Friday, September 05, 2008

Baby on Board: The attempted deportation of an infant by UMC reveals legal murk

The Tuscon Weekly has an article about attempted deportations by hospitals. An excerpt:

Among these known episodes, the Baby Mejia case ranks among the most disturbing. As the baby was en route to the Tucson International Airport for a flight to Hermosillo, Gaxiola was cobbling together a strategy. Eventually, he convinced the mother to grant him custody of the child.

"She said, 'Can you take care of my baby?'" he recalls. "I told her that if she put the baby in my custody, I would do everything I could to take care of it." The father also granted him custody by phone a few minutes later. "And at that point, I called 9-1-1," Gaxiola says, "to let the police know that a kidnapping was in progress."

He then informed the hospital that they couldn't move the baby without his consent. And he contacted Mexican authorities to inform them that an American citizen was being kidnapped.

"They told me that if any (child) arrived in Hermosillo without written parental consent, the airplane would be seized, and the pilot would be jailed while they did an investigation," Gaxiola says. "And that child would be returned to the United States."

It never got that far, as Tucson police arrived in time to stop the flight. "They were the heroes," Gaixola says. "They were so complete in their operation that they actually went back to UMC [Ed: University Medical Center] and physically saw the child there before they would close the case. The police department understood something very simple: You cannot move a child without parental consent."

So who provides oversight of these seemingly compulsory international removals? Nobody, it seems. While facilities receiving federal Medicare funds are required to make adequate arrangements for discharged patients, "there's nothing separate for certain types of citizens or noncitizens," says Debbie Johnston, director of regulatory affairs and policy for the Arizona Hospital and Healthcare Association. Nor are there guidelines for navigating these complex legal waters. "We don't have any guidance, any policy coming down from the courts or from the government on what happens when a patient is ready for discharge, and consent hasn't occurred," Johnston says.

Officials at two hospitals featured in the article, UMC and Carondelet, maintained that they only conducted repatriations with the patient's consent. However, the article showed how the line between consent and coercion can be thin:

Another patient was purportedly being driven against his will to Agua Prieta, Sonora, when Gaxiola received a phone call. "The guy told me he didn't want to go," the attorney says. "But they put him in an ambulance, and at the port of entry, the U.S. Border Patrol asked to speak to the guy in the back. The agent asked him, 'Do you want to go to Mexico?' And the guy said no."

The ambulance was turned back.

But Richardson believes the patient simply had a change of heart. "Everything was fine when the gentleman left here in the ambulance, but something changed along the way," he says. "I don't know if he was talking to people or not, but he had a cell phone with him. By the time he got (to the border), he had changed his mind, so he came back."

UMC treated the man until he was later released.

The anti-immigrant nuts are fond of saying that the US must deport all undocumented immigrants or else the healthcare system will go bankrupt. That isn't true. However, do understand that individual hospitals in the Southwest of the US can rack up a good amount of uncompensated care from incidents like these.

The folks who go into nonprofit healthcare do not go there so that they can act like vigilantes. The vigilante crowd is more attracted to organizations like Immigration and Customs Enforcement. However, the financial pressures on US hospitals are immense even without undocumented immigrants, and some hospitals will make questionable decisions.

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