Immigration and Customs Enforcement
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Imagine that you are vomiting blood with pain in your stomach, being transported via ambulance to the nearest hospital for emergency medical care. When you arrive, you receive a blood transfusion and an emergent endoscopy procedure by the gastroenterology specialists. Your family surrounds you as you hear from the doctors that your biopsy reveals a diagnosis of gastric adenocarcinoma, also known as stomach cancer. Fortunately, it has not spread to other organs in your body yet, likely because you came to the hospital as soon as you felt ill.
Next, pretend you are hearing this news as an undocumented patient who fears the next person you encounter in the hospital will be an Immigration and Customs Enforcement official, coming to deport you in your most vulnerable state.
In the past few months, the Trump administration made the decision to allow ICE into “sensitive” public spaces, including hospitals and health clinics. Since this decision, fear and desperation are palpable in a place that is a sanctuary of healing. It is heightened in the city where I proudly work: Aurora, Colorado, a diverse city brought into the national spotlight by high-profile ICE raids.
This news is deeply troubling to health-care providers like me. The effects will be detrimental for future patients, providers and health-care systems. Patients will present to hospitals very late in their disease course, risking preventable deaths such as those from infections. Late presentations will lead to urgent interventions and procedures and longer stays in the already understaffed intensive care units. For example, if the patient with gastric cancer came to the hospital after his cancer had spread throughout his body, it could cause a small bowel obstruction leading to a perforation, emergency abdominal surgery, followed by a stay in the intensive care unit. There is no doubt that health-care systems will lose money on the lack of reimbursement for these life-saving treatments. Providers will leave these jobs due to the moral distress, patient volumes and burnout that will ensue. Pregnant mothers will avoid hospitals and prenatal visits and have babies at home, quietly suffering from postpartum complications and risking death. Family members will fear for their lives and not enter hospitals to support their loved ones, leading to patients suffering scared and alone.
This sounds distressing and chaotic, because it is.
In short, ICE officials should not be allowed to enter hospitals, public health facilities or clinics. I encourage you to support the Protecting Sensitive Locations Act, which would prevent arrests near certain locations such as schools, churches, and health-care facilities.
If you are a health-care provider, I ask you to review and stand by your HIPAA rights, first and foremost.
Second, I strongly urge medical professions to prioritize fostering a safe, confidential and respectful environment each day. This may include an explicit message spoken aloud to each patient during rounds, regardless of their background.
For me, it will sound something like this: “Thank you for coming to the hospital and trusting us to take care of you. What you say to us in this room will be kept confidential and will not be shared with others unless they are involved in your medical care. You are safe here.”
Jennifer Santos is an internal medicine doctor who proudly works at a large academic medical center in Aurora, Colorado.
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