Medical advocacy in the face of Australian immigration practices: A study of medical professionals defending the health rights of detained refugees and asylum seekers

A call for nurses and interdisciplinary collaborators to urgently respond to the health and well-being needs of refugees across the world

The COVID-19 pandemic is compounding the distress of millions of refugees (made up of displaced persons, forced migrants, refugees and asylum seekers) throughout the world. This discursive paper pitches a challenge for the global nursing profession, within the multidisciplinary context, to consider its collective agency in responding to the health and well-being needs of a priority portion of the global population. Nursing leaders are encouraged to renew their commitment to the International Council of Nurses' Code of Ethics and consider the role of their profession in assisting global refugees, because the extent of present need has become an escalating major global humanitarian crisis. The nursing profession comprises half the world's healthcare workforce. The World Health Organization considers that nurses play a fundamental role in ensuring access to universal healthcare as a basic human right, addressing the global need for health promotion care, disease prevention and primary and community healthcare (International Council of Nurses, The ICN code of ethics for nurses; 2012). It is a human right to seek asylum from persecution, and in doing so, people should not be subjected to cruel, inhumane or degrading treatment or circumstances. Nurses are increasingly interested in fostering a healthy and adaptive environment in which people can thrive, despite personal, political, emotional, physical or social adversity. Nursing care is indispensable for the easement of human distress and for the promotion of comfort and coping. Nurses have an essential role in advocating for policies that will enhance immigrants' access to health/mental health services and address barriers irrespective of migrant/refugee/asylum seeker status. These are challenging times as the world responds to the pandemic crisis, and nurses are called to rise to global and local leadership roles and join with other health and social care colleagues in addressing the universal human health, social and political crisis of our time. The global nursing collective must come to terms with the need to initiate additional compelling ways to improve and integrate health and social care processes so that nursing care, mental health and social care augment a holistic achievement of appropriate care for refugees.

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

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.