A situation playing out in Chicago represents one of the many dilemmas faced by the US in dealing with undocumented immigrants.
Francisco Pantaleon, 30, suffered a severe brain hemorrhage a month ago and has been in a coma at the University of Illinois Medical Center since then. Doctors at the center have little hope for the man’s recovery and want to transfer him to an Acapulco, Mexico hospital at UIC’s expense.
That is the basic situation. Complicating it are issues that are faced more and more frequently by generally compassionate decision makers. Following are the facts they are wrestling with in this case:
Although Francisco has been in the United States for 11 years, he is apparently one of millions who walked across the border from Mexico without documents. That fact alone is enough to get him deported.
Francisco, married and a father of two, worked for a car wash and has no health insurance or other resources to pay for his care. Hospitals have long had a policy of sending medically needy undocumented immigrants back to their countries of origin.
Although family members at first agreed with the hospital’s decision, his sister Socorro and his cousin retained an attorney to prevent the transfer, fearing Francisco would not survive the trip or find adequate care in Mexico.
Balancing humanitarian care with other realities
Unless the person is very poor, long-term care in a hospital is not guaranteed to US citizens who do not have health insurance. "Hospitals don’t have the financial resources to meet all of the acute care needs [of patients without insurance], let alone take on all the chronic care needs that present with patients like this," said William Chamberlin, chief medical officer at theMedical Center.
Pantaleon, like any person regardless of nationality or insurance status, by law, has a right to be stabilized in an emergency. Then they are supposed to be transferred to another setting where they can receive adequate care. The problem is that no nursing home will take Pantaleon since he does not have insurance or resources.
His sister and cousin are basing their opposition to the move on the fact that the hospital was planning to move him to another country based solely on the family’s original permission to do so. That is basically taking deportation into their own hands, says the attorney for the family.
"It’s important to make sure that hospitals aren’t permitted to dump patients on an international level when they can’t do it on a local level," the lawyer said.
The Mexican consulate has weighed in as well. "There were certain legal procedures that the hospital should have followed that they bypassed," according to a spokeswoman for the consulate. One of those procedures is that the medical center failed to inform the consulate of plans to move Pantaleon, a Mexican citizen.
The hospital, however, said that step was not necessary. "We have worked with the individual who has had primary decision-making responsibility for the patient" and had that person’s full consent, he said. A senior vice president of government relations at the Illinois Hospital Association, said "the family ought to be grateful" that UIC found a facility in Mexico willing to take Pantaleon and volunteer to pay for the trip.
Apparently Pantaleon will continue to be cared for at the facility as the family follows through with its legal maneuvering.