In the US, a crisis has arisen due to government handling of much larger than usual numbers of asylum-seeking migrants at the southern border. Most are coming not from Mexico but through Mexico from other Central American and South American nations currently experiencing economic crises and violence. While increased numbers of folks seeking asylum strains the system, a great deal of the crisis is a direct result of how the US is handling the arrival of families and unaccompanied minors (any minor who is not in the company of a parent is deemed an unaccompanied minor even if they are with other family members such as siblings, aunts or uncles, or grandparents).

Recently, 837 bioethics professionals wrote a letter protesting the impact on physical and mental health of migrants, especially children. Over at the Hastings Center, Nancy Berlinger argues that while such outcry is important, we need to take action. After giving a brief overview of what has been happening, Berlinger says:

There is no ethical dilemma about policies of cruelty and neglect targeting children. The cruelty is the point. Once we recognize that a profound moral and ethical wrong is being perpetrated in our name, and will continue as long as it is politically expedient to dehumanize and scapegoat immigrants and as long as conditions in Central America – poverty, violence, unsustainable agriculture, weak or corrupt public systems – continue to push families through Mexico to the U.S., risking life in search of safety and the hope of a better future, how should our field respond between these moments of public outcry?

To answer this question, The Hastings Center held a national convening last fall, funded by a rapid-response grant from the Public Health Program of the Open Society Foundations, to explore feasible ways for health systems, as a sector of American society, to counter the harmful effects of federal policies and messages concerning immigrants. Participants included practitioners in health care, health law, immigrant health advocacy, and municipal government, reflecting the range of sectors (which also includes investigative journalism) involved in ongoing response to the current political environment in the U.S.

Through discussions during and following the convening, we identified a set of challenges that clinicians often grapple with in isolation as they try to serve a low-income patient population fearful of separation and detention and wary of encounters with authorities and government programs. Physicians for Human Rights, whose program staff participated in the convening, has recently reported on the broader health consequences of immigration enforcement for immigrants living in the militarized U.S.-Mexico border region. Even in immigrant-friendly cities far from the border, the “crisis” framing of immigration in politics and media impedes communication about the costs of health care for immigrants (relatively low) and about how heavily American society relies on immigrant labor and wages. The Hastings Center is  developing new projects informed by these insights, aimed at supporting collaboration between frontline practitioners and administrative “champions” in health systems serving the largely urbanized immigrant population.

Berlinger goes on to discuss additional ways of mobilizing health care for undocumented migrants and migrants waiting to hear about asylum proceedings, including “sanctuary hospitals” which do not allow Immigration and Customs Enforcement access to patients or their families. And of course, that bioethics educators can integrate these issues into curriculum. This IJFAB Blog editor, Alison Reiheld, agrees, and has already integrated care for migrants into spring and summer bioethics courses as a case of conscientious provision, and asked students to bring Lisa Harris’s excellent article on conscientious provision of abortion to bear on this distinct issue.

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IJFAB Blog readers will benefit from clicking through to read Berlinger’s entire short piece, and giving some thought to how they might move from outcry to action on migrant issues in their nations or on other issues that require more than just the slow churn of a scholarly journal article.

How does this affect our work with hospitals on policy?

Our teaching?

Our involvement with legal briefs or advice to legislatures/deliberative bodies on, say, zero tolerance polices in the US and Europe for those who aid/harbor migrants?