In The BMJ this week, two experts debate whether doctors should boycott working in Australia's immigration detention centres.
Dr David Berger at Broome Hospital in Western Australia, argues that however compassionate their intentions, "doctors who treat people who have been tortured and then acquiesce in the continuation of torture themselves are supporting torture."
On the other hand, Professor Steven Miles, Chair of Bioethics at the University of Minnesota, says these egregious circumstances "do not justify a boycott that would further isolate internees from adequate care."
Since 2015's Border Force Act, healthcare professionals have risked imprisonment by speaking out about appalling conditions in centres that have been likened to gulags and concentration camps, explains Berger.
Last month, the president of the Australian Medical Association (AMA) finally denounced Australia's appalling treatment of asylum seekers, calling it "state-sanctioned child abuse."
He stopped short of calling for a medical boycott of these facilities because, he said, it is less evil to be inside the system bearing witness and providing medical care, and public opinion would not support such a boycott.
But Berger argues that "doctors cannot work ethically within the present system" and says healthcare leaders "must take a firm stand and send a clear message to the Australian government that doctors will not support such a system."
He points out that detainees have not committed any crime, and says: "It is long past time for Australia to treat people seeking its protection in a manner commensurate with its status as a modern, democratic nation."
"If it will not do so then doctors must refuse to continue to be complicit but should do everything in their power to deliver ethical healthcare to these most vulnerable of people."
But Steven Miles argues that Australian physicians "should not boycott clinical care positions in Australia's offshore immigrant deportation centres to raise public awareness or promote redress of egregious human rights abuses."
Many Australian medical professionals are rightfully shamed and angered by the flagrant abuses being committed by their government, he writes.
But he believes that the proposed "boycott" is really a labor action - and that rather than standing down from their posts, "Australian physicians should live up to the duties of their station."
He says the AMA should buttress its commendable reports and ethics codes with more aggressive action. "It should help frontline clinicians to transmit reports, pictures, and data through encrypted and anonymous web channels to international human rights organisations"
The AMA should also establish a legal defence fund "to defend any physician whose free speech in the service of patients is prosecuted under the Orwellian Border Force Act."
"If Australian physicians choose to undertake a labor action, this should target the government rather than the detainees," he explains, adding that "physicians should not target the desperately underserved and isolated people whose welfare they are advocating for."
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Journal
The BMJ