At upcoming AMA forum to debate healthcare of asylum seekers, several doctors will put to the meeting the radical step of refusing to participate in the system

This article is more than 4 years old

This article is more than 4 years old

Doctors are preparing to discuss a boycott of Australia’s immigration detention system and flouting the legal restrictions on speaking out about conditions.

At an Australian Medical Association forum in Sydney on Sunday to debate healthcare of asylum seekers, several doctors will propose the radical step of refusing to participate in the system, Guardian Australia understands.

Doctors at Brisbane’s Lady Cilento hospital continue to refuse to discharge Baby Asha, the Australian-born infant of Nepalese asylum seekers, arguing that returning her to Nauru would be unsafe. Protesters have maintained a vigil at the hospital’s front doors for a week.

Dr John-Paul Sanggaran, who worked at the Christmas Island detention centre, has argued in the Fairfax press that the current detention system is “a form a systematic child abuse ... a form of torture”.



“The only course left to us is to refuse to participate.

Immigration detention 'not the right place' for children: Border Force's chief doctor Read more

“The AMA’s own code of ethics states: ‘regardless of society’s attitudes, ensure that you do not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman, or degrading procedures, whatever the offence of which the victim of such procedures is suspected, accused or convicted’.

“The code of conduct could not speak more clearly or directly. By continuing to work within immigration detention we merely provide legitimacy to those that would lie and mislead the public into believing healthcare of a respectable standard is being delivered.”

Dr Peter Young, formerly the director of mental health services at International Health and Medical Services (IHMS), said doctors could not arrive at the decision to withdraw their services lightly.



“But the system as it is set up, and the restrictions under the contractual arrangements that doctors and psychiatrists are made to work under, you can’t practise ethically, and you can’t practise according to professional guidelines, and if that is the case, then you shouldn’t be doing it.

“The situation as it is now, doctors participating in the system, more than being able to minimise harm for these patients, are enabling the system to continue, and lending it legitimacy.”

… ensure that you do not countenance, condone or participate in the practice of … cruel, inhuman or degrading procedures AMA code of ethics

Young resigned from IHMS in 2014, frustrated by persistent failures in the system that were not addressed despite a series of complaints.

Young signed an open letter from health and legal professionals supporting the Lady Cilento staff and calling for an end to offshore processing, deportations and the Border Force Act, which prevents professionals speaking out about detention conditions.

The group, which calls itself the Asylum Seeker Health Advocacy Group (Ashag), on Friday wrote to the prime minister and leader of the opposition, and the ministers and shadow ministers for health and immigration.

Ashag also demanded asylum seeker health services be managed through health departments with regular professional and ethical standards.

It accused the government of “acting to a political agenda, rather than the best interests of the patient under care”.

“Ashag notes that all clinicians have an ethical responsibility to speak out about government policy which is damaging to health and mental health and to resist practices which compromise clinical care and render doctors powerless in a politicised and punitive system,” the letter said.

“The current system of immigration detention, including detention of infants and children, is substandard. Offshore locations are not able to provide humane care and actively cause harm: long-term psychological damage will be the consequence of these enduring, unmodified policies.”

The Royal Australian and New Zealand College of Psychiatrists released new guidelines on Thursday for psychiatrists working in immigration detention, insisting that doctors must be free to publicly advocate better care or to highlight cases of abuse or inadequate medical care.

“Doing so should not expose psychiatrists to risk or perceived risk under the Australian Border Force Act,” the guidelines say. Currently doctors face the possibility of a two-year jail term for speaking out about abuse or healthcare failures.

Dr Nick Kowalenko, chair of the Faculty of Child and Adolescent Psychiatry, said indefinite detention had causal links to mental illness and “in the case of children and adolescents, prolonged detention makes them sick and is an unnecessary cruelty”.

“The guidelines published by the RANZCP make it clear that psychiatrists are behaving appropriately in questioning the practices of immigration detention and its impact upon patients of all ages.”



The minister for immigration has been contacted for comment.



