Can Any Doctor Ethically Work In A U.S. Immigration Detention Facility?
Given recent news, this question is particularly relevant. First, CBP recently confirmed the agency will not
administer flu vaccines to migrants held in detention, despite the
looming flu season and an
outcry from physicians who called the policy “
cruel” and “dangerous.” As
Bruce Y. Lee wrote for Forbes, “
Holding a number of unvaccinated people in a crowded space could be like maintaining an amusement park for flu viruses,” potentially fueling the fire of an epidemic.
Then, federal agencies extended their
cruelty to severely ill undocumented immigrants by suggesting that those receiving treatment for serious medical conditions will no longer receive deferrals for deportation—essentially a death sentence for those with life-threatening conditions. U.S. Citizenship and Immigration Services has now
partially walked back that decree by clarifying that jurisdiction over these deferrals will be transferred to U.S. Immigration and Customs Enforcement (ICE),
but that’s hardly reassuring for those who don’t know whether ICE will let them continue receiving treatment.
...Multiple medical organizations, including the Infectious Disease Society of America (IDSA), expressed concern in a
joint statement about withholding flu vaccinations, “an indispensable component of routine healthcare.” They called the decision “a violation of the most basic principles of public health and human rights” that “runs directly counter to the imperative that no individual should be harmed as a result of being detained.”
The statement notes that last flu season resulted in more than 57,000 deaths, including 129 children.
“For any population, if you do not vaccinate, there’s a higher risk of outbreaks, and there will be more severe illnesses,” said Matthew M. Zahn, MD, a pediatric infectious disease physician at the Children’s Hospital of California and chair of the IDSA’s Public Health Committee. “We particularly recommend flu vaccine in congregant settings because we know immunization prevents outbreaks, and we know that population is particularly at risk for outbreaks.”
Like Spiegel and his colleagues, the IDSA and other medical organizations noted previous reports of overcrowding and poor sanitation, and they called for “a comprehensive investigation of the agency’s protocol for providing health care at its facilities.”
So far, however, CBP, HHS, DHS, ICE and other federal immigration agencies have given no indication of changing course or commissioning such an investigation. Until they provide well-reasoned rationales for these failures,
there’s little left to conclude except the refrain that has been employed to explain so many other decisions by the administration: the cruelty is the point.