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Marshallese migrating to the United States face numerous challenges in accessing health care and managing illness and chronic disease. This study explores health care providers’ perceptions of and experiences with ethical dilemmas as they care for Marshallese patients. Utilizing a qualitative research design, we interviewed 21 providers to explore the ethical dilemmas they encountered while treating Marshallese patients. We used the framework of bioethical principlism to categorize and describe the ethical dilemmas reported by those providers. When explicitly asked whether they experienced such situations, approximately half (10/21) affirmed that they had, and analysis of the qualitative data indicated that all interviewees described an ethical dilemma at least once during their interviews. We characterized providers’ ethical dilemmas in terms of conflicts that arise when prioritizing different ethical principles in the care of this complex patient population, including the principles of respect for autonomy, nonmaleficence, beneficence, and justice.


Ethical Dilemmas, Health Care Access, Health Disparities, Marshallese, Pacific Islanders, Medically Uninsured, Migrants, Social Justice, Principle-based Ethics


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