Published at www.nejm.org June 2, 2010 (10.1056/NEJMc1004884)
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To the Editor: The new Arizona state immigration bill (SB-1070) signed into law on April 23 will seriously obstruct, if not undermine, the practice of medicine in the state of Arizona. It specifies that those who "conceal, harbor or shield or attempt to conceal, harbor or shield" a foreign person who came to the United States illicitly "are guilty of a class 1 misdemeanor" punishable by a fine of at least $1,000 (Sec. 5, Section 13-2929).1 It can be argued that health care providers who neglect to report illegal immigrants under their care will violate the law and be considered criminals. The bill provides physicians with no guidance as to what constitutes "reasonable grounds" to suspect that somebody is in the country illegally, leaving the particulars of such scrutiny to anyone's imagination (although the fact that Arizona shares a border with Mexico rather than a European country suggests that whites will not be "reasonable" suspects). One interpretation is that health care providers in Arizona will need to ask for a passport before seeing certain patients (and providers themselves will need to carry their own passports at all times, depending on their physical appearance or accent).
Arizona practitioners, hospitals, and medical associations need to ponder the extent of their liability under the new law and draft clear institutional policies to defend their patients and employees from potential harassment. Asking patients to produce immigration documents violates the trust that physicians, nurses, and other health care workers endeavor to earn from them.
This bill threatens one of the oldest traditions of medicine: physicians shall protect patients regardless of nationality or race.2 This legislation, if unchallenged, will force health care providers to choose between the dignity of their profession and the indignity of violating the law.
Lucas Restrepo, M.D.
Barrow Neurological Institute
Phoenix, AZ
lrestrepo@ucla.edu
This letter (10.1056/NEJMc1004884) was published on June 2, 2010, at NEJM.org.
Disclosure forms provided by the author are available with the full text of this letter at NEJM.org.
References
- State of Arizona Senate Bill 1070, 2010. (Accessed June 1, 2010, at http://www.azleg.gov/legtext/49leg/2r/bills/sb1070h.pdf.)
- Spetzler R, Patchell R, Shapiro W, Restrepo L. Doctors being put in a bad position. Letter to The Arizona Republic. April 24, 2010. (Accessed June 1, 2010, at http://www.azcentral.com/arizonarepublic/opinions/articles/2010/04/24/20100424satlets244.html.)
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