Patients in Custody
Increasingly, patients are showing up at emergency departments and other health care facilities accompanied by and in the custody of ICE and CBP officers. Medical providers and patients are experiencing this shift alongside other frightening changes in immigration policy, especially now that the government has rescinded the long-standing restrictions on enforcement at or near hospital grounds.
When Patients are in Custody
A published research report from ACLU, PHR, and American Oversight, provides a comprehensive examination of the deaths of 52 people who died in ICE custody from 2017-2021. Based on a review of over 14,500 pages of documents and independent medical expert reviews, the report exposes the ways in which the Department of Homeland Security has failed to conduct rigorous investigations, impose meaningful consequences, or improve conditions that cause immigrants to die in ICE detention. Report analysis also incorporates the review of ICE’s own investigatory reports into deaths in custody by independent medical experts, as well as interviews with two family members of people who died in ICE detention during the studied period. The report concludes with actionable recommendations for Department of Homeland Security, Congress, and state/local governments.
This resource aims to provide practical, bedside‐oriented guidance for EM clinicians when interacting with immigration enforcement officers or caring for patients in immigration custody. The authors examine the implications of immigration enforcement within healthcare settings while articulating a path forward that protects patient rights, clinical integrity, and the ethical foundations of medical practice. The following highlights clinical questions that EM clinicians may have when caring for patients in immigration custody or interacting with immigration enforcement officials in hospital settings.
This resource aims to provide guidance for medical staff grappling with these and other questions. It provides some legal context on the workings of the immigration system as it relates to patients, explains the laws and policies related to patients under immigration supervision, and grounds the information in the day-to-day realities of patient care.
National Detainee Handbook
Medical care providers may wish to consider printing out a copy or relevant sections of the National Detainee Handbook in a language of the patient’s choice and giving them a copy to review before discharge. More languages are available on the ICE website.
Pregnant Patients in Custody
The American College of Obstetricians & Gynecologists (ACOG) makes recommendations and conclusions regarding providing safe care pregnant immigrations.
For a pregnant patient, medical staff can share their understanding that restraints are generally prohibited during transport or at a medical facility. Historically, ICE generally prohibited the use of restraints on pregnant people or those in post-delivery recovery. Under ICE’s own policy, restraints are never permitted on individuals who are in active labor or delivery. Some states have laws limiting restraints that may be helpful to reference.
WRC is interested in all cases involving pregnant, postpartum, or nursing immigrant women, who are currently in custody or who were in custody (and later released).
Pregnant immigrant women are being detained in higher numbers as part of the current surge in immigration enforcement, but information about this vulnerable population is scarce. If you’ve seen a pregnant, postpartum, or nursing woman in immigration custody or recently released from custody, please let the Women's Refugee Commission know so we can document this trend.
WRC AND NILC call on Congress to codify protections for pregnant, postpartum, and lactating women, including reinstating mandatory reporting requirements and passing legislation like the Stop Shackling Pregnant Women Act, which would prohibit ICE from placing pregnant women in restraints.
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