In the Dubai International Airport, two men in scrubs pass each other. One boards a flight to perform VIP cosmetic procedures in Monaco. The other carries donated antibiotics to a Syrian refugee camp. Access to quality healthcare is a fundamental human right; however, there are dermatologists in Beverly Hills administering $1,000 Botox injections while, in the same hour, a midwife in South Sudan is delivering a baby by flashlight, her hands being the only ‘medical equipment’ available. The stark contrast between access to luxurious procedures and basic medical necessities reveals the systemic inequity, questioning the extent to which doctors are morally obligated to extend their care and expertise to people beyond their immediate communities, especially when they have the means to do so. This essay argues that physicians must bridge these gaps, as modern ethics demand, practical solutions exist, and technology renders borders irrelevant. While doctors have a primary duty to their immediate communities, their moral obligation extends globally with the evolution of medical practice. Therefore, to a large extent, doctors are morally obligated to address transnational inequities, especially when they have the means to do so.

Today’s medical practitioners are ethically obligated to extend their care beyond their immediate communities, a duty stemming from the pledges all medical professionals take upon graduating from medical school. While the original Hippocratic Oath (circa 400 BCE) is now outdated, doctors around the world continue to take pledges upon graduation from medical school. The Hippocratic Oath is an oath that doctors take when beginning their medical practice, pledging to do no harm and prioritize patient welfare while practicing their profession ethically with confidentiality1. The World Medical Association adopted the oath in 1948, and Louis Lasagna revised it in 1964. Although outdated, the oath inspires many modern pledges that incorporate elements of the four pillars of medical ethics2. The four pillars of medical ethics include autonomy, which emphasizes the patient's right to make informed decisions; beneficence, which focuses on acting in the best interests of the patient; non-maleficence, which obligates doctors to avoid causing harm; and justice, which ensures fairness in the distribution of healthcare resources and equitable treatment of patients3. Unlike the ancient oath, which focused narrowly on individual patient relationships, modern pledges have expanded on this, often including a broader commitment to ethical practice and societal responsibilities4. Moreover, philosophers have long argued that medical professionals bear a moral responsibility to provide care for those in need without regard for geographical boundaries. For example, Peter Singer’s ‘drowning child’ analogy states that “if we encounter a child drowning in a pond, and we are in a position to save the child, we should save that child even if it comes at the cost of financial loss5.” If a doctor can prevent harm without significant sacrifice, they are morally obligated to act. As a result, the evolution from Hippocrates’ local focus to today’s global justice imperative leaves no ethical ambiguity; in a globalized world where suffering transcends borders, doctors must serve where need exists, not where lines on a map dictate, by actively bridging healthcare disparities.

The argument against transnational medical care collapses when confronted with a simple truth: suffering knows no borders, and neither should healing. After all, access to quality healthcare is a fundamental human right. Critics argue that extending medical care across borders is impractical, yet doctors and organizations prove it feasible. Some may raise the issue of practical barriers, including licensing and legal constraints; communication challenges, including language barriers and cultural differences; and resource constraints, including funding and available infrastructure for doctors to be able to extend their care6. However, organisations are combating the issue of unequal global access to healthcare and cooperating with doctors to provide their services beyond borders. A few examples of these organisations include Doctors Without Borders7, Central American Medical Outreach8, and Care Beyond Borders9. These organisations have helped individuals in underprivileged communities access quality aid, ranging from providing medical consultations to life-saving services, by overcoming certain constraints. For example, Doctors Without Borders often collaborates with local health ministries, gaining permissions and sometimes temporary licenses or exemptions to practice7. Many of the healthcare professionals involved with the organisation volunteer their services, which can also reduce the complexity of legal requirements compared to formal employment10. In 2023 alone, Doctors Without Borders treated over 12 million patients in 70+ countries, proof that cross-border care is scalable11. Skeptics may claim such efforts are unsustainable, but CAMO’s 25-year track record in Honduras shows how partnerships create lasting infrastructure12. Therefore, it is evident that where there is a moral commitment, systemic obstacles can be overcome. When doctors possess both the capability and opportunity to reduce global health disparities, they need to serve where need exists, not where borders dictate.

Beyond organizational efforts, technology has revolutionized cross-border care by redefining ‘proximity,’ transforming it into an ethical imperative that doctors can no longer ignore. Where critics once claimed there to be an overwhelming amount of challenges, technological advancements have made extending care possible, empowering doctors to erase borders. Telemedicine, using telecommunications and other technologies to diagnose and treat patients, made it possible for doctors to extend their care to patients in remote areas13, invalidating the ‘distance excuse.’ AI translation tools, such as DeepL Medical, break down language barriers with 98% accuracy in medical translations14, enabling Doctors Without Borders to treat patients in 30+ languages without interpreters7. Even bureaucratic barriers are crumbling with the development of blockchain technology and online databases. Blockchain medical records, such as WHO’s migrant health records, WISDM, securely share migrant health records across Jordan and Syria, eliminating redundant testing and delays15. While blockchain breaks down bureaucratic barriers, other transformative technologies include diagnostic tools that compensate for resource gaps between nations. New AI imaging tools, such as Qure.ai for tuberculosis detection in India16, or Butterfly iQ, a $2,000 handheld ultrasound device used in Kenya that delivers quality images rivaling the $100,000 hospital machines in Kenyan clincis17, enable doctors to perform accurate diagnostics from all around the globe. Portable labs, such as Oxford Nanopore’s MinION, a USB-sized DNA sequencer, diagnose Ebola in Congolese rainforests within hours rather than weeks18. These innovations make doctors’ refusal to assist ethically indefensible, especially when the tools to provide care are readily available and capable of overcoming barriers that once seemed insurmountable.

