Immigrant's death linked to inability to pay for medical care

March 11, 2011

A comatose immigrant woman died after she was discharged from Georgetown University Hospital and removed from her feeding tubes—against the wishes of her family—in a case that has raised concerns about the impact of finance on medical care.

Rachel Nyirahabiyambere was admitted to Georgetown University Hospital, an institution “in the Jesuit tradition,” after she suffered a debilitating stroke in April 2010. When she remained comatose and unresponsive, and family members failed to arrange for her transfer to a hospice facility, the hospital petitioned for a court-appointed guardian to arrange for her future. That guardian, whose appointment the woman’s family members opposed, arranged to have Nyirahabiyambere moved to a nursing home, where her feeding tube was removed, leading inevitably to her death.

The case is complicated by the family’s inability to reach a decision on the woman’s medical care. But the woman’s inability to pay for care—because she did not carry health insurance, and as a recent immigrant was not eligible for Medicaid—was clearly a factor in the handling of her case.

A New York Times report on the case quotes bioethicist Arthur Caplan: “Any hint that withdrawing treatment might be linked to financial considerations—that’s a big ethical no-no. That’s death panel stuff.”

Moreover, providing nutrition through a feeding tube is not normally classified as “treatment,” but as fundamental “care” for a patient. The Vatican has indicated that the removal of nutrition and hydration, in order to hasten the advent of death, is never morally acceptable.

 

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Further information:

• Immigrant left to die by starvation after Jesuit hospital decides care is too expensive (LifeSiteNews)
• Immigrant’s Health Crisis Leaves Her Family on Sideline (New York Times)