Health professionals confront the intentional harms of indefinite immigration detention: an Australian overview, evaluation of alternative responses and proposed strategy

Abstract

Purpose Indefinite immigration detention causes well-documented harms to mental health, and international condemnation and resistance leave it undisrupted. Health care is non-independent from immigration control, compromising clinical ethics. Attempts to establish protected, independent clinical review and subvert the system via advocacy and political engagement have had limited success. The purpose of this study is to examine the following: how indefinite detention for deterrence (exemplified by Australia) injures asylum-seekers; how international legal authorities confirm Australia’s cruel, inhuman and degrading treatment; how detention compromises health-care ethics and hurts health professionals; to weigh arguments for and against boycotting immigration detention; and to discover how health professionals might address these harms, achieving significant change. Design/methodology/approach Secondary data analyses and ethical argumentation were employed. Findings Australian Governments fully understand and accept policy-based injuries. They purposefully dispense cruel, inhuman and degrading treatment and intend suffering that causes measurable harms for arriving asylum-seekers exercising their right under Australian law. Health professionals are ethically conflicted, not wanting to abandon patients yet constrained. Indefinite detention prevents them from alleviating sufferings and invites collusion, potentially strengthening harms; thwarts scientific inquiry and evidence-based interventions; and endangers their health whether they resist, leave or remain. Governments have primary responsibility for detained asylum-seekers’ health care. Health professional organisations should negotiate the minimum requirements for their members’ participation to ensure independence, and prevent conflicts of interest and inadvertent collaboration with and enabling systemic harms. Originality/value Australia’s aggressive approach may become normalised, without its illegality being determined. Health professional colleges uniting over conditions of participation would foreground ethics and pressure governments internationally over this contagious and inexcusable policy.

The psychological effects of forced family separation on asylum-seeking children and parents at the US-Mexico border: A qualitative analysis of medico-legal documents

“…Clinicians and health professionals can articulate the pressing need for a trauma-informed immigration system in a powerful way through their expertise [ 38 ]. The authoritative voice of clinicians in documenting trauma and advocating for policy change is part of a global movement which recognizes immigration policies as a critical structural determinant of health [ 39 – 41 ].…”

A Report on the Impact of Immigration Detention on the Health and Well-being of Refugees & Asylum Seekers

“…It is evident from reports that the numbers of asylum seekers and refugees have increased rapidly in the past years, and the numbers continue to increase every year to seek international protection. However, seeking asylum and determining refugee status in immigration detentions is usually long and exceeds the expected time frames (Dudley et al, 2021;Essex et al, 2022). In some cases, immigration detention practices breach international laws and violate the rights of those detained (International Detention Coalition, 2023).…”

It is time to expand community alternatives to immigration detention

“…Besana and colleagues describe1 the likely impact that aspects of the UK’s Nationality and Borders Bill2—such as the introduction of institutional reception centres and a temporary immigration status—will have on asylum seekers. It is important to highlight that the bill would also expand indefinite immigration detention and permit the use of offshore detention, emulating Australian policy and practice that has drawn international condemnation 3. Immigration detention severely affects the mental health of those detained—a population already vulnerable to poor mental and physical health 4…”