Ethics of Care in Supporting Disabled Forced Migrants: Interactions with Professionals and Ethical Dilemmas in Health and Social Care in the South-East of England

Abstract

This article explores the interactions between disabled forced migrants with care needs and professionals and the restrictive legal, policy and practice context that health and social care professionals have to confront, based on the findings of a qualitative study with 45 participants in the SouthEast of England. In-depth interviews were conducted with 15 forced migrants who had diverse impairments and chronic illnesses (8 women and 7 men), 13 family caregivers and 17 support workers and strategic professionals working in social care and the third sector in Slough, Reading and London. The legal status of forced migrants significantly affects their entitlements to health and social care provision, resulting in prolonged periods of destitution for many families. National asylum support policies, difficult working relationships with UK Border Agency, higher eligibility thresholds and reduced social care budgets of local authorities were identified as significant barriers in responding to the support needs of disabled forced migrants and family caregivers. In this context, social workers experienced considerable ethical dilemmas. The research raises profound questions about the potential and limitations of health and social care policies, provision, and practice as means of protection and support in fulfilling the human rights of forced migrants with care needs.

The continuity of social care when moving across regional boundaries

“…Studies of a range of transitions within social care, such as those associated with geographic movement, transitions between care settings and between children's and adults' services, have highlighted factors shared with the current study (e.g. Hudson, 2006;Ottosdottir & Evans, 2014;Owen, Hubert, & Hollins, 2008;Reed et al, 2003). These include complexity, a lack of involvement in decision making, a lack of preparation, loss of services, discontinuity and a lack of proactivity (Abbott & Carpenter, 2014;Beresford, 2004;Gridley, Brooks, & Glendinning, 2014;Hudson, 2006;Owen et al, 2008;Reed et al, 2003).…”

Re/Making Immigration Policy through Practice

“…A lack of statutory guidance for local authorities on how to approach work with migrants complicates matters further (Price and Spencer 2015). Additionally, legislative changes have increasingly drawn social workers, among others, into policing immigration status and migrants' access to social goods in the UK (Forbess and James 2014;Humphries 2004;Ottosdottir and Evans 2014). While acknowledging the multiple and contradictory pressures facing social workers, I maintain that the case study presented here indicates the profound infl uence of legal consciousness upon the practice of social work with refused asylum seekers and the detrimental impacts thereof.…”

“…Dispersed refused asylum seekers have been targeted for harassment and violence on the basis of their ethnicity and immigration status (Athwal 2007). Dispersal cuts refused asylum seekers off from their existing social networks and support services (Chantler 2012;Ottosdottir and Evans 2014;Stewart 2012). Single recipients and small families are frequently housed with other refused asylum seekers, but sometimes housemates lack a common language and cannot communicate with one another.…”

Disability and chronic illness

“…Despite the option to use human rights assessments to provide social care for asylum seekers with limited entitlements, social Professionals in statutory and third sectors that provided health and social care support struggled to respond to the care needs of disabled asylum seekers because of the strict eligibility criteria required for care assessments, and the conflictual nature of social policies designed to meet the needs of 'vulnerable adults and children' and immigration policies that applied to those in the asylum system (Grady, 2004;Sales and Hek, 2004;Robinson, 2013;Ottosdottir and Evans, 2014). Statutory sector professionals, such as social workers, experienced tensions between the legal framework governing the situation of asylum seekers and their efforts to address their human rights and care needs (Ward et al, 2008;Newbigging and Thomas, 2011;Ottosdottir and Evans, 2014). In Ottosdottir's (2015) research, social workers expressed frustrations about the ethical dilemmas they faced when they were under pressure from the local authority to withhold support to asylum seekers with limited entitlements because of funding constraints.…”

“…In Ottosdottir's (2015) research, social workers expressed frustrations about the ethical dilemmas they faced when they were under pressure from the local authority to withhold support to asylum seekers with limited entitlements because of funding constraints. Support must be negotiated between local authorities, the Home Office and even the NHS, and social workers felt that they were at risk of losing sight of fundamental human rights principles and their professional ethics of care (underpinned by a holistic approach to the person's needs) when they became involved in such negotiations (ibid; Ottosdottir and Evans, 2014).…”