Doctors working in the immigration detention network should consider a boycott of the system until the standard of care is improved, an article published by the Australian Medical Association in the respected Medical Journal of Australia has argued.

The article, written under the title, “Ethical challenges for doctors working in immigration detention”, is authored by Dr Bridget Haire, a medical ethics academic at the university of New South Wales, and Dr John-Paul Sanggaran and Dr Grant Ferguson, who both worked as medical doctors in detention centres on Christmas Island and were signatories to the 92-page doctors’ letter of concern.



“Given reports that the health care currently provided to asylum seekers in immigration detention may be both substandard and harmful, a coordinated response to the problem is now needed to ensure change occurs,” the authors write.

It continues: “Should health care professionals consider boycotting the provision of services in immigration detention until conditions are made satisfactory?”

Speaking to Guardian Australia, Haire particularly raised the issue of care in offshore detention centres. “Regardless of what people think of the policy of offshore detention, it is absolutely morally and ethically unacceptable that asylum seekers are subject to a standard of care that is lower than in Australia,” she said.

The authors raise the recent death from septicemia of 24 year-old Iranian asylum seeker Hamid Kehaezai, the confiscation of a child asylum seeker’s hearing aid, and the “abrupt cessation” of a child’s anticonvulsant medication as examples of the medical neglect of asylum seekers in detention.

“Doctors who work in detention centres may feel an ethical responsibility to voice their concerns, but this may conflict with their obligations to their employer,” the article argues.

The article cites the Christmas Island letter of concern, a leaked independent assessment of the standard of healthcare on Nauru, and a recent Amnesty report into the standard of care on Manus as supporting documents.

IHMS, the private medical provider that runs all healthcare facilities in immigration detention – on Manus, Nauru and Christmas Island as well as on the Australian mainland – look set to renew their multimillion-dollar contract for medical care in onshore centres in the coming weeks.

A spokeswoman for IHMS told Guardian Australia the organisation was preparing a formal response to the Medical Journal of Australia, to be sent in the coming days.

The article’s authors call on professional medical bodies to push the issue of reform in standards of care in detention centres.

“We call on the colleges and the AMA to lobby for effective change, so that asylum seekers receive appropriate care and those delivering it are not professionally compromised. We also call for robust, independent and transparent monitoring of standards within immigration detention, and a system to register and independently deal with complaints,” the article argues.

Last month, the former chief psychiatrist responsible for the mental health of all asylum seekers detained by Australia described their treatment as akin to torture.

Dr Peter Young told Guardian Australia: “If we take the definition of torture to be the deliberate harming of people in order to coerce them into a desired outcome, I think it does fulfil that definition.”

A large number of peak medical bodies in Australia, including the Royal Australasian College of Physicians, the AMA, the Royal Australian College of General Practitioners and the Royal Australian and New Zealand College of Psychiatrists, came out in support of Young and have called for the re-establishment of a medical oversight body for immigration detention.

In December last year the immigration department abolished the Independent Health Advisory Group.

The immigration minister, Scott Morrison, introduced in September 2013 a policy of transferring asylum seekers who arrive by boat for offshore processing and resettlement within 48 hours of their arrival in Australia. The policy resulted in a number of medical screening procedures being abandoned and was broadly criticised by experts at the time.

Morrison’s office has been contacted for a response to the MJA article.