The Ethics of Advocacy for Undocumented Patients

Nancy Berlinger and Rajeev Raghavan, “The Ethics of Advocacy for Undocumented Patients,” Hastings Center Report 43, no. 1 (2013): 14–17. DOI: 10.1.002/hast.126

Abstract: Approximately 11.2 million undocumented immigrants have settled in the United States. Providing health care to these residents is an everyday concern for the clinicians and health care organizations who serve them. Uncertain how to proceed in the face of severe financial constraints, clinicians may improvise remedies–a strategy that allows our society to avoid confronting the clinical and organizational implications of public policy gaps. There is no simple solution-no quick fix-that will work across organizations (in particular, hospitals with emergency departments) in states with different concentrations of undocumented immigrants, varying public and private resources for safety-net health care, and differing approaches to law and policy concerning the rights of immigrants. However, every hospital can help its clinicians by addressing access to health care for undocumented immigrants as an ethical issue. We offer some recommendations for doing this in a structured, fair, and transparent way. We also describe the problems that may result when clinicians are forced to grapple with this issue on their own.

Immigrant Health and the Moral Scandal of the “Public Charge” Rule

A long-anticipated policy change proposed by the Trump administration that would count the use of many federally-subsidized programs against immigrants currently eligible to use them threatens public health and would undermine ethical practice in health professions and systems. The policy would expand the definition of a public charge, someone likely to become dependent on government […]
Read More

Beyond Breaking News: Ways of Seeing Migrants and Their Children

In his iconic 1977 essay on migration, A Seventh Man: A Book of Images and Words about the Experience of Migrant Workers in Europe, John Berger wrote: “To try to understand the experience of another it is necessary to dismantle the world as seen from one’s own place within it, and to reassemble it as […]
Read More

Migrants’ Lives, Immigration Policy, and Ethics Work

The Russian poet Anna Akhmatova was a mother separated from her child by a state policy of terror. During the 1930s, she and other mothers would gather outside a Leningrad prison, desperate for information. One day, after 17 months of “waiting in prison queues,” another woman whispered to her, “‘Could one ever describe this?’ And […]
Read More

Shocking the Conscience: Justice Department versus the Health of Immigrant Women and Children

In April, the U.S. Justice Department announced that it would criminally prosecute migrants who had been apprehended after crossing the U.S.-Mexico. border. An immediate consequence of this announcement, explained in detail here, is the separation of children from their parents. Rather than being allowed to stay with their children in an immigrant detention center while […]
Read More