Some North Carolina doctors have raised concern that fear over their immigration status and a lack of trust in the health system could prevent some undocumented immigrants from seeking medical care and thus contribute to a rise in infectious diseases, infant mortality and emergency health costs, the Raleigh News & Observer reports.

Immigrants can have high rates of infectious diseases such as tuberculosis and often are uninsured, according to the News & Observer. Many health officials maintain that providing immigrants with basic care -- such as immunizations, prenatal care and screening for contagious diseases -- would prevent diseases' spread. However, there also is a "growing sentiment" among opponents of undocumented immigration that such services should not be funded by taxpayers, according to the News & Observer. Several counties across the nation have begun to question whether they should provide certain health services to undocumented immigrants. Federal law requires that emergency health care be provided regardless of immigration status.

In addition, there is concern that the use of medical records in immigration cases might become more common, the News & Observer reports. Alamance County, N.C., Health Director Barry Bass said he was ordered to release records of five patients to comply with an inquiry by the State Bureau of Investigation. One of the patients, an undocumented immigrant, faces felony charges for allegedly using the Social Security number of a deceased person. Medical records are protected by federal law, but in some cases, a judge can have them released, usually in criminal and civil cases, the News & Observer reports.

Christopher Snyder, president of the North Carolina Academy of Family Physicians, said, "Whether you're legal or illegal, it's always been assumed that your medical information is private and can't be used against you," adding, "The doctor-patient relationship is sacred, and I'm not sure that has really been challenged until now. We're in uncharted territory."

Peter Morris, medical director for Wake County Human Services, said increased use of medical records in immigration cases could destroy the years of trust built between the medical community and immigrant population. "Any person who lives in our community presents a potential public health risk," Morris said, adding, "To scare them away could mean that a public health risk goes undetected until it has affected more of us than it should have" (Collins, Raleigh News & Observer, 8/18).

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