Is It Ethical to Bend the Rules for Undocumented and Other Immigrant Patients?

AMA J Ethics. 2019 Jan 1;21(1):E100-105. doi: 10.1001/amajethics.2019.100.


Physicians and other health care professionals who work in hospitals and clinics serving low-income populations will encounter undocumented immigrants as patients, family members, community members, and persons whose health-related rights can be overlooked, imperiled, or difficult to use. The routine uncertainty arising in how to provide good care to patients who are excluded from key public insurance provisions, together with the desire to be a good advocate for this patient population, can give rise to so-called workarounds as problem-solving strategies. This article explores the ethics of workarounds in the care of undocumented patients and considers how advocacy by health care professionals and organizations can assist immigrants in communities they serve.

MeSH terms

  • Delivery of Health Care / ethics*
  • Emigrants and Immigrants* / legislation & jurisprudence
  • Ethics, Medical*
  • Health Policy
  • Humans
  • Physicians / ethics
  • Quality of Health Care / ethics
  • Social Justice / ethics
  • Undocumented Immigrants* / legislation & jurisprudence
  • United States