Abstract
Australia has one of the harshest regimes for the processing of asylum seekers, people who have applied for refugee status but are still awaiting an answer. It has received sharp rebuke for its policies from international human rights bodies but continues to exercise its resolve to protect its borders from those seeking protection. One means of doing so is the detention of asylum seekers who arrive in Australia by boat. Health care providers who care for asylum seekers in these conditions experience a conflict of “dual loyalty,” whereby their role in preserving and maintaining the health of patients can run counter to their employment in detention facilities. Many psychiatrists who have worked in the detention setting engage in forms of political activism in order to change the process of seeking refuge.
Similar content being viewed by others
Notes
Although the “Pacific Solution” was abolished by the Labor government, it next introduced the “Malaysia Solution” whereby new boat arrivals would have been sent to Malaysia for processing, raising a new raft of concerns about their rights, including the right to health. This proposal, however, was defeated in a High Court challenge.
The People’s Inquiry into Asylum Seeker Detention was convened by the Australian Council of Heads of Schools of Social Work. It resulted in the book Human Rights Overboard (Briskman et al. 2008) and several other reports.
The current detention provider is Serco and health provision is now subcontracted through IHMS, which allows clinicians to be employees of a medical services provider. Nonetheless, contractual arrangements are with the Immigration Department, which still raises ethical issues for those delivering health services.
References
Austin, P., D. Silove, and Z. Steel. 2007. The impact of immigration detention on the mental health of asylum seekers. In Yearning to breathe free: Seeking asylum in Australia, ed. D. Lusher and N. Haslam, 100–113. Melbourne: Federation Press.
Briskman, L., S. Latham, and C. Goddard. 2008. Human rights overboard: Seeking asylum in Australia. Melbourne: Scribe.
Coffey, G. 2006. Locked up without guilt or sin. The ethics of mental health service delivery in immigration detention. Psychiatry, Psychology and Law 13(1): 67–90.
Coffey, G.J., I. Kaplan, R.C. Sampson, and M.M. Tucci. 2010. The meaning and mental health consequences of long-term immigration detention for people seeking asylum. Social Science and Medicine 70(12): 2070–2079.
Crock, M., B. Saul, and A. Dastyari. 2006. Future seekers II: Refugees and irregular migration in Australia. Sydney: The Federation Press.
Dudley, M., J. Jureidini, S. Mares, et al. 2004. In protest. Australian and New Zealand Journal of Psychiatry 38(11–12): 978–979.
Green, J.P., and K. Eager. 2010. The health of people in Australian immigration detention centres. Medical Journal of Australia 192(2): 65–70.
Human Rights and Equal Opportunity Commission. 2004. A last resort? National inquiry into children in immigration detention. Sydney: Human Rights Unit. http://www.hreoc.gov.au/human_rights/children_detention_report/report/PDF/alr_complete.pdf. Accessed September 13, 2010.
International Dual Loyalty Working Group. 2002. Dual loyalty and human rights in health professional practice: Proposed guidelines and institutional mechanisms. https://s3.amazonaws.com/PHR_Reports/dualloyalties-2002-report.pdf. Accessed October 4, 2009.
Lusher, D., N. Balvin, A. Nethery, and J. Tropea. 2007. Australia’s response to asylum seekers. In Yearning to breathe free: Seeking asylum in Australia, ed. D. Lusher and N. Haslam, 9–29. Melbourne: Federation Press.
Mares, P. 2002. Borderline: Australia’s response to refugees and asylum seekers in the wake of the Tampa. Sydney: UNSW Press.
McLean, T.D. 2003. Doctors and immigration detention: Dual loyalty, ethics and the law. Adelaide: Flinders University.
Newman, L. 2006. Response. Journal of Bioethical Inquiry 3(3): 197–198.
Noddings, N. 1984. Caring: A feminine approach to ethics and moral education. Berkeley: University of California Press.
Porter, E.J. 2006. Can politics practice compassion? Hypatia 21(4): 97–122.
Radden, J. 2002. Notes towards a professional ethics for psychiatry. Australian and New Zealand Journal of Psychiatry 36(1): 52–59.
Radden, J. 2004. The debate continues: Unique ethics for psychiatry. Australian and New Zealand Journal of Psychiatry 38(3): 115–118.
Silove, D., P. Austin, and Z. Steel. 2007. No refuge from terror: The impact of detention on the mental health of trauma-affected refugees seeking asylum in Australia. Transcultural Psychiatry 44(3): 359–393.
Stagoll, B. 1986. Epistemology and torture. Australian and New Zealand Journal of Family Therapy 7(2): 97–101.
Steel, Z., S. Mares, L. Newman, B. Blick, and M. Dudley. 2004. The politics of asylum and immigration detention: Advocacy, ethics, and the professional role of the therapist. In Broken spirits: The treatment of traumatized asylum seekers, refugees, war and torture victims, ed. J.P. Wilson and B. Droždek, 659–688. New York: Brunner-Routledge.
Tronto, J.C. 1993. Moral boundaries: A political argument for an ethics of care. New York: Routledge.
Tronto, J.C. 1995. Care as a basis for radical political judgments. Hypatia 10(2): 141–149.
Tronto, J.C. 2008. The ethics of care: Personal, political, and global. Hypatia 23(1): 211–217.
Zion, D. 2006. In that case. Journal of Bioethical Inquiry 3(1–2): 121.
Zion, D., L. Briskman, and B. Loff. 2009. Nursing in asylum seeker detention in Australia: Care, rights and witnessing. Journal of Medical Ethics 35(9): 546–551.
Interviews
Anne (pseud). 2006. Interviewed by Deborah Zion. For Australian Research Council Grant, Caring for Asylum Seekers in Australia. Melbourne: School of Public Health and Preventive Medicine, Monash University.
Bruce (pseud). 2007. Interviewed by Deborah Zion. For Australian Research Council Grant, Caring for Asylum Seekers in Australia. Melbourne: School of Public Health and Preventive Medicine, Monash University.
Barry (pseud.) 2008. Interviewed by Deborah Zion. For Australian Research Council Grant, Caring for Asylum Seekers in Australia. Melbourne: School of Public Health and Preventive Medicine, Monash University.
Acknowledgements
This project was funded by an Australian Research Council Discovery Grant.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zion, D., Briskman, L. & Loff, B. Psychiatric Ethics and a Politics of Compassion. Bioethical Inquiry 9, 67–75 (2012). https://doi.org/10.1007/s11673-011-9346-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11673-011-9346-7