Abstract

Mr. A's physician recommends immediate dialysis. However, Mr. A is in the United States illegally, has no family living in the area, and is unemployed. The Emergency Medical Treatment and Labor Act requires the hospital not only to examine Mr. A, but to provide him with any needed stabilizing treatment without considering his lack of insurance coverage or ability to pay. The needed treatment to stabilize Mr. A is dialysis. Therefore, the physician admits him and starts dialysis. But Mr. A will need to continue dialysis indefinitely. Because he has no insurance and is an illegal immigrant, he is not eligible for any outpatient dialysis units. He is also unable to afford any medical treatments. Once Mr. A is stabilized, should he be discharged? His physician and social worker turn to the hospital ethics committee for help. What should Mercy Hospital do?