This post is by Macharia Edmonds, a summer intern with the Health Justice Program and a law student at Northwestern University School of Law in Chicago, IL.
Too often in this country, the treatment of those not born in America differs from those born within our borders. Some New York hospitals have done the unthinkable and are discharging some non-citizen patients to their death. These hospitals are practicing what is called medical deportation. This occurs when a hospital discharges a severely injured, sometimes disabled, non-citizen patient who is in need of long term care to a medical facility in their home country. Unfortunately these facilities are usually not equipped to adequately treat the patient’s medical needs and the patient often suffers considerable pain and sometimes death from this lack of treatment.
Under New York state law, a patient is required to sign off on a discharge plan which details any health care arrangements needed after the discharge. These patients are sometimes incapacitated or can have a limited English proficiency which makes understanding the choices they are dealt with difficult if not impossible. In situations where the patient does not speak English the hospital can and should provide an interpreter. In situations where the patient may be incapacitated, things become more complex. If the patient is not able to consent to a discharge then the hospital should look to either an appointed surrogate or a family member. If there is no one from these groups available to decide, there is often confusion as to who has the right to make this decision.
The New York State Legislature has attempted to address this issue by introducing S7429 and A8647C, a bill that creates a three person panel which would be in charge of making these decisions in the absence of other family or appointed representatives. This panel would presumably be able to protect patients from being denied adequate medical treatment. This bill is well intentioned but has a number of issues. Some of these issues include who is allowed to serve on this panel, the lack of information given to the patient and family during the decision making process, and the lack of restrictions and regulations on discharges to foreign medical facilities. NYLPI has offered and will continue to offer to the Senate and Assembly suggestions for this bill so that it ensures these patients who are incapacitated and not able to advocate for themselves receive the proper medical care. No matter what country you are a citizen of, simply being a human being should require a certain level of care.