Healthcare Professionals’ Experience, Training, and Knowledge Regarding Immigration-Related Law Enforcement in Healthcare Facilities: An Online Survey

Abstract

U.S. immigration policies and enforcement can make immigrants fearful of accessing healthcare. Although current immigration policies restrict enforcement in “sensitive locations” including healthcare facilities, there are reports of enforcement actions in such settings.

Unstable gynaecological patient with an ankle monitor: implications of US Immigration and Customs Enforcement’s Alternatives to Detention programme in the healthcare setting

“…On further research in the ED, perioperative patient safety, radiology and security departments, no guidelines or protocols were identified specific to the care of patients with ankle monitors. This is in line with recent data from a national survey of healthcare providers in the USA, in which 82.5% were unaware of any policies or procedures relevant to immigration-related law enforcement activity in their places of work 23. In fact, there is no high-quality evidence specific to ankle monitor safety in the operating room or in other clinical settings 19…”

“…Despite the large number of patients who wear an ankle monitor as part of their ATD conditions and multiple potential clinical issues such as perioperative safety, imaging compatibility and harmful physical consequences of the ankle device, there is a paucity of knowledge on the impact of immigration-related law enforcement among healthcare professionals 23. Education and training efforts on the topic of care of ‘shackled’ patients and updates on relevant federal and state law are lacking in medical schools and hospital settings 13 23.…”

“…Despite the large number of patients who wear an ankle monitor as part of their ATD conditions and multiple potential clinical issues such as perioperative safety, imaging compatibility and harmful physical consequences of the ankle device, there is a paucity of knowledge on the impact of immigration-related law enforcement among healthcare professionals 23. Education and training efforts on the topic of care of ‘shackled’ patients and updates on relevant federal and state law are lacking in medical schools and hospital settings 13 23. This gap in knowledge was clear in our case at multiple occasions: among the perioperative team on being confronted with questionable safety of the ankle device during emergency surgery, among the gynaecology and radiology team when deciding on a proper imaging study for the patient, and among the ED, gynaecology, SICU and security teams, as well as the patient herself, when considering the physical logistics and legal ramifications of device removal.…”