Dignified Health Care Shouldn’t Stop With ICE Detention

Earlier this year, on an episode of the popular HBO series The Pitt, chaos erupted when ICE agents entered the busy emergency room with Pranita, a detained immigrant. Their presence led to tense conflicts with staff, and patients hiding for fear of detainment. Most importantly, it reflected a growing reality in hospitals across the country: immigration enforcement in medical settings becoming more visible — and more disruptive — while vulnerable patients are left without adequate medical care.

Health care workers and advocates deserve tools that can help traverse these difficult situations, which is why we put together our new resource: Advocating on Behalf of Patients in Immigration Custody.

Though precise numbers are difficult to track, real-world accounts paint a picture of enforcement officers commandeering the exam room, ignoring the advice of doctors and staff. For example, Julio César Peña, a California husband and father to a U.S. military service member, couldn’t tell his own wife what hospital he was at because an officer was in the room, listening to their call. Emmanuel Dumas, a Haitian immigrant, was finally hospitalized after months of complaining of a toothache that then became a deadly infection. When his family was finally allowed to visit him, they were shocked to see that he was shackled to his bed while on life support. Even young children are suffering. After an infant developed respiratory issues while held with her mother in family detention, she was brought to a Texas hospital. ICE insisted on being present to “monitor” the child and mother while nurses tried to care for her.

Medical staff already have a difficult job to do, and adding immigration officers to the mix only makes it harder. Moreover, staff can experience distress when immigration priorities take precedence over their ability to provide care that meets their own moral standards as well as their legal duty of care. As The Pitt demonstrated, many people also don’t feel safe when immigration enforcement is present. This compromises the public health of communities, because people then become afraid to visit the hospital, meaning they don’t get the care they need, can’t go to work, or may not even be able to visit a loved one.

This is not just an immigration issue, but a civil rights one too. While we advocate for a future free of deadly immigration detention and the universal right to health care, hospitals and medical staff can do their part to protect the universal rights of all people to bodily integrity and humane treatment, regardless of immigration status.

It starts with understanding that immigration custody does not erase a person’s rights as a patient. Laws governing informed consent, confidentiality, and appropriate medical treatment still apply. The interests of enforcement should not override a hospital’s duty to provide safe, respectful care. Our resource goes into greater detail about the nuances of civil versus criminal custody and the role of different parts of the U.S. immigration system.

We also stress in our resource that hospitals and health care systems should adopt clear policies that protect patient privacy and guide all staff on how to respond to enforcement presence. For example, protecting patient privacy under HIPAA is complicated with officers in a crowded emergency room and wanting constant eyes on the patient. The provider has to balance the patient’s rights to make their own medical decisions and inform their family, with officers who may try to rush patients through intake and treatment and limit their communication.

Training and policies on how to respond to these situations have the benefit of helping providers understand their rights and responsibilities. This will reduce the stress and anxiety they currently experience in the absence of these resources, while also reinforcing patient-centered care.

Many patients may end up like Pranita on The Pitt, whisked away to a place like the Moshannon Valley Processing Center and outside of the hospital’s care. But during the vulnerable moments when they are in a hospital receiving medical care, they deserve the same dignity as everyone else.

With this resource, we hope we can provide our health care workers with one more tool to support themselves and their colleagues and help heal their communities.