Eligibility of overseas visitors and people of uncertain residential status for NHS treatment

doi:10.1136/bmj.329.7461.346

BMJ 2004;329:346-349 (7 August), doi:10.1136/bmj.329.7461.346

Education and debate

Ethics in practice

Eligibility of overseas visitors and people of uncertain residential status for NHS treatment

Andrew J Pollard, senior lecturer in paediatric infectious diseases¹, Julian Savulescu, director²

¹ Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, ² Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford OX1 1PT

Correspondence to: A J Pollard andrew.pollard@paediatrics.oxford.ac.uk

Current UK regulations deny free treatment for HIV to illegalimmigrants and failed asylum seekers. Is this policy resultingin unjustifiable harm to infants who are born to infected mothers?

The first 150 words of the full text of this article appear below.

Introduction

A pregnant woman from Africa who has been in the United Kingdomfor six months is found to be HIV positive on antenatal screeningperformed by her general practitioner. Testing by an HIV physicianshows that she has a high viral load. The physician plans tostart antiretroviral therapy to reduce the risk of transmissionof HIV to the fetus. In the meantime, the woman attends thehospital antenatal clinic and is asked to prove her eligibilityfor treatment. She is unable to provide her passport and isthen denied access to the consultant. The woman defaults fromfurther follow up by HIV or obstetric services.

The issues

Although fictional, this case reflects cases that have occurredrecently. Do doctors who discover a pregnant woman is infectedwith HIV have a duty to provide antiretroviral treatment, withoutseeking to determine her right to reside in the United Kingdom,when intentionally denying therapy . . . [Full text of this article]

Background considerations

Access to health care

Grounds for treatment

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Incentive to illegal immigration and visiting for the purposes of medical treatment?

Proposal

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This article has been cited by other articles:

Torres-Cantero, A.M., Miguel, A.G., Gallardo, C., Ippolito, S. (2007). Health care provision for illegal migrants: may health policy make a difference?. Eur J Public Health 17: 483-485 [Abstract] [Full text]
Fowler, A, Collins, L, Larbalestier, N, Kulasegaram, R, de Ruiter, A, Micunovic, V (2006). HIV, HAART and overseas visitors. Sex. Transm. Infect. 82: 516-516 [Full text]
Ashcroft, R. E (2005). Standing up for the medical rights of asylum seekers. J. Med. Ethics 31: 125-126 [Full text]
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Rapid Responses:

Read all Rapid Responses

You mean eligibility for Russian roulette?: Richard G Fiddian-Green
bmj.com, 7 Aug 2004 [Full text]
Ethical Consideration: Badri Raj Pande
bmj.com, 7 Aug 2004 [Full text]
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bmj.com, 9 Aug 2004 [Full text]
Eligibility of overseas visitors and people of uncertain residential status for HIV treatment: Nigel O'Farrell, et al.
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Duty of Easy Rescue: Rory O'Conor
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Disapointed: harold sidney pearson
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Civilised behaviour: L Sam Lewis
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