Free Should Illegal Immigrants Receive Dialysis? Essay Example
Under the Hippocratic Oath, physicians pledge to take all measures required to treat those who are ill. Since illegal immigrants are forbidden from partaking federal health care assistance, unless the treatment is made under emergency care (Neevel 2009), there is an intersection at which healthcare and the law may conflict. The law, however, cannot prevent illegal immigrants from seeking medical treatment for any disease at any hospital using their own money. Although that is not very likely since illegal immigrants are banned from employment, which means they have no known source of income while in the country, it is not entirely possible. Some illegal immigrants may have money brought in money from their home countries or have successfully sought employment, albeit illegally.
Presuming that a destitute illegal immigrant comes into the emergency section of the hospital suffering from kidney failure that requires dialysis, the question as to whether he or she should receive it arises. The answer to that should depend on the circumstances. As an artificial process that simulates the natural functioning of healthy kidneys by removing waste products and excess fluids from the body to prevent the build-up of toxic materials, dialysis is not a cure, but merely a life-sustaining procedure. A life sustaining procedure is a “medical procedure or intervention that, in the judgment of the attending physician, would serve only to prolong the dying process but not avert death when applied to a qualified patient” (Gilmore p. 76). Thus, if the patient comes in for emergency treatment that involves conducting a dialysis procedure, this is clearly beyond the federal mandate of allowing emergency care to be given to illegal immigrants. Conducting dialysis does not save the life of the patient, but only prolongs it.
However, renal failure that requires dialysis can stem from several causes. Dialysis is usually recommended to patients suffering from end-stage renal disease (ESRD). An end stage renal disease is the last phase of a chronic kidney disease where the kidneys have lost their natural functioning. At present, it is not curable and death is imminent. The purpose of dialysis in such cases is merely to prolong the life of patients (Medline Plus 2013). There is research, however, that showed that the quality of death of ESRD patients is better after withdrawing dialysis (Cohen et al 2000). Not much ethical issues are involved in this case because the measure does not require saving the life of the patient. However, the patient should be made comfortable and free from pain as much as possible.
There are cases, however, when recovery from acute renal failure is possible. An acute renal failure occurs when kidneys suddenly lose their ability to filter waste from food products in the blood. The development of this condition is sudden and rapid and requires emergency attendance. Failure to stop the body from building up too much toxicity can lead to sudden death. Although dialysis still serves the function of prolonging the life of the patient, dialysis is only a temporary measure that is used until the normal functioning of the kidneys of the patient are restored. In such cases, it is ethical and moral for healthcare professionals to give dialysis to the patient until his or her kidneys’ functioning is restored. Recovery in this case is highly likely for healthy patients (Mayo Clinic Staff 2015).
When it comes to illegal immigrants, healthcare professionals are usually torn between the ethics of their profession and the law. Although the law requires them to distance themselves from such patients, professional ethics may direct them otherwise. Even when the law allows them to provide medical assistance, professional ethics considerations may still hinder them from doing so. Such is the case of providing life-sustaining measures, such as dialysis. Notwithstanding the nature of these measures, physicians should consider whether they are to be conducted on long-term basis or merely temporarily until the patient recovers his body functioning. Only then should they decide whether to give life-sustaining measures or not.
Cohen, L., Germain, M., Poppel, D., Woods, A., Pekow, P., and Kjellstrand, C. (2000). Dying Well After Discontinuing the Life-Support Treatment of Dialysis. Arch Intern Med, vol, 160, no. 16, pp. 2513-2518.
Gilmore, A. (2012). A Safer Death: Multidisciplinary Aspects of Terminal Care. Springer Science & Business Media
Mayo Clinic Staff (2015). Diseases and Conditions: Acute Renal failure. Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/kidney-failure/basics/definition/con- 20024029
Medline Plus (2013). End-stage kidney disease. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000500.htm
Neevel, C. (2009). At the Intersection of Immigration and Health Care Law: The Lack of Clear Standards Governing Medical Repatriation and Suggestions for Future Oversight. Gonzaga Law Review, vol. 45, no. 3, pp. 821-844.