A Grim History that Repeats Itself: A Reflection on Bioethics and How It Applies to Immigrants and Refugees
By Joshua Corbilla
As far as I can remember, my educators have always instilled in me the importance of learning history in order to redress the mistakes of the past for a better future. But being constantly bombarded by atrocious news recently made me question whether my instructors were merely being idealistic. As an immigrant myself, one particular controversy hit too close to home: inhuman treatment of immigrants and refugees alike.
In September of last year, the New York Times reported a story of Dr. Mahendra Amin, a physician who unethically performed invasive gynecological procedures on several female immigrants detained at an ICE facility in Georgia without informed consent [1]. According to the article, health providers from various medical institutions who assessed the procedures Dr. Amin had performed on his female immigrant patients in the past believe that many of his diagnosis and treatment procedures were excessively aggressive and unnecessary. In addition, although Dr. Amin argued that he ensured that his patients were fully aware of all the medical procedures performed on them, many of his patients denied his claim and expressed how they were coerced into undergoing his proposed surgical procedures against their will.
It is important to note that the overt violation of medical bioethics by Dr. Amin is not a novel circumstance. In 1932, six hundred African-American men were enrolled to participate in a syphilis study conducted in Tuskegee Institute in Alabama. The researchers deliberately deceived the patients by falsely explaining that the study aimed to cure their “bad blood” (a term that denotes certain ailments such as syphilis, fatigue and anemia [2]) even though treatment for syphilis was still inexistent when the research commenced. Furthermore, the participants were not provided informed consent; and thus, did not gain a full understanding of the long-term impact, risks, consequences posed by the study. In addition, patients were not given the ability to terminate their participation in the study if viable treatment options for Syphilis were to emerge [2]. Like the patients of Dr. Amin, hundreds of African-Americans were manipulated and taken advantage of by those in power. They were deprived of their natural right to have autonomous control over their own bodies and were relegated into expendable and exploitable beings.
The Tuskegee Study
The ethical dilemma regarding the mistreatment of refugees and immigrants is not solely a domestic issue; in fact, it is widely prevalent in the international level, as well. For example, similar to the United States, Australia has a policy of detainment of asylum-seekers at one of their offshore processing facilities. In the article “Australia’s Complicity in Detention Centre Violence”, writer Asher Hirsch details the heinous violence and injustices by the security officers toward the detainees in the detention centers. He reports that drugs, such as tranquilizers were allegedly used unethically in order to neutralize aggressive refugees[3]. Additionally, according to an anonymous whistleblower and a former officer in the facility, sexual abuse and rape of detainees occurred almost every day in the facility, and perpetrators were not held accountable for their punishable crimes [3]. As a result of these atrocious conditions, many detainees suffered from deterioration of mental health and have led to a drastic increase in cases of self-harming juveniles [4]. In a recent review published by Thinh Ngo and Mathew Hodes, they elucidate the positive correlation between exposure to traumatic experiences as a refugee or asylum seeker and the persistence of Pervasive Refusal Syndrome (PRS) in children [5]. Thus, it is evident that hostile and inhumane practices in detention centers may have a long-lasting impact on the psychological development of these vulnerable children detained in inhospitable conditions.
One of the most important tenets of medical bioethics is the principle of beneficence. In simple terms, beneficence refers to the obligation of health care providers to optimize benefits and minimize (and better yet eliminate) potential negative consequences to patients when providing them with services or recruiting them for research purposes. Although this idea was developed to establish firm ethical practices in the medical setting, it is very much applicable to any situation where someone in power interacts with a vulnerable group. The patients of Dr. Amin, the six hundred African-Americans in the Tuskegee Syphilis Experiment and the detainees in the Australian detention centers were all from different periods in history, but are certainly united by their shared trauma: they were victimized by authorities who took advantage of their vulnerable situation.
Empathy towards refugees
One possible way to break this repeating cycle of injustice is to begin reassessing how well the principle of beneficence is implemented in our lives on an individual level. In a broader sense, beneficence can be viewed as the deliberate consideration of all the possible harm and damage that our behaviors can inflict on another individual. This process could be initiated by attempting to understand other people’s circumstances from their point of view. For instance, we can begin by asking ourselves: “What would I feel if I were to be detained inside a detention center with people who might not care about my condition?”. By reflecting on how we respond to this question, we imagine all the difficulties and challenges that may arise in that given situation. Then, we can ask ourselves, “If I would despise being trapped inside a building without knowing when I will be able to leave, then why should I let anyone else suffer the same fate?”. Injustice and cruelty arise from our inability to see ourselves in other people’s situation. Therefore, with increased empathy and sensitivity, we as a society, can strive to finally eradicate the cycle of violence and immorality towards other people, who simply want to live a life filled with love and acceptance—just like any of us.
Sources
[1] https://www.nytimes.com/2020/09/29/us/ice-hysterectomies-surgeries-georgia.html
[3] http://rightnow.org.au/opinion-3/australias-complicity-in-detention-centre-violence/
[5] https://pubmed.ncbi.nlm.nih.gov/31106597/