a Loyola University Chicago Stritch School of Medicine.
Am J Bioeth. 2019 Apr;19(4):51-57. doi: 10.1080/15265161.2019.1572812.
Because the United States has failed to provide a pathway to citizenship for its long-term undocumented population, clinical ethicists have more than 20 years of addressing issues that arise in caring for this population. I illustrate that these challenges fall into two sets of issues. First-generation issues involve finding ethical ways to treat and discharge patients who are uninsured and ineligible for safety-net resources. More recently, ethicists have been invited to help address second-generation issues that involve facilitating the presentation for care of undocumented patients. In the current environment of widespread fear of deportation in the immigrant community, ethicists are working with health care providers to address patient concerns that prevent them from seeking care. I illustrate that in both generations of issues, values implicit within health care, namely, caring, efficiency, and promotion of public health, guide the strategies that are acceptable and recommended.
由于美国未能为其长期无证移民提供获得公民身份的途径，临床伦理学家在处理为这一人群提供医疗服务时遇到的问题上已有二十多年的经验。我举例说明这些挑战可分为两类问题。第一代问题涉及找到以合乎道德的方式治疗和安置无保险且不符合“安全网”资源条件的患者的方法。最近，伦理学家还应邀帮助解决涉及促进无证患者就诊的第二代问题。在当前移民群体普遍担心被驱逐出境的环境下，伦理学家正在与医疗服务提供者合作，解决使患者担心就医的问题。我举例说明，在这两代问题中，医疗保健中隐含的价值观，即关爱、效率和促进公共卫生，指导着可接受和推荐的策略。
