Question

Fairfield Hospital serves a diverse community with a large number of migrant farm workers. Dr. Robyn Joseph, a nurse practitioner on staff at the hospital, just completed a study of a local group of farm workers which concluded that most of the workers avoid going to the hospital and its clinics for care because of fear that they or their family members will be identified and arrested by immigration and customs enforcement officers (ICE), even if the individual is in the country legally. There have been recent outbreaks of preventable, communicable diseases and at least one child has died of measles.

Fairfield Hospital has an Executive Council comprised of the lead administrators of every unit as well as representatives from doctors, nurses, other health professionals and administrative and ancillary staff. Dr. Joseph asks the executive council to discuss ways that Fairfield Hospital could engage the community with its services.

Imagine that you are on the Executive Council, what would you suggest and why?

Resources:

National Immigration Law Center - Health Care Providers and Immigration Enforcement

Schweikart, SJ (2018) Case and Commentary: Should Immigration Status Information be considered Protected Patient Information. AMA Journal of Ethics. 21:1. E32-E37.

Answer 1

If i am the member of an executive council of Fairfield hospital, then i would suggest that the hospital including its all the health professionals should follow the medical ethics. Since there have been recent outbreaks of preventable, communicable diseases, some appropriate measures are urgently needed by the hospital to engage the community having a large number of migrant farm workers, with its services and thus to prevent the spread of communicable diseases. I would suggest that the hospital should organize some medical camps in the areas where this community reside and works. Hospital should reach to the migrant workers and try to remove the fear of being identified and arrested in them. Awareness programmes related to the outbreaks and risks of communicable diseases should be conducted in the community. According to medical ethics and in order to protect the whole community from the outbreaks of communicable diseases, the identity of the migrant workers could be kept confidential, so that they can trust the hospital. The migrant workers should be encouraged and motivated to visit the hospital.

I would give the above suggestions because it would be not ethical to risk the life of all individuals of whole community due to the outbreaks of communicable diseases. If the spread of these communicable diseases is not controlled immediately, then very soon the diseases would acquire the form of epidemic. If the migrant workers are in the country legally, then there is nothing to worry about and hospital should keep the identity of such workers confidential.