Ethical issues and obligations with undocumented immigrants relying on emergency departments for dialysis.

Document Type

Article

Publication Date

12-1-2021

Publication Title

J Am Coll Emerg Physicians Open

Keywords

diversity; washington; swedish; EMTALA; dialysis; emergency‐only dialysis; end state renal disease; ethics

Abstract

Undocumented immigrants with end-stage renal disease in the United States are uniquely disadvantaged in their ability to access dialysis. This article examines the unique circumstances of the medical condition and healthcare system, including the relevant legal and regulatory influences that largely relegate undocumented immigrants to relying on emergency-only dialysis through a hospital's Emergency Medical Treatment and Labor Act obligations. We explore the ethical implications of this current state, emphasizing the adverse effects on patients and staff alike. We also review necessary actions that range from the actions an individual emergency physician to changes needed in federal policy.

Clinical Institute

Kidney & Diabetes

Department

Biomedical Ethics

Department

Emergency Medicine

Department

Nephrology

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