Patients and borders, money and mission: responding to medically needy persons from other countries who lack financial resources

Lauris Christopher Kaldjian

doi:10.1353/pbm.2012.0022

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Patients and borders, money and mission: responding to medically needy persons from other countries who lack financial resources

Journal article

Peer reviewed

Patients and borders, money and mission: responding to medically needy persons from other countries who lack financial resources

Lauris Christopher Kaldjian

Perspectives in biology and medicine, Vol.55(2), pp.186-200

2012

DOI: 10.1353/pbm.2012.0022

PMID: 22643757

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Abstract

When financially impoverished persons from resource-poor countries travel to resource-rich countries to seek medical treatment, health-care professionals and hospital administrators must decide how to respond. These financially impoverished "medical travelers" are medically no different from financially impoverished citizens or immigrants, but their national residence and purpose of travel may cause them to be seen as having a lower degree of standing within the communities that hospitals are expected to serve. In responding to such persons, health-care professionals and administrators encounter tension between the mission-driven intention to provide care and a budget-driven intention to protect operating margins. Responses require practical wisdom and a readiness to wrestle with tensions related to objectives (charitable versus financial), role-specific obligations (clinicians versus administrators), and contrasting moral frameworks. There are also challenges of reconciling plural moral values, setting moral priorities, and considering whether national borders should constrain our view of persons as neighbors. Finding a way forward amidst many tensions is hard moral work, but it may be facilitated by granting a moral imperative to physical proximity, respecting role-fidelity among clinicians and administrators, furthering candid moral dialogue, and promoting a presumption to treat whenever it is feasible to do so.

Health Services Needs and Demand - organization & administration

Social Values

Humans

Needs Assessment - economics

Health Services Needs and Demand - economics

Health Personnel - ethics

Health Services Needs and Demand - ethics

Morals

Health Personnel - organization & administration

Patient Advocacy - ethics

Decision Making - ethics

Health Policy - legislation & jurisprudence

Patient Advocacy - legislation & jurisprudence

Emigration and Immigration - legislation & jurisprudence

Stress, Psychological

Needs Assessment - ethics

Details

Title: Subtitle: Patients and borders, money and mission: responding to medically needy persons from other countries who lack financial resources
Creators: Lauris Christopher Kaldjian - Program in Bioethics and Humanities, 1-106 MEB, University of Iowa Carver College of Medicine, 500 Newton Road, Iowa City, IA 52242, USA. lauris-kaldjian@uiowa.edu
Resource Type: Journal article
Publication Details: Perspectives in biology and medicine, Vol.55(2), pp.186-200
DOI: 10.1353/pbm.2012.0022
PMID: 22643757
ISSN: 0031-5982
eISSN: 1529-8795
Language: English
Date published: 2012
Academic Unit: General Internal Medicine; Internal Medicine
Record Identifier: 9984094527902771

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