Modern medicine’s ability to save life – to keep people alive who would once have died – gives rise to an increasing number of ethical dilemmas. An article in a recent edition of the New England Journal of Medicine discusses the case of Quelino Jimenez, a Mexican illegal immigrant who was employed as a construction worker in Chicago. He had a fall that rendered him tetraplegic; after emergency treatment to stabilize his condition, and some time in the hospital, he was repatriated against his will to Mexico, where, aged 21, he died because of a lack of medical care.
Jimenez, like the majority of the 11 million illegal immigrants in the Unites States, was uninsured. The law already prescribes that hospitals receiving Medicare funding must provide emergency care to anyone in need of it, without discrimination as to legal or insurance status. However, they are not under obligation to provide, nor will they be reimbursed for providing, long-term care for those who need it. Looking after tetraplegics is expensive and consumes much time and effort. Hospitals will therefore be anxious to transfer them (and the costs) elsewhere.
It is an elementary principle of medical ethics that doctors are not permitted to sort patients into deserving sheep and undeserving goats when providing treatment for them: they are supposed to do their best for everyone, prince or prisoner. The best for Quelino Jimenez was certainly not to be returned to conditions in which, only too predictably, he would be medically neglected.