Below are two articles on care of children with complex medical conditions and an undocumented status. I also found one addressing the idea that children of immigrant families have better than expected health outcomes than non-immigrant, which does not really hold true when the child has a chronic medical condition. Useful literature, especially in the light of current events.
Parsi K et al. Complex discharges and undocumented patients: growing ethical concerns.J Clin Ethics. 2012 Winter;23(4):299-307.
Abstract: A growing number of discharges at acute-care hospitals involve patients who are undocumented and lack legal status. Because such patients are ineligible for public assistance, long-term care facilities will routinely deny them admission. These discharges become complex discharges because of such financial barriers. If local family support is unavailable, discharging such patients to a safe and suitable location becomes increasingly difficult. These complex discharges implicate a number of ethical principles. We describe such complex discharge cases, apply various ethical frameworks, and call for potential policy solutions to address this growing ethical concern.
Young J et al. Providing life-saving health care to undocumented children: controversies and ethical issues. Pediatrics. 2004 Nov;114(5):1316-20.
Abstract: Pediatricians and hospitals with special pediatric expertise are facing the dilemma of rationing care to uninsured, undocumented children, especially for expensive life-saving care such as transplants, chemotherapy, and dialysis. This article reviews a relevant case history and provides a review and discussion of the ethical and policy issues associated with this problem.
Javier JR et al. The relationship of immigrant status with access, utilization, and health status for children with asthma. Ambul Pediatr. 2007 Nov-Dec;7(6):421-30.
Abstract (truncated): Despite their high levels of poverty and less access to health care, children in immigrant families have better than expected health outcomes compared with children in nonimmigrant families. However, this observation has not been confirmed in children with chronic illness… Compared with children with asthma in nonimmigrant families, children with asthma in immigrant families are more likely to lack a usual source of care (2.6% vs 1.0%; P < .05), report a delay in medical care (8.9% vs 5.2%; P < .01), and report no visit to the doctor in the past year (7.0% vs 3.8%; P < .05). They are less likely to report asthma symptoms (60.8% vs 74.4%; P < .01) and an emergency room visit in the past year (14.1% vs 21.1%; P < .01), yet more likely to report fair or poor perceived health status (25.0% vs 10.5%; P < .01). Multivariate models revealed that the relationship of immigrant status with health measures was complex.