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Must nurses care for migrants?

By: Leah Curtin, RN, ScD(h), FAAN

Basic human rights apply to everyone.

THERE SEEMS to be much controversy about giving healthcare to “undocumented” immigrants—or even “documented” ones. In fact, some people believe that anyone who doesn’t have health insurance has no right to healthcare. According to the Universal Declaration of Human Rights, they are wrong. And what’s even worse is when a government not only doesn’t uphold the right, but actually violates it. For example, the treatment of migrant children on the U.S. southern border is a gross violation of these children’s basic rights on several levels. Period. Full stop. It isn’t a matter of politics or party. It’s a matter of basic human rights. Nothing that their parents do or fail to do has any bearing on their rights as human beings.

How dare I say such a thing? Let’s go back the United Nations’ Universal Declaration of Human Rights, of which the United States is a signatory. What follows comes directly from the declaration:

Article 1: All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

Article 2: Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.

Article 25: Everyone has the right to a standard of living adequate for the health and wellbeing of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”

Perhaps it is worth the time to refresh our understanding of human rights: Human rights are just claims to the fulfillment of fundamental, universal human needs. They don’t depend on any legal jurisdiction, but they do need to be claimed. They’re part and parcel of being human, but you aren’t less human if they’re violated. No one can live a fully human life without them, and in some cases, they can’t live at all without them.

Human rights can be violated, but they don’t go away because they’re violated. In fact, their violation demands retribution. They don’t disappear when one crosses state or national boundaries—whether or not that state or nation recognizes and protects them in their existing jurisdictions.

So, if you want to know if nurses have an ethical obligation to care for undocumented immigrants, the answer is a resounding yes. To refuse to care for them is, ipso facto, unethical.

leah curtin registered nurse faan




Leah Curtin, RN, ScD(h), FAAN Executive Editor, Professional Outreach American Nurse Today


13 Comments. Leave new

  • Majorie Powey
    October 31, 2019 8:23 am

    Thank you Leah Curtin for your comments in Practice Matters on caring for immigrants. As a Public Health Nurse for 20 years in a rural NM County I cared for both documented and undocumented immigrants. Many were amazing people. Their work ethic was extraordinary. Their children were always well behaved and hugged me when I visited the school in Arrey – a farming community. At Christmas they were the people who would bring me homemade tamales or biscochitos.

    I was horrified by the separation of children and parents at the border. That is a violation of every standard of basic human rights. For many of those children the trauma will never be resolved. I had friends in El Paso who witnessed the horrific massacre at Walmart. As nurses we must stand up and speak up against these crimes against humanity.

  • As some of you have addressed the ‘unfairness’ of caring for undocumented persons while others wait in line and suggested that question: let me be clear. The issue is not who pays for care. This is a social issue, not a nursing issue. As citizens we can help determine who will pay and how much only through or votes. As professional nurses we give care according to our assessment of the patients’ needs — and we triage accordingly. Our duty is to those persons who present for our care. We are not in the business of judging people. We are in the business of giving care. As for how much nurses are paid, how many patients they care for etcetera, this is determined by negotiations with employers. It has nothing to do with the legal or financial status of the persons for whom we care. Thank you, Leah Curtin

  • Nancy Sterling Trimble PhD, RN, APRN, Deacon in the ELCA
    October 12, 2019 4:24 pm

    These are the last lines of the Florence Nightingale Pledge which many of us recited at our graduations.

    ….and devote myself to the welfare of those committed to my care. (1893) ….and as a ‘missioner of health’ I will dedicate myself to devoted service to human welfare.(1935). Indeed, refusal of care is unethical and may be considered abandonment! I am always dismayed when I see the judgmental attitudes of my professional peers rather than using good and ethical judgment in the situation. We are dedicated to the most vulnerable. There certainly will be those who slip through and fool us, but we cannot predicate practice for many because of one or two. After all, unless you are or are descended from Native peoples, your family were immigrants. Very good article, Dr. Curtin.

  • I, too, agree 100%, Leah. Thank you for expressing the thoughts of so many of us. As a retired OR nurse, who graduated 51 years ago….I have voiced and acted on this view since a young RN.

  • I meant NOT profit-producing staff btw.
    Sorry, I left out a keyword.

  • Thank you for the article. Yes, as the wife of a deceased legal immigrant, we should provide care to as many people as physically and financially possible. The issue is who pays for their care and is it morally correct to provide care to people coming in illegally while neglecting citizens or those who have waited in line? You really never answer that question. The other issue is nurses are considered necessary but the profit-producing staff in the hospitals. That is why they are giving too many patients to nurses. Would nurses take a pay cut in order to reduce the number of patients they are assigned? Not one person answers this question.

  • Thank you Dr. Curtin! Agree wholeheartedly! And if anyone needs yet another ethical reference, please refer to the ANA Code of Ethics.

  • That’s right. A person in crisis would undeniably be triaged accordingly. You wouldn’t treat a cold ahead of a stroke. We do not segregate our healthcare. And humanity is not limited to US citizens.

  • Douglas DiToro RN
    October 9, 2019 9:12 am

    Very appropriate and accurate. However lets start with providing all these great concepts to our own less fortunate citizens ie veterans with a myriad of problems both physical and mental: our homeless, our disenfranchised, our neglected Native Americans and our struggling middle class and unemployed older workers. As nation we are the greatest in taking in the poor, refugees and others but we can not accept all the worlds peoples who want to come here. We cannot accept the some 1.5 million who wish to come to the USA. We accept 1 million a year legally, It is not fair to those who go through the process to come here legally but then have to wait for those who enter illegally to go to the head of the line. A nation is only so strong as it borders. Unfettered immigration without control and verification as to legitimacy of the applicant is a blueprint for disaster. Just remember 9-1-1

  • Kudos to you, Leah Curtin!
    You have said what so sorely needs to be said again and again and right across our country. So many living amongst us seem to have forgotten the basis of your well-documented substantiation for honoring human rights. So sad!

    The impact of what our government has done to the many thousands of immigrant children who are still locked up in cages and separated from their parents is indeed a clear example of a violation of human rights. Our nation should have to own the impact of the psychological damage being done to these children, which will likely last their lifetimes (See the Adverse Childhood Experiences Scale).

    Nurses, of all people, should understand that we are all inter-connected when it comes to treating people who become ill, or who need the public health interventions of prevention and population and community health interventions.

    I would call on nurses everywhere to hear your call and to lead by example; to earn the designation the people of America bestow on us year after year in the National Gallup Polls; namely that of being the nation’s most trusted and respected profession…and to do that by honoring the ethical values inherent in the human rights you so eloquently brought to the attention of nurses and the nation.
    Thank you.
    Dr. Stephanie Paulmeno, DNP, MS, RN, NHA, CPH, CCM, CDP

  • Our treatment of anyone viewed as “other” should be radically addressed. We all bleed the same color, we all came to be the same way. No matter religion or lack of, race, ethnicity, sexual orientation, everyone deserves to be treated with kindness and respect. I love all of man-kind

  • Thank you! We all are human and deserve to be treated as such no matter where we come from or our immigrant status. I would gladly give my services as an RN to anyone seeking the need for health care. Most of us at one time in our lives have been on the end of not having health care benefits. Your status as documented or undocumented should never keep a person from being treated as a human being.

  • Sharon H. Allan
    October 8, 2019 6:58 pm

    I Agree 100%!!


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