Project Explores Ethical Challenges in Caring for Undocumented Patients

A new project is exploring the ethical challenges that clinicians and organizations face when providing medical care to undocumented immigrants in the United States.

Of the estimated 11 million undocumented residents in the United States, most have no health insurance and are ineligible for public insurance programs. They are prohibited from obtaining insurance under the 2010 Patient Protection and Affordable Care Act.

The project is being conducted by the Hastings Center, a bioethics think tank, and is supported by a grant from the Overbrook Foundation Domestic Human Rights Program.

“Health care professionals can be deeply troubled when they encounter situations that seem unfair,” Nancy Berlinger, a Hastings Center scholar who is co-director of the project, said in a statement. “How to provide good care to patients who cannot afford to pay for care is one of those situations. When a patient is also undocumented, the situation becomes even more complex. This project aims to help clinicians and organizations by exploring the difficult questions of how ethical obligations compete with economic constraints, conflicting mandates, and political considerations.”

According to Michael Gusmano, the other co-director of the project, the research team will review existing policies and regulations and identify how they shape access to care for undocumented patients.

“We know that some laws and programs are designed to provide access to health care for this population and others explicitly forbid the use of public funds to pay for care for this population,” he said. “This creates a complex policy environment that causes difficulties for the patients, health care professionals, and health care organizations. Our project seeks to clarify, as much as possible, these policy choices and identify their consequences.”

When they become sick or injured, these undocumented low-income patients have limited access to health care. Organizations that are federally mandated to provide some level of care on the basis of medical need face difficult resource allocation challenges when undocumented patients’ medical needs exceed available resources.

The project’s advisory group includes clinicians and health care leaders from organizations that serve communities that include undocumented patients. It also include experts in human rights law and theory, health care ethics, and safety net health policy. The project will produce a special report, a Web site with resources for the public, and journal articles.

SourceNew Project Examines Medical Safety Net for Undocumented Patients [The Hastings Center]