Year: 2019
Type: article
Abstract: Undocumented immigrants are part of the health care workforce, whether they are eligible to work in the United States through the Deferred Action for Childhood Arrivals (DACA) program or other visa programs or permits.This case commentary considers whether-and if so, when-a clinician should reveal her immigration status to patients.After reviewing the literature on clinician self-disclosure, this commentary discusses how sharing immigration status could benefit the patient-particularly if the clinician has an immigration status that could interrupt care-but could also draw the focus away from the patient, possibly eroding trust between patient and physician.Finally, this commentary addresses mental health burdens experienced by undocumented and "DACA-mented" trainees and considers the roles that hospitals, residency programs, and health professions schools should play to support them. CaseDr T has a busy morning ahead of her in the cardiology clinic.Her first patient is Mr B, a 67-year-old man, for whom she has been caring since he suffered a heart attack 3 years ago.Dr T always enjoys seeing Mr B, and they have developed a good relationship over the years.Dr T walks into the exam room, greets Mr B, and notices that he isn't his usual jovial self."What's wrong, John?" Mr B responds, "I saw you in the newspaper the other day, Doc.The article mentioned that you were an illegal immigrant and were one of those 'Dreamers.'I've told you some pretty personal things about my life, and I feel like that was something you should have told me."Dr T has recently become active in advocating for immigrants' rights and, as a Deferred Action for Childhood Arrivals (DACA) recipient herself, she has been vocal about her own status as undocumented.Until now, she had not considered how her immigration status might affect her relationships with her patients.She wonders if she should have disclosed her immigration status to Mr B earlier and how to address his concerns now.
Source: The AMA Journal of Ethic
Authors: Isha Marina Di Bartolo, Dominic Sisti
Institution: University of Pennsylvania
Language: English
Subfield: Sociology and Political Science
Field: Social Sciences
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W2911275280