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Journal of Bioethical Inquiry
Published in: Journal of Bioethical Inquiry 1/2018

01-03-2018 | Critical Perspectives

The Ethics of Discharging Asylum Seekers to Harm: A Case From Australia

Authors: Ryan Essex, David Isaacs

Published in: Journal of Bioethical Inquiry | Issue 1/2018

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Abstract

In February 2016 a twelve-month-old asylum seeker, who came to be know as Baby Asha, was transferred from Nauru and hospitalized in Brisbane. This case came to public attention after Doctors refused to discharge Asha as she would have been returned to detention on Nauru. What in other circumstances would have been considered routine clinical care, quickly turned into an act of civil disobedience. This paper will discuss the ethical aspects of this case, along with its implications for clinicians and the broader healthcare community.
Footnotes
1
Australia re-introduced offshore processing of asylum seekers in 2012 and re-opened centres on both Manus Island (Papua New Guinea) and Nauru.
 
2
While APODs and community placements offer a number of superficial improvements and thus remain preferable to other forms of detention, they also remain problematic. In the longer term APODs do little to mediate the harms of detention (AHRC 2014; Essex and Govintharajah 2017). Community placements raise similar concerns (Clement 2012; Essex 2013).
 
Literature
Australian Council of Heads of Schools of Social Work (ACHSSW). 2006. We’ve boundless plains to share: The first report of the People’s Inquiry into Detention. Australian Council of Heads of Schools of Social Work.
Australian Parliamentary Select Committee. 2015. Taking responsibility: Conditions and circumstances at Australia’s Regional Processing Centre in Nauru. Select Committee on the Recent allegations relating to conditions and circumstances at the Regional Processing Centre in Nauru.
Banja, J., J. Eig, and M.V. Williams. 2007. Discharge dilemmas as system failures. The American Journal of Bioethics 7(3): 29–31.CrossRefPubMed
Bull, M., E. Schindeler, D. Berkeman, and J. Ransley. 2013a. A demography and taxonomy of long-term immigration detention in Australia. International Journal for Crime, Justice and Social Democracy 2(1): 98–112.CrossRef
______. 2013b. Sickness in the system of long-term immigration detention. Journal of Refugee Studies 26(1): 47–68.
Corbett, E., H. Gunasekera, A. Maycock, and D. Isaacs. 2014. Australia’s treatment of refugee and asylum seeker children: The views of Australian paediatricians. Medical Journal of Australia 201(7): 393–398.
Department of Immigration and Border Protection. 2016. Immigration detention and community statistics summary 31 May 2016.
______. 2017. Immigration detention and community statistics summary 30 April 2017.
Dudley, M. 2003. Contradictory Australian national policies on self-harm and suicide: The case of asylum seekers in mandatory detention. Australasian Psychiatry 11(1 suppl): S102–S108.
______. 2016. Helping professionals and border force secrecy: Effective asylum-seeker healthcare requires independence from callous policies. Australasian Psychiatry 24(1): 15.
Dudley, M., Z. Steel, S. Mares, and L. Newman. 2012. Children and young people in immigration detention. Current Opinion in Psychiatry 25(4): 285–292.
Essex, R. 2013. Asylum seeker health and bridging visas: History repeating. Australian and New Zealand Journal of Public Health 37(6): 506–508.
Essex, R. 2015. Ethics, foreseeability, and tragedy in Australian immigration detention. Journal of Bioethical Inquiry 12(4): 537–539.
Essex, R., and P. Govintharajah. 2017. The mental health of children and adolescents in Australian alternate place of immigration detention. Journal of Paediatrics and Child Health 53(6): 525–528.
Green, J.P., and K. Eagar. 2010. The health of people in Australian immigration detention centres. Medical Journal of Australia 192(2): 65–70.
Isaacs, D. 2015a. Are healthcare professionals working in Australia’s immigration detention centres condoning torture? Journal of Medical Ethics.
______. 2015b. Nauru and detention of children. Journal of Paediatrics and Child Health 51(4): 353–354.
Jankowski, J., T. Seastrum, R.N. Swidler, and W. Shelton. 2009. For lack of a better plan: A framework for ethical, legal, and clinical challenges in complex inpatient discharge planning. HEC forum.
Mares, S., and J. Jureidini. 2004. Psychiatric assessment of children and families in immigration detention—Clinical, administrative and ethical issues. Australian & New Zealand Journal of Public Health 28(6): 520–526.
Mares, S., L. Newman, M. Dudley, and F. Gale. 2002. Seeking refuge, losing hope: Parents and children in immigration detention. Australasian Psychiatry 10(2): 91–96.
Mendez, J.E. 2015. Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, 5 March 2015, A/HRC/28/68.
Moran, J.R., A.F. Gross, and T.A. Stern. 2010. Staying against advice: Refusal to leave the hospital. Primary care companion to the Journal of clinical psychiatry 12(6): e1–e16.
Moss, P. 2015. Review into recent allegations relating to conditions and circumstances at the Regional Processing Centre in Nauru.
Newman, L., and Z. Steel. 2008. The child asylum seeker: Psychological and developmental impact of immigration detention. Child and Adolescent Psychiatric Clinics of North America 17(3) 665–683.
Schlairet, M.C. 2014. Complex hospital discharges: Justice considered. HEC forum 26(1): 69–78.
Steel, Z., S. Momartin, C. Bateman, A. Hafshejani, D. Silove, and N. Everson. 2004. Psychiatric status of asylum seeker families held for a protracted period in a remote detention centre in Australia. Australian and New Zealand Journal of Public Health 28(6): 527–536.
Sultan, A., and K. O’Sullivan. 2001. Psychological disturbances in asylum seekers held in long term detention: A participant-observer account. Medical Journal of Australia 11: 593–596.
Swidler, R.N., T. Seastrum, and W. Shelton. 2007. Difficult hospital inpatient discharge decisions: Ethical, legal and clinical practice issues. The American Journal of Bioethics 7(3): 23–28.
United Nations. 2017. Report of the Special Rapporteur on the human rights of migrants on his mission to Australia and the regional processing centres in Nauru, 24 April 2017, A/HRC/35/25/Add.3.
Wilson, J.E., J. Shuster, A.A. Rowe, S.B. Fleisch, A. Wilson, and S.E. Nicolson. 2016. Identifying and addressing the hidden reasons why patients refuse discharge from the hospital. Psychosomatics 57(1): 18–24.
Young, P., and M.S. Gordon. 2016. Mental health screening in immigration detention: A fresh look at Australian government data. Australasian Psychiatry 24(1): 19–22.
Zwi, K., and S. Mares. 2015. Stories from unaccompanied children in immigration detention: A composite account. Journal of Paediatrics and Child Health 51(7): 658–662.
Zwi, K., B. Herzberg, D. Dossetor, and J. Field. 2003. A child in detention: Dilemmas faced by health professionals. Medical Journal of Australia 179(6): 319–322.
Metadata
Title
The Ethics of Discharging Asylum Seekers to Harm: A Case From Australia
Authors
Ryan Essex
David Isaacs
Publication date
01-03-2018
Publisher
Springer Singapore
Published in
Journal of Bioethical Inquiry / Issue 1/2018
Print ISSN: 1176-7529
Electronic ISSN: 1872-4353
DOI
https://doi.org/10.1007/s11673-017-9833-6

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