Intended for healthcare professionals


Australia’s torture of asylum seekers

BMJ 2016; 354 doi: (Published 31 August 2016) Cite this as: BMJ 2016;354:i4606
  1. David Berger, executive committee member
  1. Doctors4refugees, Australia
  1. daveberger{at}

It’s time for doctors to march

The Guardian newspaper’s publication of 8000 leaked pages alleging horrendous abuse and appalling conditions for detainees at Australia’s immigration detention centre on the Pacific island of Nauru has again brought Australia’s treatment of indefinitely imprisoned asylum seekers into sharp public focus.1

The so-called Nauru files, published on 10 August, describe alleged assaults, sexual abuse, self harm attempts, and child abuse. The Guardian’s analysis showed 51.3% of the 2116 reports involve children, although children were only about 18% of those in detention at the time.

Doctors’ leaders in Australia, including Michael Gannon, president of the Australian Medical Association, have again roundly condemned the alleged treatment revealed. But the response of the country’s immigration minister, Peter Dutton, has been to trivialise and dismiss the reports, even accusing asylum seekers of self immolation in their attempts to get to Australia.2 3

Advocates of humane treatment for asylum seekers are left once more scratching their heads and wondering how much more evidence is needed before anything will change? As doctors, we are now conditioned to believe that evidence is prime and that progress occurs as a result of refining the evidence base.

Even in medicine, however, this is not a smooth process,4 and in the parallel universe of politics it is even less so. In fact, in our increasingly “post-factual” age, these rules are often reversed.

In the UK’s recent Brexit referendum reputable authorities attempting to refute blatant falsehoods with evidence were cynically derided. Leave campaigner Michael Gove MP, himself an Oxford educated intellectual, proclaimed: “People in this country have had enough of experts.”5 In the United States, the anti-expert stance and flagrant lies of Donald Trump’s presidential campaign need no rehearsal here. In the Philippines, the new president has used an exaggerated threat of drug use causing civic breakdown to justify a rampant campaign of vigilante killings of alleged drug dealers, subverting the justice system in a grim echo of the Stalin era denunciations.6

This contempt for truth is not new when manipulating popular opinion. The leading Nazi politician Hermann Goering had this to say when interviewed in 1946: “The people can always be brought to the bidding of their leaders. That is easy. All you have to do is tell them they are being attacked, and denounce the peacemakers for lack of patriotism and exposing the country to danger. It works the same in any country.”7

To this end in Australia, Islamic terrorism, immigration, and asylum have all been conflated by cynical politicians to stoke a populist view that the nation’s integrity is under threat from small numbers of people, including children, who are fleeing oppression. In such a fervid, paranoid atmosphere, evidence of ill treatment of these people may appal the morally minded but is an electoral boon to populist politicians seeking to establish their “tough man” credentials.

As doctors, with an ethical duty to advocate for the best interests of our patients, it is our duty to protest the brutal treatment of innocent people for political ends in the strongest possible terms. We have enough evidence now to realise that evidence of ill treatment alone is not going to change things and that in this topsy-turvy world it may even make things worse. Doctors in Australia must now make a mass public statement of their revulsion at the bipartisan support of our politicians for a policy of cruelty and oppression towards the innocent: “We are your doctors. We live our professional lives by a code of ethics over 2000 years in development. We say that what is happening in Australia is wrong and debases us all. We demand that this ill treatment cease.”

I say to all Australian doctors—young, old, the political, and the apolitical—that not just our ethical credibility as a profession but our shared humanity depends on this action. Evidence based argument has failed. Your physical bodies are now needed, in their thousands, to proclaim a message of common decency. Please join the doctors’ march on 5 November in Sydney. I call for the heads of international medical organisations, including the BMA, to voice their abhorrence for Australia’s conduct in the strongest possible terms directly to the senior Australian representative in their countries. I call for the heads of all Australian medical organisations, including the AMA and the specialist colleges, to support this effort to bring the country to its humanitarian senses by speaking and marching alongside their colleagues in Sydney, Melbourne, and other cities.8


  • Head to Head, doi: 10.1136/bmj.i1600
  • Editorial, doi: 10.1136/bmj.h2907
  • Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I am a non-executive director of the BMJ Group. These opinions do not necessarily reflect those of my employer in Australia, Western Australia Country Health Service. Doctors4refugees is currently challenging the secrecy provisions of the 2015 Border Force Act in the High Court of Australia.

  • Provenance and peer review: Not commissioned; not externally peer reviewed.


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