Response to the problem
Given the amount of dialogue that has occurred and time that has past, something more substantial needs to
occur for more definitive ethical actions to be enacted addressing the global nursing shortage. The suggestion
is to expand beyond previous recommendations and establish a summit, led by nursing leaders, to be sponsored
by source and destination countries’ public and private sectors with the authority to recommend policy
decisions regarding an international treaty. Composition of the participants would not only include public and
private sector healthcare leaders but also emigrants from source and destination countries. Although InterGovernmental
Organizations (IGO), organizations created through a treaty by member states of the United
Nations, have the powers to initiate treaties, it is also possible for a proposal to be originated by an NGO such
as the ICN.39 It is recommended that the ICN, as a consultant to the WHO, an IGO, lead the initiative.
Although the process of developing and ratifying a treaty may be lengthy, it will raise awareness during the
evolution of the treaty as concerned parties become involved and will result in a binding international agreement.
Part of the treaty-making process is the precursor during which a declaration may be made based upon
consensus regarding certain recommendations. International lawyers would call these ‘‘soft’’ or nonbinding
steps.39
Steps in developing and ratifying a treaty, ultimately set forth by the IGO, have multiple sub-steps; however,
the key steps after the precursor are the following: (a) initiating the treaty-making process; (b) formulation
of the multilateral treaty including preliminary studies, initial draft preparation, negotiations, and
consultation with governments and the public; (c) adopting the multilateral treaty including the choice of
forum, tasks to be performed, and decision-talking; and (d) bringing the multilateral treaty into force,
including general considerations, reservations and options, and the domestic aspects of ratification.39
Embracing the challenge of establishing a global treaty is a call to arms of strategic international participants
with the potential to set the stage for creating an environment of global collaboration in healthcare