A medical ethicist says people who are angry at a South Florida hospital for repatriating a brain-damaged patient to his native Guatemala should instead push Congress to expand emergency healthcare coverage to illegal aliens.
Arthur Caplan, a professor of bioethics at the University of Pennsylvania Center for Bioethics, says Martin Memorial Medical Center was unfairly criticized after the Stuart, FL hospital chartered an airplane and returned Luis Jimenez, 37, to his native Guatemala in 2003. The hospital had been providing unreimbursed long-term care for the uninsured day laborer ever since he suffered severe head injuries in a 2000 automobile accident that left him partially paralyzed. The hospital placed the value of the uncompensated care at around $1.5 million.
"Those who are outraged over sending him home should try to push for illegal aliens to be covered. Good luck with that," Caplan says. "You can yell at the hospital all you want, but if he was in a public plan they probably would have kept him here because he would have had coverage. In a way, each one of us decided to send him home."
A civil jury in Stuart this week sided with the hospital and rejected claims made by Jimenez's relatives that he was illegally repatriated. Jimenez"s family had sought $1 million to cover the cost of his continuing care in Guatemala, along with unspecified punitive awards to discourage other hospitals from taking similar actions. The case was closely followed by many healthcare and immigration experts because it raises the issue of who is responsible for providing long-term care for illegal aliens who don't qualify for federal or state aid.
While happy with the jury's verdict, Mark E. Robitaille, CEO at Martin Memorial, says he is also disappointed "that the issue of providing healthcare to undocumented immigrants remains unresolved on a state and national level."
"This is not simply an issue facing Martin Memorial. It is a critical dilemma facing healthcare providers across Florida and across the United States," says Robitaille, who was not with the hospital when Jimenez was repatriated. "What is truly unfortunate is that since Mr. Jimenez was first admitted to Martin Memorial nine years ago, nothing has been done to address this issue by our political leadership."
Like Caplan, Robitaille says he's not optimistic that the issue will be addressed soon. "This is an opportunity for leaders at the state and federal levels to find a solution, rather than relying on individual healthcare providers to develop solutions on a case-by-case basis," he says. "Unfortunately, none of the proposed national healthcare reform bills currently being debated in Washington address the issue of how to adequately provide healthcare for undocumented immigrants in a way that is fair and equitable to everyone involved."
Caplan says that, even though Martin Memorial was acting out of financial interest when it repatriated Jimenez, the hospital had fulfilled its ethical obligation to the Guatemalan with the care he'd received for nearly three years.
"When it is an emergency you have to be humane and do what you can do. But once they are stabilized and once they are beyond what the medicine can do, I don't have a problem with them returning him to Guatemala," Caplan says. "If there were more that could be done, they have a duty, even though he is not a paying person, to try and get him care that might help him regain function. But there was no indication that was the case."
"To put it bluntly, there is a difference between transferring someone back home and dumping him back home," he says. "From what I saw in the court discussion, they were closer to transferring than they were to dumping."