The case for making hospitals 'sanctuary' facilities

Hospitals and other health providers can do more to be "sanctuary" facilities to immigrants, especially as anecdotal evidence suggests that fewer undocumented immigrants are seeking out healthcare, experts say. 

Part of the reason for this is more aggressive operations by U.S. Immigration and Customs Enforcement (ICE) in hospitals of late, write Altaf Saadi, M.D., a neurologist and National Clinical Scholars Program fellow at University of California, Los Angeles; Sameer Ahmed, J.D., staff attorney for the American Civil Liberties Union of Southern California; and Mitchell Katz, M.D., director of the Los Angeles County Health Agency, in an article for the Journal of the American Medical Association. 

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Though there is no overarching definition for what a "sanctuary" city or facility is, hospitals have traditionally served in that kind of role, they write. Many facilities do not ask patients for their immigration status during intake and patient information is protected under regulations except in very limited situations. 

"There has always been a sense among many health care professionals that medicine represents a higher calling," the authors write. "These ideals are being challenged in health care settings and other places that should be safe from politics, and it is important that health care professionals speak with a single voice to fulfill their ethical responsibilities." 

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Hospitals can protect immigrant patients by having clear guidelines for interacting with ICE agents and training staff on these procedures, according to the article. For example, agents should provide their identification when visiting a hospital, and staff members should not provide information on patients unless a warrant or subpoena has been issued.  

Make sure patients know their information will not be shared with ICE agents as well. 

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Be cautious when dealing with ICE agents in non-investigative situations, the authors warn. Mission Hospital in Mission Viejo, California, for example, declined to join an information-sharing program because it might give the impression to immigrant patients that the hospital would not be a safe place to receive care. 

In addition to planning internally for these situations, providers should speak out publicly on these issues, the authors write. Take a stand in favor of legislation and programs that would protect both patients and healthcare facilities.