Intended for healthcare professionals

Head To Head

Should doctors boycott working in Australia’s immigration detention centres?

BMJ 2016; 352 doi: (Published 22 March 2016) Cite this as: BMJ 2016;352:i1600
  1. David Berger, district medical officer in emergency medicine1,
  2. Steven H Miles, Maas Family Foundation chair in bioethics2
  1. 1Broome Hospital, Broome, 6725 Western Australia, Australia
  2. 2University of Minnesota, N504 Boynton, Minneapolis, MN 55414, USA
  1. Correspondence to: D Berger daveberger{at}, S H Miles miles001{at}

However well intentioned, working in detention centres amounts to complicity in torture, says David Berger, but Steven Miles thinks that there are better ways to take action

Yes—David Berger

Australia’s inhumane treatment of asylum seekers and refugees, including mandatory detention of children on foreign islands, has reached a watershed. Doctors are having to resort to civil disobedience to meet their professional and ethical obligations towards patients, unprecedented in a contemporary Western democracy.1

Since 2015’s Border Force Act, healthcare professionals have risked imprisonment to speak out about appalling conditions in centres that have been likened to gulags and concentration camps.2 3

In February 2016 doctors at Brisbane’s Lady Cilento Children’s Hospital also defied the act by refusing to discharge a baby in what may turn out to be a failed bid to prevent her being sent back to Nauru.4

The president of the Australian Medical Association, Brian Owler, has recently denounced Australia’s appalling treatment of asylum seekers, calling it “state-sanctioned child abuse.”5 But he stopped short of calling for a medical boycott of these facilities because, he said, it is less evil to be inside the system bearing witness and providing medical care, adding that public opinion would not support such a boycott.

But doctors cannot work ethically within the present system; to argue otherwise is wilful blindness, which history tells us will not be judged kindly by future historians.

Factories for mental illness

Amnesty International, the United Nations’ Refugee Agency, and others agree that Australia’s arbitrary and indefinite detention of innocent people, including children, in appalling conditions, amounts to torture.6 7 In 2010, the government’s mental health advocate dubbed its onshore immigration detention centres “factories for mental illness.”8

It is …

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