AMA Journal of Ethics

Although undocumented immigrants contribute to the pool of available organs and to the US tax base, they are not eligible for organ transplantation in most US states.

Undocumented patients are a vulnerable population, since they often lack access to health insurance and can be afraid to present for care. This month on Ethics Talk, we discuss challenges in caring for undocumented patients with Dr. Mark Kuczewski, Scott Schweikart, and Dr. Nancy Berlinger.

When combined with motivation to provide good care, uncertainty about how to do so for patients who are excluded from key public insurance provisions can give rise to workarounds. Their practical and ethical complexities should be recognized when considering how to best serve immigrant communities.

Gene editing with CRISPR/Cas9 raises concerns about equitable access to therapies that could limit research participation by minority group members. These concerns can be addressed through public education, transparency, and stakeholder partnerships.

Rare genetic disease research has something to teach precision medicine about addressing some patients’ limited access to treatment. Health disparities exacerbated by high costs and limited availability of drugs can, perhaps, be mitigated when patient activism accelerates drug development.

When prescribing antibiotics, physicians should weigh individual benefit against both environmental and community harms.