IU physician to speak Thursday on treatment policy for undocumented patients

Guest post courtesy of IU Newsroom intern Annie Brackemyre

Few topics have been so politically divisive in recent years as health care and immigration reform. Dr. Brian Decker is working to reframe the debate around treating undocumented patients as a discussion of ethical principles.

This Thursday, as a part of the IU Poynter Center’s Healthcare Ethics Seminar Series, Decker will discuss how IU and nationwide medical centers provide dialysis to undocumented patients.

Dr. Brian Decker

Dr. Brian Decker

Decker has been a member of the nephrology faculty at the Indiana University School of Medicine since completing his nephrology fellowship in 2007. Before pursuing nephrology, he received his M.S. and Pharm.D. from Purdue University. His primary research interests are the clinical pharmacology of medications and the implementation of personalized medicine in patients with chronic renal disease. He also serves as an active member on the Eskenazi Health ethics committee.

“Beyond the physician community, the issue of treatment does get politicized,” Decker said. “People do take sides. When you are on the front line, see these patients face-to-face and see the bad outcomes in store because they aren’t receiving dialysis, it is much more difficult to see this politically. We see this from a humanistic stand point.”

According to a Pew Research Center, the Affordable Care Act does nothing to help provide health insurance for the approximately 12 million undocumented immigrants currently living in the United States. They are ineligible for healthcare subsidies and are unable to purchase coverage in the health insurance marketplace.

The only subsidized medical care that they do have access to is emergency care, covered through Medicaid, if they meet the low income requirements.

Patients with chronic or end stage renal failure typically receive dialysis treatments three times a week, although some patients may require daily treatments. Undocumented patients are able to receive treatment only after they are already acutely ill and check in to an emergency room.

Decker explained that the nephrology community broadly agrees that this treatment routine does not offer undocumented patients an acceptable standard of care.

According to Decker, 16 undocumented patients with chronic and end stage renal disease are currently being treated in Indianapolis, although only on emergency basis. He estimated that as of 2010, there are 5,500 undocumented immigrants with end stage renal disease nationwide.

Decker will address ethical conflicts that he has confronted as a practicing physician.

“These are not textbook hypotheticals, but rather the real questions that I have as a doctor,” he said. “These are the ethical questions that I struggle with.”

The seminar runs from 4 p.m. to 5:30 p.m. Feb. 12 at the Poynter Center, 618 E. Third St. It is free and open to the public. An RSVP to eayoung@indiana.edu is appreciated.

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