Ethical challenges for doctors working in immigration detention

To the Editor: We applaud the professional stance taken by Sanggaran and colleagues in highlighting the ethical challenges for medical practitioners working in Australia's immigration detention centres,1 and extend our support to other clinicians and custodial officers who carry out their duties with respect, care and consideration for human rights.

The authors make a clear and compelling case for a “robust, independent and transparent monitoring” system in places of detention.1 The Australian Medical Association has worked with previous and current federal governments towards achieving such a system, through formal ratification of the Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT).2 This would create, within 3 years of the protocol's ratification, a “national preventive mechanism” to oversee compliance with human rights obligations in places of detention — immigration detention centres, prisons, juvenile detention centres and locked mental health facilities. Australian enterprises in offshore locations such as Nauru and Manus Island may also be subject to independent review.

Australia signed OPCAT in 2009 but has not yet ratified the decision, despite a National Interest Analysis and a bipartisan parliamentary committee recommending prompt ratification.3 As of October 2014, 74 other countries had ratified the protocol.4 Some Australian state and territory parliaments have introduced enabling legislation, which is the jurisdictional mechanism for implementing internationally binding obligations. This will be part of the robust, independent and transparent monitoring system that Sanggaran and colleagues called for.

We call on the Australian Government to heed their request to provide a safe environment for people living in detention and to allow health practitioners to practise ethically.