Asgary and Smith (2013) identify an important challenge: the difficult position of physicians caught between the obligation to treat every human being with the same professional rigor, and their feelings of responsibility toward the state and its judicial decisions on asylum requests. The authors show that in some cases this conflict leads to a tendency to "sacrifice their medical responsibilities". The authors' core demand is that health care workers should be independent of the state and judiciary systems, and thus prioritize (...) the interests of the patient. We agree entirely with the authors, that well-performed documenting is the only ethically justifiable option and should not be influenced by a feeling of responsibility for contributing to judicial decisions. However, the authors also address the more general, and ethically more challenging, issue of the responsibility of health care workers and the state toward asylum seekers and ask, how much health care provision is appropriate? (shrink)

The UK government has recently taken steps to exclude certain groups of migrants from free treatment under the National Health Service, most controversially from treatment for HIV. Whether this discrimination can have any coherent ethical basis is questioned in this paper. The exclusion of migrants of any status from any welfare system cannot be ethically justified because the distinction between citizens and migrants cannot be an ethical one.

Irregular migrants are morally entitled to a wide range of legal rights, including basic human and civil rights. Therefore, states ought to create a firewall between those charged with protecting and enforcing these rights and those charged with enforcing immigration laws.

Citizenship presents two faces. Within a political community it stands for inclusion and universalism, but to outsiders, citizenship means exclusion. Because these aspects of citizenship appear spatially and jurisdictionally separate, they are usually regarded as complementary. In fact, the inclusionary and exclusionary dimensions of citizenship dramatically collide within the territory of the nation-state, creating multiple contradictions when it comes to the class of people the law calls aliens--transnational migrants with a status short of full citizenship. Examining alienage and alienage law (...) in all of its complexities, The Citizen and the Alien explores the dilemmas of inclusion and exclusion inherent in the practices and institutions of citizenship in liberal democratic societies, especially the United States. In doing so, it offers an important new perspective on the changing meaning of citizenship in a world of highly porous borders and increasing transmigration. As a particular form of noncitizenship, alienage represents a powerful lens through which to examine the meaning of citizenship itself, argues Linda Bosniak. She uses alienage to examine the promises and limits of the "equal citizenship" ideal that animates many constitutional democracies. In the process, she shows how core features of globalization serve to shape the structure of legal and social relationships at the very heart of national societies. (shrink)

Many poor and oppressed people wish to leave their countries of origin in the third world to come to affluent Western societies. This essay argues that there is little justification for keeping them out. The essay draws on three contemporary approaches to political theory - the Rawlsian,the Nozickean, and the utilitarian - to construct arguments for open borders. The fact that all three theories converge upon the same results on this issue, despite their significant disagreements on others, strengthens the case (...) for open borders and reveals its roots in our deep commitment to respect all human beings as free and equal moral persons. The final part of the essay considers communitarian objections to this conclusion, especially those of Michael Walzer. (shrink)

Congress recently decided that undocumented aliens are ineligible for medical benefits under the 1966 Medicaid Act, overruling a judicial decision that would have required the federal government to reimburse states partially for the costs of providing free care. Is providing such care simply a matter of prudence and charity? Or do illegal aliens have strong moral claims to medical care that generate duties for hospitals and government agencies?

In this Article, I examine a normative idea of territoriality which I call ethical territoriality. By ethical territoriality, I mean the conviction that rights and recognition should extend to all persons who are territorially present within the geographical space of a national state simply by virtue of that presence. I start by briefly reprising a claim I have developed elsewhere — that territorialism is preferable, on liberal democratic grounds, to status-based approaches to immigrants’ rights. Here, though, I set out to (...) interrogate the logic of ethical territoriality itself. I ask why the mere fact of a person’s territorial presence should serve as the basis for rights and recognition. Further, even conceding that it should, I ask how this commitment is to be operationalized. What is the scope of the territory in which presence figures so significantly in normative terms, and who, precisely, gets access to presence in that territory? My purpose in this Article is to get beyond the status vs. territorial presence-as-basis-for-membership dispute in the immigration debates and to begin a critical discussion of the ethical territorial commitment itself. (shrink)

A contract in which the potential immigrants to the U.S. waive their right to non-emergency welfare benefits in return for their being allowed to come to the U.S. is not unjust. This is because the right to allow persons to immigrate in return for their waiving any future claim on non-emergency welfare benefits is included in other moral rights that the U.S. has. Nor is the transaction exploitative since it is beneficial to the average immigrant and since he gains a (...) fair share of the transactional surplus. Thus, if such a transaction is permissible for the U.S. citizens and they favor it, then the U.S. government as their agent is other-things-equal obligated to implement it. (shrink)

Immigrants lacking health insurance access the health care system through the emergency departments of non-profit hospitals. Because these persons lack health insurance, continued care can pose challenges to those institutions. I analyze the values of our health care institutions, utilizing a Walzerian approach that describes its appropriate sphere of justice. This particular sphere is dominated by a caring response to need. I suggest that the logic of this sphere would be best preserved by providing increased access to health insurance to (...) this population. This access would marry the rights of these members of our community to access care to our responsibility to contribute to financing of the system. I close with some considerations on what it means to be a member of the community. (shrink)