Why Permitting ICE in Hospitals Poses a Looming Public Health Crisis

This week, the Trump administration took a significant step that could harm public health by ending protections that kept Immigration and Customs Enforcement (ICE) away from hospitals and clinics. This move goes beyond being merely harsh; it poses a serious risk to the health of many individuals.

Hospitals should be safe spaces for everyone seeking care. Fear of ICE could keep undocumented individuals from getting the medical attention they need. This fear not only impacts their health but also affects the entire community. If people avoid treatment, diseases can spread, chronic conditions may worsen, and emergencies can become life-threatening. Families will face tough choices; for example, a mother might skip important prenatal care or attempt to give birth at home, both of which can lead to serious complications for her and her baby.

Undocumented workers play crucial roles in our healthcare system, from providing direct patient care to keeping hospitals clean and operational. When we put these workers in jeopardy, it disrupts healthcare services, especially in underserved areas that already struggle with staffing shortages. Targeting these workers threatens the very systems meant to support the sick and vulnerable.

Healthcare professionals find themselves at the heart of this issue. What we choose to do now will either increase suffering or help ease it. It’s our duty to care for anyone who seeks help. This duty runs contrary to collaborating with ICE. Trust is key in healthcare, and that trust cannot exist if patients fear that their providers are aligned with law enforcement.

Healthcare workers must be prepared for ICE’s presence in our workplaces. Understanding our rights is critical. Under the Fourth Amendment, ICE agents can’t enter clinics or hospitals without a valid warrant. If ICE appears, staff should check if they have the right documents. A legitimate warrant will come from a U.S. district or state court and must clearly specify details about what they’re seeking. If they don’t have this, we can ask them to leave politely.

It’s also crucial to know that ICE agents may misrepresent their authority to gain access or gather information. Unlike police, they don’t have the same powers unless specifically authorized. Without judicial warrants, healthcare workers don’t have to give any information to ICE about themselves, patients, or coworkers.

Along with understanding the legal aspects, healthcare workers should develop clear response plans for when ICE arrives. Here are some steps that can help:

1. Alert colleagues immediately: If you see ICE agents, let your coworkers know and activate the response plan.
2. Document the encounter: Take note of the agents’ names and badge numbers. Use your phone to capture video footage as evidence.
3. Refuse entry: Only allow ICE agents in if they present a valid warrant with specific details.
4. Stay silent: You and your colleagues have the right to remain silent and should encourage others to do the same.
5. Avoid physical obstruction: Protect patients and coworkers without escalating the situation. Use legal means to ensure agents operate within their limits.

Healthcare institutions also need to stand together. Administrators should clearly state their commitment to protecting patients from ICE. Training for all staff on how to handle these situations is essential. Hospitals should also collaborate with legal experts and community organizations to build support systems.

Ultimately, while we should make use of legal rights, the best way to protect each other from state violence is through community support, careful planning, and solidarity.

ICE actions in healthcare settings threaten the core values of medical ethics and public health. We must not allow fear to compromise our commitment to care for those in need.

Eric Reinhart is a social psychiatrist, psychoanalytic clinician, and political anthropologist based in Chicago.