Empirical Ethics and the Health “Brain-Drain”
: The experiential and ethical landscape of compulsory community service for a group of South African doctors

Student thesis: Master's ThesisMaster of Science


Purpose: To explore the personal ethics, values and beliefs of recently independently practicing South African doctors regarding the HBD and comserve, how they relate these to migratory decisions, and to assess the effect of their experiences on where they might be situated on the individualist-collectivist continuum.
Method: Qualitative research method using 11 semi-structured interviews, analysed using thematic analysis under a methodology of critical realism.
Results: Participants’ complex personal ethics were categorised under the headings of ‘Special Duties’, ‘Freedom and Autonomy’, ‘Justice and Accountability’, and ‘The Individualist-Collectivist Continuum: Effects of Reality Meeting Ideology’.
Conclusion: Participants use a variety of ethical theories to oppose or support comserve, with subsequent effects on migratory decisions. Most find the policy to be theoretically ethically justifiable but note that processes, in reality, undermine this. There are also several factors that appear to affect participants’ position on the individualist-collectivist continuum.
Date of Award2021
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorGry Wester (Supervisor)

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