The title of the article in the Journal of Medical Ethics
asks this question. The authors from the University of Montreal consider
this subject while the topic of “illegal aliens” or foreign nationals (FN’s) has
been a hot topic in the United States.
They however attempt to answer the problem from an international
perspective. The FN that we hear about
is usually in the country illegally, but may be in the country as a legal non-citizen,
visitor, non-permeant resident, refuge claimant, resettled refugee and in rare
cases a person detained by the government.
A patient who arrives at the emergency room requiring
hemodialysis would likely rapidly be started on renal replacement therapy. This is an emergency and since this is considered,
an emergency there would likely not be a question about the provision of such therapy.
What then about transplantation of a kidney?
Is renal transplantation an emergency treatment? We usually consider transplantation to be a
more economical form of treatment of the acute renal failure in the end, but the
lack of long term funding for medical care of the FN puts a different spin on
the subject. It is not just the procurement of the organ and the surgery but
also provision of and management of the immunotherapy necessary to prevent
rejection of the kidney and the technology to manage the therapy. A foreign national that returns to their
home country where there is not an infrastructure that can provide the drug
therapy or monitoring will reject the kidney.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.