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No Country for Sick Men: Undocumented Persons 

No Country for Sick Men: Undocumented Persons
No Country for Sick Men: Undocumented Persons
Legal and Ethical Issues in Emergency Medicine

Diane L. Gorgas

and Simiao Li-Sauerwine


Caring for undocumented immigrants in the emergency setting brings legal and ethical challenges. This chapter discusses the spectrum of these challenges, including duty to report to immigration authorities, the restrictions placed by the Health Insurance Portability and Accountability Act (HIPAA) on ability to report, and the ethical perspective on duty to provide compassionate care for undocumented persons. Providing emergency care is mandated under the Emergency Medical Treatment and Active Labor Act (EMTALA), but coordinating care for chronic medical conditions requiring high-resource treatments may fall under the venue of emergency medicine. This chapter reviews strategies for providing chronic treatment of end-stage renal disease (ESRD) among undocumented persons, and discusses the legal and ethical questions involving this patient population.

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