Migration health ethics in Southeast Asia: a scoping review

Shu Hui Ng; Sharon Kaur; Phaik Yeong Cheah; Zhen Ling Ong; Jane Lim; Teck Chuan Voo

doi:10.12688/wellcomeopenres.19572.2

Migration health ethics in Southeast Asia: a scoping review

Wellcome Open Res. 2023 Nov 20:8:391. doi: 10.12688/wellcomeopenres.19572.2. eCollection 2023.

Authors

Shu Hui Ng¹, Sharon Kaur², Phaik Yeong Cheah^{3

4}, Zhen Ling Ong^{5

6}, Jane Lim⁷, Teck Chuan Voo⁷

Affiliations

¹ School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, 47500, Malaysia.
² Faculty of Law, University Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, 50603, Malaysia.
³ Mahidol Oxford Tropical Medicine Research Unit, Bangkok, 10400, Thailand.
⁴ Centre for Tropical Medicine and Global Health, Oxford, OX3 7LG, UK.
⁵ Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, 50603, Malaysia.
⁶ Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
⁷ Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.

Abstract

Background: Asia hosts the second-largest international migrant population in the world. In Southeast Asia (SEA), key types of migration are labour migration, forced migration, and environmental migration. This scoping review seeks to identify key themes and gaps in current research on the ethics of healthcare for mobile and marginalised populations in SEA, and the ethics of research involving these populations.

Methods: We performed a scoping review using three broad concepts: population (stateless population, migrants, refugees, asylum seekers, internally displaced people), issues (healthcare and ethics), and context (11 countries in SEA). Three databases (PubMed, CINAHL, and Web of Science) were searched from 2000 until May 2023 over a period of four months (February 2023 to May 2023). Other relevant publications were identified through citation searches, and six bioethics journals were hand searched. All searches were conducted in English, and relevant publications were screened against the inclusion and exclusion criteria. Data were subsequently imported into NVivo 14, and thematic analysis was conducted.

Results: We identified 18 papers with substantial bioethical analysis. Ethical concepts that guide the analysis were 'capability, agency, dignity', 'vulnerability', 'precarity, complicity, and structural violence' (n=7). Ethical issues were discussed from the perspective of research ethics (n=9), clinical ethics (n=1) and public health ethics (n=1). All publications are from researchers based in Singapore, Thailand, and Malaysia. Research gaps identified include the need for more research involving migrant children, research from migrant-sending countries, studies on quality of migrant healthcare, participatory health research, and research with internal migrants.

Conclusions: More empirical research is necessary to better understand the ethical issues that exist in the domains of research, clinical care, and public health. Critical examination of the interplay between migration, health and ethics with consideration of the diverse factors and contexts involved is crucial for the advancement of migration health ethics in SEA.

Keywords: Bioethics; Clinical Ethics; Migrants; Migration Health; Public Health Ethics; Refugees; Research Ethics; Southeast Asia.

Publication types

Systematic Review

Grants and funding

This research was supported by Wellcome Trust, ID: 222870/Z/21/Z. PYC’s research is supported by Wellcome (ID 220211/Z/20/Z). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.