Ultimately, in our interconnected world, a doctor’s ‘community’ includes any patient reachable by a smartphone or satellite link, and every physician with an internet connection now holds that capability. Consider Masimo SafetyNet’s $20 pulse oximeter, which texts vital signs from Ethiopian homes to hospitals19. When such affordable tools exist, a doctor’s refusal to remotely monitor high-risk patients, despite minimal time investment, constitutes a failure to ‘do no harm.’ As this essay has demonstrated through evolving ethical frameworks, proven cross-border care models, and disruptive technologies, the question is no longer whether doctors can bridge global health disparities, but whether they will. When a single teleconsultation could save a life halfway around the world, will we continue to let borders be the difference between treatment and neglect? The tools exist. The ethics are unambiguous. The only remaining variable is the doctor’s choice. Will they take it upon themselves to extend their care beyond borders?

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References
1. The. Hippocratic oath | Definition, Summary, & Facts [Internet]. Encyclopedia Britannica. 1998 [cited 2025 Jun 30]. Available from: https://www.britannica.com/topic/Hippocratic-oath.
2. admin. The History of the Hippocratic Oath - Northeastern [Internet]. Northeastern. 2015 [cited 2025 Jul 6]. Available from: https://absn.northeastern.edu/blog/the-history-of-the-hippocratic-oath/.
3. Varkey B. Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice [Internet]. 2020 [cited 2025 Jun 30];30:17–28. doi: https://doi.org/10.1159/000509119.
4. WMA - The World Medical Association-WMA Declaration of Geneva [Internet]. Wma.net. WMA - The World Medical Association-WMA Declaration of Geneva; 2025 [cited 2025 Jul 7]. Available from: https://www.wma.net/policies-post/wma-declaration-of-geneva/.
5. Roberts JTF. Peter Singer’s Famine, Affluence, and Morality: Is Charity Good? | TheCollector [Internet]. TheCollector. 2023 [cited 2025 Jul 7]. Available from: https://www.thecollector.com/peter-singer-famine-affluence-morality/.
6. Jalal M, Karna Dev Bardhan, Sanders D, Illing J. International: Overseas doctors of the NHS: migration, transition, challenges and towards resolution. Future Healthcare Journal [Internet]. 2019 [cited 2025 Jul 6];6:76–81. doi: https://doi.org/10.7861/futurehosp.6-1-76.
7. Home | Doctors Without Borders - USA [Internet]. Doctors Without Borders - USA. 2025 [cited 2025 Jul 6]. Available from: https://www.doctorswithoutborders.org/.
8. Central American Medical Outreach, Inc. (CAMO) [Internet]. CAMO. 2025 [cited 2025 Jul 6]. Available from: https://www.camo.org/.
9. Home Simple | Care Beyond Borders [Internet]. Care Beyond Borders. 2025 [cited 2025 Jul 6]. Available from: https://cbb.org.uk/.
10. Testimony of MSF on IP Provisions in DR-CAFTA & Consequences For Access to Essential Medicines [Internet]. Doctors Without Borders - USA. 2021 [cited 2025 Jul 6]. Available from: https://www.doctorswithoutborders.org/latest/testimony-msf-ip-provisions-dr-cafta-consequences-access-essential-medicines.
11. MSF. International Activity Report 2023 www.msf.org [Internet]. 2023. Available from: https://www.msf.org/sites/default/files/2024-07/msf-international-activity-report-2023.pdf.
12. Central American Medical Outreach. Building sustainable health infrastructure: 25 years of impact in Honduras [Internet]. Wooster (OH): CAMO; 2023. Available from: https://camo.org/our-impact.
13. Haleem A, Javaid M, Singh RP, Suman R. Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International [Internet]. 2021 [cited 2025 Jul 7];2:100117. doi: https://doi.org/10.1016/j.sintl.2021.100117.
14. Overcome language barriers in healthcare with AI | DeepL [Internet]. Deepl.com. 2025 [cited 2025 Jul 7]. Available from: https://www.deepl.com/en/industries/healthcare.
15. World Health Organization. Blockchain in health: the WISDM project [Internet]. Geneva: WHO; 2022. Available from: https://www.who.int/news-room/feature-stories/detail/blockchain-in-health-the-wisdm-project.
16. Qure AI | AI assistance for Accelerated Healthcare [Internet]. Qure.ai. 2025 [cited 2025 Jul 7]. Available from: https://www.qure.ai/.
17. The clear answer in point-of-care ultrasound | Butterfly iQ3 [Internet]. Butterflynetwork.com. 2022 [cited 2025 Jul 7]. Available from: https://www.butterflynetwork.com/?srsltid=AfmBOoqLdpoiwFSbZcFmlmKJOB52o7zeFJNmAEjlHEdG3YXQNRiLNX_F.
18. MinION portable nanopore sequencing device [Internet]. Oxford Nanopore Technologies. 2025 [cited 2025 Jul 7]. Available from: https://nanoporetech.com/products/sequence/minion.
19. Masimo - SET Pulse Oximetry [Internet]. Masimo.com. 2024 [cited 2025 Jul 7]. Available from: https://www.masimo.com/technology/pulse-oximetry/masimo-set-pulse-oximetry/.