Dual Loyalties in U.S. Immigration Detention
The U.S. immigration system has been criticized for failing to meet the needs of the people it is intended to serve. The detention system, in particular, has drawn extensive attention in recent years from non-governmental organizations (NGOs), immigrant advocates, health organizations, and journalists who have been calling for detention center reform due to well-documented reports of abuse, poor health care, sexual assaults, and deaths in detention facilities.
Health professionals who work in the immigration detention system are bound by the same standards of conduct that apply to their treatment of patients in private clinics and hospitals: to treat their duty to patient as their first priority and to always act in the best interests of the patient. However, health professionals’ ability to maintain loyalty to their patients and to act in their best interests becomes severely compromised when the interests of their employer intrude upon or directly conflict with the needs of patients.
Due to its emphasis on security and control, the health care management system utilized by the US immigration detention regime, executed by the Immigration Customs Enforcement (ICE) and the ICE Health Service Corps (HSC) under the Department of Homeland Security umbrella, risks infringing upon the right of detainees to obtain adequate physical and psychological care while in detention.
Our report examines the issues of dual loyalties in the US immigration detention system and makes recommendations to correct them.
“Loyalty to patients is the basis of all medical ethics and should be every medical professional’s first priority. When a physician is forced to choose between the needs of their employer and the patient, someone is going to lose.” — Christy Fujio, Asylum Program Director
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