Intended for healthcare professionals


Hospitals as places of sanctuary

BMJ 2018; 361 doi: (Published 17 May 2018) Cite this as: BMJ 2018;361:k2178
  1. Altaf Saadi, neurologist1,
  2. Martin McKee, professor of European Public Health
  1. 1National Clinician Scholars Program, University of California Los Angeles, California, USA
  2. 2London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to: A Saadi ASaadi{at}

Innovative response from US to a hostile environment could benefit the UK

Migration has become one of the greatest challenges of the early 21st century. The British and American governments have intensified efforts to find and deport people believed to be in the country without authorisation. Health professionals find themselves in an ethical dilemma between their duty to provide care to patients and their governments’ political agendas. But though both countries pursue the same objective, they are doing so in different ways, each with implications for health professionals.

National differences

In the US, immigration enforcement is largely in the hands of Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP). Since the 2017 presidential inauguration, enforcement at or near health facilities has increased, although both organisations’ internal policies deem hospitals to be “sensitive locations,” where immigration enforcement is to be avoided.1 High profile cases have contributed to a climate of fear that creates anxiety and hopelessness among immigrants, who fear detention and deportation of themselves or members of …

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