Rosalinda Aguilar is a 29-year-old woman from Mexico currently living in Colorado. She has been in the United States for the past 15 years but does not have legal immigration status. Ms. Aguilar has been working as a nanny in an informal employment relationship that does not provide health insurance. After seeing a flyer for free breast cancer screenings she visits a county clinic for a mammogram. The mammogram reveals a lump in her breast. The county clinic is able to offer screening through the National Breast and Cervical Cancer Early Detection Program, but is unable to provide treatment to Ms. Aguilar.
Ms. Aguilar has saved some money to pay out of pocket for whatever might come her way but with your help and her family, friends she will be able to pay for surgery and staging. After couple doctors visits, Ms. Aguilar's doctor recommends that she consult with a medical oncologist and a radiation oncologist about treatment. At her appointment with a local oncology practice, Ms. Aguilar explains that she and her family do not have insurance and cannot afford to pay for any additional treatment. She asks whether the practice would be willing to treat her for free or at a significantly reduced cost, and whether there are any resources she can turn to for additional funds. Unfortunatlly, they did not want to proceed. Please help my friend in need of treatment.

Discussion
It is not surprising that many physicians feel an ethical obligation to provide medical care for patients who do not have health insurance or the resources to pay for treatment. These feelings may be heightened in the field of oncology, in which there are often clear treatment steps and the consequences of foregoing treatment are grave. Patients without legal immigration status (commonly named undocumented immigrants or illegal aliens) face—and present their oncologists with—additional challenges. Public and private resources to support patient care frequently exclude undocumented immigrants from eligibility. I want to raise awareness to resources that may be available for patients regardless of their immigration status, and to recognize that there is often no immediate solution to this issue.