health topics on which collecting data and carrying out research may not always be desirable?

  • How can we ensure that data on migration health are not misused?

  • How can confidentiality and privacy be protected when Big Data is used to monitor movement of migrant populations?

International migrants, including but not limited to migrant workers, families seeking reunification, international students, refugees, asylum seekers, trafficked persons, irregular (undocumented) migrants.
  • Should an undocumented migrant seek healthcare for their ill child, if there is a risk of being deported?

  • Should migrants participate in research if the research findings might contribute to anti-migration narratives?

  • Should a refugee speak out on poor living conditions in camps, with the risk of further restriction of rights or deportation?

  • Should migrants themselves declare underlying disease conditions when applying for a residency or work permit?