Doctors unite against “immoral” no-residency patient decree

The Spanish society of primary care physicians, SEMFyC, the largest in the sector, is encouraging doctors to reject the government's decision to partly deny illegal migrants the right to public healthcare.

The association, which is 20,000 members strong, feels that this decision violates the Hippocratic Oath and their deontology code on several fronts, including their obligation to "watch out for the patient's wellness, loyalty, justice and autonomy."

The SEMFyC is encouraging members to keep seeing their undocumented patients and to declare themselves conscientious objectors in order to protest the new law. Loyalty to the patient must prevail, they say.

"We cannot stop seeing people who, just because they have lost their residency permit, might be in a situation of sanitary defenselessness," said Josep Basora, president of the medical association.

They don't disappear just because the government says they no longer have the right to medical assistance"

The conservative government's royal decree sets out several measures that include taking the health card away from undocumented migrants; from September 1, they will only be allowed emergency services, as well as medical attention during pregnancy and delivery (children will continue to be fully eligible for medical services).

"The exercise of the medical profession comes with ethical obligations that doctors cannot drop at their convenience, not even because of government decisions," said a spokesperson for the association.

Many professionals say they will object the decision and continue to see their patients, whether they have their papers in order or not. "These people who are having their health card taken away are our patients. They do not disappear just because the government says they no longer have the right to medical assistance," said Abel Novoa, author of the document Análisis ético ante la retirada de asistencia sanitaria a inmigrantes sin permiso de residencia (Ethical analysis of the removal of the health card from immigrants without residency permits), which was presented in Madrid on Thursday.

Novoa, who is also a member of the SEMFyC's bioethics group, said he will organize his own schedule in order to be able to see his undocumented patients during working hours. "It is our duty as doctors."

The SEMFyC underscored that, according to the Medical Deontology Code, conscientious objection is "the doctor's refusal to submit out of ethical, moral or religious convictions to a conduct that is required legally, through a mandate of the authorities, or through an administrative decision, in such a way that complying would seriously violate his or her conscience (article 32.1)."

Objection is the only way out for professionals wishing to fight this "unfair and immoral" measure, and also to pressure for change, according to the organization. That is why they have created an objection registry where doctors may sign up to leave record of their position on this issue; in any case, they will also have to inform their superiors of their decision.