Abstract
In 2018, at least 12 adults and 3 children died in U.S. detention facilities. In 2017, 12 people died in U.S. detention facilities and at least 10 women filed complaints against ICE for mistreatment that led them to miscarry. At the time of this writing, 26 people have died in US Custody during the Trump Administration and 74 people have died in U.S. detention facilities between 2010 and 2018 (over half of which were preventable), including Raul Ernesto Morales-Ramos, Augustina Ramirez-Arreola, Moises Tino-Lopez, Jose Azurdia, and Roxana Hernandez. I am not going to argue that these deaths are wrong – I take that as obvious. Instead, I will suggest that nonideal theory shows why bioethicists have special obligations for condemning these deaths and getting involved to make them stop. When we heed nonideal theory’s demand to consider empirical realities, we will see that the role of the bioethicist extends wherever health care does. Moreover, when bioethicists expressly embrace nonideal rather than ideal theories to ground our work, we will see that there are plenty such theories available to us. Shelly Wilcox’s nonideal theory of immigration justice is especially well suited for bioethicists to use in relation to detainee health care and enter the conversation where they are so desperately needed.
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Notes
- 1.
Of course, I recognize that there are some exceptions to this rule. I am merely pointing out that mainstream bioethics and the topics it takes up have not deviated from those that led to the field’s founding.
- 2.
In fact, when I have spoken of this around the United States and in Latin America, the most common refrain I hear is: “I really feel for these people but how can I worry about health care for them when we can’t even care for our own people.”
- 3.
I am certainly not the first person to highlight this. Clearly, the impetus for this collection is recognition of this fact. In addition, more bioethicists are speaking out on these matters. Ruth Macklin, for example, has stated that bioethics must take stands on social justice issues, especially inequality. Catherine Myser, Camisha A. Russell, Derek Ayah, and John Hoberman have all said bioethics needs to speak out more on issues involving racism. Finally, the Johns Hopkins Berman Institute of Bioethics highlights its commitment to social justice.
- 4.
What should constitute “adequate screening”? What is a just fee schedule for visa applicants? What is the appropriate number of visas that should be available to Mexicans and Central Americans?
- 5.
This is not to say that the U.S. policies are entirely responsible here – there are many factors at play. Rather, it is to say that it is clear that U.S. foreign policy along with immigration policy (especially deportation policies) starting in the 1980s and 1990s play a large role in the refugee crisis and large exodus from the Northern Triangle.
- 6.
Of course, much before that the United States was intervening in Guatemala, Nicaragua, and Panama in order to create the Panama Canal and expand U.S. business interests, for example for United Fruit Company.
- 7.
I would argue they could owe health care that is more robust to these migrants once they are admitted to the U.S. too on this framework, but this is beyond the scope of this essay.
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Wolf, A.B. (2021). Dying in Detention: Where Are the Bioethicists?. In: Victor, E., Guidry-Grimes, L.K. (eds) Applying Nonideal Theory to Bioethics. Philosophy and Medicine, vol 139. Springer, Cham. https://doi.org/10.1007/978-3-030-72503-7_15
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