Ethical Dilemma of Illegal Immigrant Seeking Treatment - Case Study Example

Ethical Dilemma of Illegal Immigrant Seeking Treatment Ethical Dilemma of Illegal Immigrant Seeking Treatment Case Study Santana is a 34 year old male patient who enters the emergency department of Lincoln Medical and Mental Health Center with a lot of bleeding from his right arm and a clear demonstration of bruising on the other arm and legs. Susan, one of the emergency department nurses realizes that the patient is not a native speaker because she would not understand his explanation on the cause of his bleeding. Susan seeks the help of a colleague nurse who understood Mexican. The interpretation of the patient’s story reveals that he was hit by a car while crossing the street during one of his job searching escapades. However, the car did not stop after the hit and as a result Santana was forced to run to the nearest emergency department despite the deep pain he was in. The medical history of the patient reveals that he has no health insurance. Furthermore, the patient is one of the undocumented immigrants from Mexico who has stayed in America for three years. With notable hesitation Santana explains to the nurse that he lives with his relatives who are also illegal immigrants. The nurse discovers that the patient has a broken arm and needs immediate medical care and close monitoring. Without mush thought or delay, Susan attends to her patient by providing the recommended nursing care and treatment for the patient’s condition. Susan is approached by one of her colleagues who emphasizes that the patient she is attending to is an illegal immigrant and, thus, she is violating the provisions of the law by treating him. This does not stop Susan from providing further emergency care to Santana. She tells her colleague that all she is doing is performing her duties as an emergency care nurse. Introduction Health care is a basic human right and, therefore, all human beings have the right to unbiased access to quality medical care services regardless of their citizenship status. Nurses are obliged to provide care with compassion, professionalism and respect while upholding the worth, uniqueness and dignity of every individual without bias (The American Nurses Association, 2001). Hence, nurses should provide quality care for patients regardless of their personal attributes, health condition, economic, social and political standing. Therefore, nurses should not discriminate patients during care based on the fact that they are illegal immigrants. Nurses should have their primary commitment while striving to protect and promote the rights, safety and health of the patient (The American Nurses Association, 2001). The federal law stipulates that illegal immigrants who have stayed in the country for a period of less than 5 years are not legally eligible for Medicaid (Winograd, 2006). This illustrates that emergency care nurses are often faced with a dilemma related to their ethical and legal obligations in the provision of unbiased care for all individuals. Position Statement This paper presents argumentative discussion of the legal ethical dilemma that emergency department nurses are faced with in the treatment of illegal immigrants. The discussion aims at illustrating why the ethical obligations of nurses, as provided by the American Nurses Association, should not be limited by the legal provisions against care for illegal immigrants. The discussion will be based on evidence from credible information materials on the issue and an accurate reflection of the implication of legal provisions on the role of nurses and their ethical obligations. This discussion will be based on the case study which provides illustrations of situations where the ethical obligation of nurses surpasses the requirement of the law. It is important to note that for the sake of confidentiality and privacy, the names given in the case study are not the actual names of the people involved in the case. Supportive Evidence The provisions of the American Nurses Association require nurses to provide care that is not restricted by social or economic status (The American Nurses Association, 2001). This justifies the emergency nursing care that Susan provided for Santana despite the fact that he was an illegal immigrant who had no access to health insurance and was not employed. The philosophy of humanitarianism protects the rights of individuals to medical care and therefore human dignity must be upheld in emergency care regardless of the fact that a patient is an Illegal immigrant (Dwyer, 2004, p. 34). There has been a lot of political debate on the health care provision to illegal immigrants. Physicians and philanthropists who oppose the biased care argue that human health and upholding human rights in medical care surpasses any other provision. Therefore it can be argued that Susan was performing her nursing roles by treating the illegal immigrant while considering the need for respecting the dignity and rights of all individuals. It is argued that it is an obligation of all nurses to provide appropriate and adequate examination, treatment and care to all individuals who appear in the emergency department. The nursing care within the emergency department should therefore not be biased on social, political or economic grounds. The unbiased care ensures that the condition of the patient is determined so that decision making is enhanced on the further medical action which the patient requires (Winograd, 2006). Moreover the law stipulates that it is the role of the emergency department to stabilize patients after an appropriate medical evaluation. In this sense it can be argued that Susan adhered to the provision of the law by stabilizing her patient while putting her ethical obligations into consideration. The American Nurses Association mandates nurses to ensure privacy and confidentiality of patient information. The law also provides that all emergency department staff must ensure that the privacy of patient information is upheld (Guest, 2002, p. 31). The confidentiality that nurses require to keep of their patients included prohibiting disclosure of information about patients including their citizenship status (The American Nurses Association, 2001). This provision illustrates that the obligations of nurses prevents them from being biased in treatment and thus provide care to patients regardless of their citizenship status. It is said that the treatment of patients should focus on the benefit of human beings and not for the purpose of rhyming with political belief (Dwyer, 2004, p. 40). This illustrates why the political arguments against health care to illegal immigrants. The action that Susan took by treating Santana illustrates that she considered the benefit that the treatment would cause the patient and disregarded political belief on the treatment of illegal immigrants. Susan’s colleagues violated the requirement of the American Nurses Association because they failed to cooperate with her in providing care for the legal immigrant. Nurses are mandated to collaborate with their colleagues in the provision of unbiased care to patients (The American Nurses Association, 2001). The fact that Susan’s colleague argued that she was breaking the law by treating the illegal immigrant from Mexico illustrates lack of collaboration and thus violation of the provisions of the American Nurses Association. Counter Evidence Politicians and some health care professionals have argued that the high costs of health care in the treatment of illegal immigrants are heavy burdens to the taxpayers. These arguments led to the enactment of legal prohibition for Medicaid to illegal immigrants who had lived in America in a period not exceeding five years (Grimm and Wells, 2009, p. 127). This is the reason that Susan’s colleagues were adamant in collaborating with her in providing emergency care to Santana regardless of the fact that the accident he was involved caused him to sustain an injury that needed immediate medical attention. It is evident form the case study that Santana has no employment which makes him lack medical issuance cover. Political and professional groups who oppose Medicaid to illegal immigrants argue that even if these immigrants were given medical insurance cover they would not afford it. This is because most of them are not within formal employment which makes them unable to acquire adequate income to pay for their medical bills (Dwyer, 2004, p. 36). It is said that the inability of these immigrants to cover their medical expenses should not be a responsibility of the taxpayer and thus the prohibition of Medicaid for illegal immigrants. Position preference Because all human beings have a right to access medical care, my position preference is that all individuals must be given unbiased nursing care regardless of their citizenship status. Moreover nurses are trained to be compassionate care providers who respect all patients with equality in care and upholding their dignity. The provisions of the American Nurses Association, nursing training in addition to personal values motivate my personal preference. Therefore the treatment of illegal immigrants within the emergency department should not be blinded by political belief at the expense of human life and upholding the ethics of nursing practice which are valued by all compassionate nurses and medical practitioners. Implication for Nursing The legal provisions which prohibit nurses from providing medical care to illegal immigrants put them at a position of breaking their ethical and professional obligations. The ethical framework for nursing practice is stipulated by the American Nurses Association and provides guidelines which must be followed by the nurse. This dilemma illustrates that nurses have difficulty in deciding on what to do when confronted by emergency cases of illegal immigrants such as that of Santana in this case study. Nurses are thus subject to legal suit or termination of employment for breaking the law, which prohibits treatment of illegal immigrants. This is because nurses are trained to provide compassionate care to all individuals regardless of their social and economic status and without discriminating patients on the basis of nationality or citizenship and exemplified by Nurse Susan. Biomedical Ethic Biomedical ethic is a guideline that presents medical practitioners with values that must be upheld in professional practice and research (Eaton, 2008, p. 99). Nurses are therefore obliged to adhere to the values of autonomy, non-maleficence, justice, beneficence and dignity. Autonomy means that the rights of patients include choice or refuse of treatment or a medical procedure. In the case study, Santana had accepted treatment to his injuries as demonstrated by the fact that he came to the hospital for care and did not refuse the emergency management by Nurse Susan. Dignity is a value within the biomedical ethic which says that patients have the right of being treated with dignity as exemplified by the compassion of Susan for her patient regardless of him being an illegal immigrant. Beneficence is a value within the biomedical ethic which requires practitioners to act in the best interest of their patients (Eaton, 2008, p. 101). This is demonstrated by Susan who goes ahead to provide emergency care for the illegal immigrant because the interest of the patient was considered by the nurse as an ethical obligation despite the possible legal implications. Non-maleficence means that practitioners must not do any harm to the patient while justice is a value in the biomedical which provides for equality and fairness in treatment. It is evident from the case study that Susan practiced fairness and equality in treating the illegal immigrant because she did not discriminate him from the treatment based on political belief. Conclusion Even though it is argued by political and professional debates that the medical care to illegal immigrants is a burden to the taxpayers, nursing practice should follow the provisions of the American Nurses Association. This means that care to patients should not be biased regardless of the medical condition of the patient, nationality, citizenship or economic status. Nurses are therefore faced with a dilemma related to their legal and ethical obligation in providing compassionate, collaborative, impartial, dignifying, respectful and adequate care to all patients. References Dwyer, J. (2004). “Illegal immigrants, health Care, and social responsibility.” Hastings Center Report 34, No. 5, pp. 34-41. Eaton, M 2008, Managing the Risks Associated with Using Biomedical Ethics Advice, Journal of Business Ethics, 77, 1, pp. 99-109 Guest, J. A. (2002). “Caring for a city of immigrants.” Modern Healthcare, 32(5), 31 Grimm, J. W. & Wells, J. L. (2009). Illegal immigrants in the emergency Department: an ethical dilemma for nurses? Emergency Nurses Association. Elsevier Inc. pp. 127-128 The American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Nursing World. pp.1-14 Winograd, B. (2006). Trial examines legality of aid to immigrants. Wall Street Journal, pp. A.9-A.9 Read More