“The health system is not NOAH’S ARK”
“Health care is not about laws, it is about being humane”
“One thing is clear, health workers should not bear the burden of (…) refusing or agreeing to offer necessary treatments”.
Abstract
Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children’s rights are needed to promote equitable practices and advocacy against regulations limiting services.
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References
UNDP, Human Development Report. (2009). Overcoming barriers: Human mobility and development 2009. New York: United National Development Programme.
PICUM. (2007). Access to health care for undocumented migrants in Europe. Brussels: Platform for International Cooperation on Undocumented Migrants.
Fortuny, K., Capps, R., & Passel, J. S. (2007). The characteristics of Unauthorized Immigrants in California, Los Angeles County, and the United States. Washington, DC: The Urban Institute.
Ter Kuile, S., et al. (2007). The universality of the Canadian health care system in question: Barriers to services for immigrants and refugees. International Journal of Migration, Health and Social Care, 3(1), 15–26.
Ruiz-Casares, M., et al. (2010). Right and access to healthcare for undocumented children: Addressing the gap between international conventions and disparate implementations in North America and Europe. Social Science and Medicine, 70(2), 329–336.
CESCR. (2000). The right to the highest attainable standard of health (article 12 of the International Covenant on Economic, Social and Cultural Rights). General Comment No. 14. E/C.12/2000/4. Committee on Economic Social and Cultural Rights.
Cole, P. (2009). Migration and the human right to health. Cambridge Quarterly of Health Ethics, 18(1), 70–77.
Alexander, S. (2010). Humanitarian bottom league? Sweden and the right to health for undocumented migrants. European Journal of Migration and Law, 12, 215–240.
Arnold, F., et al. (2008). Medical justice for undocumented migrants. Lancet, 371(9608), 201.
BMA. (2008). Asylum seekers and their health [Electronic Version]. Retrieved June 10, 2008 from http://www.bma.org.uk/ap.nsf/Content/asylumseekershealth.
Hjern, A., & Bouvier, P. (2004). Migrant children: A challenge for European paediatricians. Acta Paediatrica, 93, 1535–1539.
Committee on Community Health Services. (1997). American academy of pediatrics: Health care for children of immigrant families. Pediatrics, 100, 153–156.
World Medical Association. (2009). Medical ethics manual. Ferney-Voltaire Cedex: The World Medical Association.
Lancet. (2008). Migrant health: What are doctors’ leaders doing? Lancet, 371(9608), 178.
Duvivier, R., et al. (2010). Migrants and the right to health: The students’ perspective. The Lancet, 375(9712), 376.
Bragg, R. (2008). Maternal deaths and vulnerable migrants. Lancet, 371(9616), 879–881.
Lancet, T. (2007). Access to health care for undocumented migrants in Europe. Lancet, 370(9605), 2070.
Young, J., Flores, G., & Berman, S. (2004). Providing life-saving health care to undocumented children: Controversies and ethical issues. Pediatrics, 114(5), 1316–1320.
Hargreaves, S., & Burnett, A. (2008). UK Court decision: Health care and immigration. Lancet, 371(9627), 1823–1824.
Acknowledgments
The study was funded by research grant No. MOP-97991 from the Canadian Institutes of Health Research. We thank all health care professionals who responded to the survey as well as the staff at participating institutions who facilitated administration. We thank Dragan Kljujic for his invaluable contribution to data management. We thank Jill Hanley, Ronald Ludman, Toby Measham, Francesca Meloni, Catherine Montgomery, Marie Munoz, Marie-Jo Ouimet, Karine Vanthuyne, and Ashley Wazana for their comments regarding the survey instrument. The Editor and two anonymous reviewers provided helpful comments.
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Ruiz-Casares, M., Rousseau, C., Laurin-Lamothe, A. et al. Access to Health Care for Undocumented Migrant Children and Pregnant Women: The Paradox Between Values and Attitudes of Health Care Professionals. Matern Child Health J 17, 292–298 (2013). https://doi.org/10.1007/s10995-012-0973-3
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DOI: https://doi.org/10.1007/s10995-012-0973-3