Medical schools have ethical obligation to accept undocumented immigrants

Medical schools have an ethical obligation to change admission policies in order to accept applications from undocumented immigrants known as Dreamers, according to an article in the December, 2014 issue of the journal Academic Medicine.

Not allowing Dreamers to apply to medical school "represents a kind of unjustified discrimination and violates the basic ethical principle of the equality of human beings," write co-authors Mark G. Kuczewski, PhD and Linda Brubaker, MD, MS of Loyola University Chicago Stritch of Medicine. Academic Medicine is the journal of the Association of American Medical Colleges.

In 2012, Loyola became the first medical school in the United States to amend its admissions policies to include qualified students who have received Deferred Action for Childhood Arrivals (DACA) status and are legally recognized as U.S. residents. In August, 2014, Loyola welcomed seven Dreamers to the class of 2018.

The students are known as Dreamers after a proposed federal law called the DREAM Act (Development, Relief and Education of Alien Minors). Although the DREAM Act has yet to become law, the DACA program makes medical training, licensure and medical practice feasible, Drs. Kuczewski and Brubaker write.

The authors write that three main ethical principles and policy considerations support Dreamers' eligibility:

"First, a belief in equality, perhaps the fundamental value in contemporary democratic society, means that these potential applicants must be considered - just like others - on their merits. Second, the medical profession's duty of beneficence, the obligation to help patients, means that medical schools cannot turn away a significant pool of diverse talent in developing the physician workforce. Third, and related to beneficence, the value of social justice requires that medical schools seek to produce a physician workforce that better serves those communities that have been traditionally underserved, such as ethnic minorities and recent immigrants."

Social justice means enabling the participation of all - Dreamers, recent immigrants, minorities, U.S. citizens - in the life and opportunities of the community to the extent possible. "Enabling qualified Dreamers to become physicians is therefore an ethical obligation of the medical education community."

To be eligible for DACA status, an applicant must be between the ages of 16 and 31; must have arrived in the United States before age 16; have resided continuously in the U.S. for at least five years; be currently enrolled in school, have completed high school or earned a GED; have no serious criminal involvement; and be able to prove he or she was in the U.S. on June 15, 2012.

The DACA program was created by the Obama administration and is subject to change by a future president, Drs. Kuczewski and Brubaker write. "Our duty to serve the communities our institutions serve requires that we steward the resources available including the talent of Dreamers. It is time to make the dream a reality."