Update belowArizona’s infamy for creating draconian anti-immigrant legislation was already well established before Senate Bill 1405 was introduced to state lawmakers in January; however, the bill brought the state to a new low. If passed, SB 1405 would require Arizona hospitals to check on the immigration status of every patient, and report results to state or federal law enforcement authorities. There are numerous problems with forcing health professionals to serve as immigration agents, and so it is not surprising that health care organizations have uniformly opposed the bill. To begin with, its passage foreshadows a public health crisis. The knowledge that seeking care at a hospital will lead to scrutiny by law and immigration authorities is certain to deter many thousands from seeking care. Even if a prospective patient has legal status in the US, he or she may fear consequences for undocumented loved ones, or simply be repulsed at the prospect of having to defend against baseless suspicions. A population that does not seek care when it is needed is a population that will increasingly spread sickness. As anyone who has waited too long to see a doctor knows, our health care system is already heavily burdened.? Health care professionals have their hands full keeping up with the various requirements and paperwork needed by the many different organizations that authorize and pay for medical services. The addition of more, unnecessary responsibilities imperils hospitals’ ability to help the sick.By passing SB 1405, Arizona legislatures would compromise health professionals’ ethical commitments. The foremost duty of any health care provider is, of course, to “do no harm.” Reporting a patient for a suspected violation that poses no immediate danger to anyone, however, does serious harm by leading directly to detention, separation from family and friends, and forced migration. A law that keeps individuals from seeking care violates the principle, embraced by the American Medical Association among other groups, that health professionals must support access to medical care for all people.Dr. Lucas Restrepo of Phoenix expressed the troubling issues best in a June 2010 letter to the New England Journal of Medicine, “Asking patients to produce immigration documents violates the trust that physicians, nurses, and other health care workers endeavor to earn from them.” Health professionals have a responsibility to support laws that promote the best interests of their patients, and to speak out when those interests are threatened. Please join PHR, the Mayo Clinic in Arizona, the Arizona Hospital and Healthcare Association, and many others in opposing SB 1405. If you are an Arizona resident, you can send a responsive letter created by the Arizona Public Health Association to your state representatives. Residents of other states will want to stay tuned for related news: in the past year, anti-immigrant initiatives originating in Arizona have spread in near-identical form to dozens of additional states.Update: On March 17, 2011, the Arizona Senate responded to the widespread concerns of the medical community and rejected SB 1405 by a vote of 18 opposed, 12 in favor. Although this victory is heartening, health professionals must remain vigilant as similar proposals are virtually certain to be made in states across the country in the coming years.
