Why should physicians care about President Trump’s decision
to end the Deferred Action for Childhood Arrivals (DACA) program?
Because it brings “great harm” to health care, to medical
education, and to the country, said
the American College of Physicians in a statement issued moments after
Attorney General Jeff Sessions announced the President’s decision.
Directly affected by the decision are Dreamers enrolled in
U.S. medical schools. “According to the
Association of American Medical Colleges, in 2016, 108 students with DACA
status applied to medical school, and 34 matriculants with DACA status entered
medical school, bringing total medical school enrollment to approximately 70
students,” ACP noted in its statement. “Without the protections afforded to
them by DACA, these students would be forced to discontinue their studies and
may be deported. As these students train to become physicians, they will have
the experience and background necessary to treat an increasingly racially and
ethnically diverse patient population to fulfill the cultural, informational,
and linguistic needs of their patients…”
Also affected are Dreamers “studying to be nurses, first-responders,
scientists, and researchers, and approximately 1,000 foreign-born recruits who
enlisted in the military under the protections offered by DACA could face
deportation, according to the Washington
Post.”
Public health will also be adversely affected, according to
ACP. “If the nearly 800,000 people who are currently benefiting from DACA have
their protections removed, many will avoid seeking health care in order to
reduce the risk of detection and deportation, and as noted above, those who
seek to serve in the health care professions will be denied that
opportunity. Many will be forced to
return to violent, war-torn and dangerous countries with poor health care
services.”
That the President will delay full enforcement of his
decision to end DACA “in no way mitigates the harm that will be done to the
800,000 law-abiding persons who have achieved permits under DACA to work or
study in the United States without fear of deportation” said ACP. “They are now
at risk of losing their jobs, being forced to drop out of school, and being
deported in just a matter of months.”
ACP called on President Trump to reverse his decision and
continue protections for those with DACA-status—even though there is virtually
no chance that he will. More likely,
Congress will need to act, by enacting legislation to block the deportation of
Dreamers and to create a pathway for citizenship, as proposed by S. 128, the
Bar Removal of Individuals who Dream and Grow our Economy (BRIDGE) Act, and S.
1615, the DREAM Act of 2017.
ACP’s decision to stand up for Dreamers reflects our
long-standing commitment to creating a national immigration policy that
recognizes the enormous contributions that immigrants make to the United
States, and to health care in particular.
In 2011, ACP
issued a policy paper that called “for a national immigration policy on health
care that balances legitimate needs and concerns to control our borders and to
equitably differentiate in publicly supported services for those who fully
comply with immigration laws and those who do not, while recognizing that
society has a public health interest in ensuring that all resident persons have
access to health care.” Further, ACP
asserted in this paper that “Any policy intended to force the millions of
persons who now reside unlawfully in the U.S. to return to their countries of
origin through arrest, detention, and mass deportation could result in severe
health care consequences for affected persons and their family members
(including those who are lawful residents but who reside in a household with
unlawful residents— such as U.S.-born children whose parents are not legal
residents), creates a public health emergency, results in enormous costs to the
health care system of treating such persons (including the costs associated
with correctional health care during periods of detention), and is likely to
lead to racial and ethnic profiling and discrimination.”
On January 30 of this year, ACP’s
Board of Regents released a comprehensive statement on immigration policy,
expanding on the 2011 paper, which “strongly opposes discrimination based on
religion, race, gender or gender identity, or sexual orientation in decisions
on who shall be legally admitted to the United States as a gross violation of
human rights.” Based on this policy, ACP
has opposed President Trump’s executive orders to bar persons from several
majority Muslim countries from entering the United States.
ACP also said that “Priority should be given to supporting
families in all policies relating to immigration and lawful admission to the
United States to live, study, or work.”
Accordingly, “ACP opposes deportation of undocumented medical students, residents, fellows,
practicing physicians, and others who came to the United States as children due
to the actions of their parents (‘Dreamers’) and have or are eligible for
Deferred Action for Childhood Arrivals (DACA) status. We urge the
administration to preserve the DACA action taken by the previous administration
until such time that Congress approves a permanent fix. The College also urges
Congress to promptly enact legislation to establish a path to legal immigration
status for these individuals to ensure that ‘Dreamers’ are permanently
protected from deportation.”
For ACP, concern about immigration policy and its impact on
health care clearly is nothing new. What
is new, regrettably, is that the current administration has chosen to embrace
immigration policies that are discriminatory against persons based on their
religion and country of origin, threaten to split up families that have members
here both lawfully and unlawfully, make
it less likely that immigrants who lack legal residency will access needed
health care services, and now, threaten with the deportation of Dreamers, who
for all practical purposes, are as American as the rest of us, having lived
almost their entire lives in the United States, and who stand to contribute so
much to our country if the country has the wisdom to welcome them.
This is why it is more important than ever that doctors
defend Dreamers, and others who would be harmed by the current administration’s
ill-advised immigration policies.
Today’s question: what do you think of ACP’s response to
President Trump’s decision to discontinue DACA?