A growing number of discharges at acute-care hospitals involve patients who are undocumented and lack legal status. Because such patients are ineligible for public assistance, long-term care facilities will routinely deny them admission. These discharges become complex discharges because of such financial barriers. If local family support is unavailable, discharging such patients to a safe and suitable location becomes increasingly difficult. These complex discharges implicate a number of ethical principles. We describe such complex discharge cases, apply various ethical frameworks, and (...) call for potential policy solutions to address this growing ethical concern. (shrink)

The American Journal of Bioethics, Volume 12, Issue 9, Page W1-W3, September 2012.

Hospitals in the United States have been engaging in the practice of returning immigrant patients, usually undocumented immigrant patients, to their country of origin when the patient has long-term medical needs for which no reimbursement is available. I argue that for such an action to be ethical, it must be done in accordance with the mission and values of hospitals. I describe three standards that an individual instance of repatriation must meet to be ethical: (1) patient best interests, (2) medical (...) due diligence, and (3) informed consent. I argue that these should form the basis for best practices in regard to medical repatriation for all hospitals in the United States. (shrink)