The health of asylum seekers in Australia's immigration detention centres has been the subject of a doctors' letter of concern and two recent reports.1-3 Here, we present an analysis of the ethical dilemmas faced by health practitioners working in these centres1 and seek to promote a strong and considered policy discussion.
- 1. Christmas Island doctors' letter of concern — in full. The Guardian 2014; Jan 13. http://www.theguardian.com/world/interactive/2014/jan/13/christmas-island-doctors-letter-of-concern-in-full (accessed Jun 2014).
- 2. This is breaking people: human rights violations at Australia's asylum seeker processing centre on Manus Island, Papua New Guinea. Sydney: Amnesty International Australia, Dec 2013. http://www.amnesty.org.au/images/uploads/about/Amnesty_International_Manus_Island_report.pdf (accessed Jun 2014).
- 3. Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements. Nauru site visit report: 16–19 February 2014. The Guardian 2014; May 30. http://www.theguardian.com/world/interactive/2014/may/29/nauru-family-health-risks-report-in-full (accessed Jun 2014).
- 4. Joint Select Committee on Australia's Immigration Detention Network. Final report. Chapter 4 — Provision of health services to people in detention. Canberra: Commonwealth of Australia, 2012. http://www.aph.gov.au/Parliamentary_Business/Committees/Joint/Former_Committees/immigrationdetention/report/c04 (accessed Jun 2014).
- 5. Medical Board of Australia. Good medical practice: a code of conduct for doctors in Australia. March 2014. http://www.ahpra.gov.au/News/2014-02-13-revised-guidelines-code-and-policy.aspx (accessed Jun 2014).
- 6. Australian Medical Association. AMA code of ethics – 2004. Editorially revised 2006. https://ama.com.au/codeofethics (accessed Sep 2014).
- 7. Australian Medical Association. Medical professionalism – 2010. https://ama.com.au/position-statement/medical-professionalism-2010 (accessed Jun 2014).
- 8. Marr D. Christmas Island: delays in medical transfers life-threatening, say doctors. The Guardian 2013; Dec 21. http://www.theguardian.com/world/2013/dec/21/christmas-island-delays-in-medical-transfers-life-threatening-say-doctors (accessed Jun 2014).
- 9. Cotterill A, Andrews M, Ditchfield M, et al; Australasian Paediatric Endocrine Group, Royal Australasian College of Physicians, Australian and New Zealand Society for Paediatric Radiology, Royal Australian and New Zealand College of Radiologists. Assessment of age of refugees and those persons accused of providing refugees with illegal access to Australia: the unethical use of ionizing radiation (x‐rays) and/or genital examination [letter to the Minister for immigration and Citizenship]. 19 Aug 2011. http://www.apeg.org.au/Portals/0/documents/o_age assessment letter to immigration minister.pdf (accessed Sep 2014).
- 10. Australian Human Rights Commission. National Inquiry into Children in Immigration Detention 2014. Transcripts from the inquiry's public hearings. https://www.humanrights.gov.au/our-work/asylum-seekers-and-refugees/national-inquiry-children-immigration-detention-2014-1 (accessed Sep 2014).
- 11. Whyte S. Doctors gagged on mental ills of children in asylum centres. http://www.smh.com.au/federal-politics/political-news/doctors-gagged-on-mental-ills-of-children-in-asylum-centres-20140731-3cx99.html (accessed Sep 2014).
- 12. Laughland O, Nissi D, Farrell P. Hamid Kehazaei dies after family give permission to switch off life support. The Guardian 2014; Sep 6. http://www.theguardian.com/world/2014/sep/05/hamid-kehazaeis-family-give-doctors-permission-to-switch-off-his-life-support (accessed Sep 2014).
- 13. Gordon M. Case worker sacked after calling Manus Island detention centre a hellhole. Sydney Morning Herald 2014; Jun 20. http://www.smh.com.au/federal-politics/political-news/case-worker-sacked-after-calling-manus-island-detention-centre-a-hellhole-20140619-3ah2u.html (accessed Jul 2014).
- 14. Australian Health Practitioner Regulation Agency. Mandatory notifications. http://www.ahpra.gov.au/Notifications/Who-can-make-a-notification/Mandatory-notifications.aspx (accessed Jun 2014).
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.