by Jessica Hane, MD at University of Minnesota; Jennifer Arnold, MD at University of Minnesota; Kathleen Wilcox, MD at Hennepin Healthcare; Adnan Ahmed, MBBS at ResCare Minnesota; and Jonathan D. Kirsch, MD at University of Minnesota
“Philosophically committed to the objectives of the facility,” read the original job posting for a physician by The GEO Group in the prestigious Journal of the American Medical Association (JAMA). The GEO Group is a for-profit company that runs correctional facilities not just in the United States, but also in the United Kingdom, South Africa and Australia. It also operates several Immigration and Customs Enforcement (ICE) processing centers in the United States. The job listing was removed on July 23 due to a physician’s advocacy, but was posted on the JAMA Career Center for nearly a month.
As we learn about the deaths and human-rights violations occurring under The GEO Group, we ask that medical journals be more discerning in their job postings and for physicians to be wary of an employer’s requirement for philosophical compliance.
On their website, The GEO Group claims to be committed to the principles of diversity and inclusion. However, recent reports of overcrowding and lack of basic sanitation in the facilities they run tell a different story. The company is currently facing a class action lawsuit for breaking anti-slavery laws and only paying detainees $1 per day for their work in the facilities. There are also reports of threats of solitary confinement for detainees if they refuse to work. Under public pressure, several businesses have severed ties with The GEO Group due to ethical concerns.
As physicians, our ultimate duty is to the health and well-being of our patients — not to the priorities of a private company profiting from detainment. Asylum seekers in detention deserve quality medical care. However, physicians cannot ethically provide that care if they are also asked to philosophically comply with an employer that violates basic human rights. Physicians must first remain loyal to their patient, with a philosophical commitment to “providing competent medical care, with compassion and respect for human dignity and rights” (AMA). Health care providers can best deliver that care if they do not have a dual loyalty to private correctional facilities, and are instead affiliated with either non-profit humanitarian groups or federal oversight agencies that are aligned with the Hippocratic Oath.
At a time when so many citizens lack access to affordable, appropriate care, providing this care to detainees may seem challenging; however, there is precedent. During World War II, the US Public Health Service provided medical care to 19,000 individuals interned by the Immigration and Naturalization Service. As a third party, they had clinical independence to make decisions in the best interests of patients. These internees were afforded protection under the Geneva Prisoners of War Convention of 1929. Current detainees also deserve full protection.
Abiding by the Hippocratic Oath extends beyond the borders of our own hospitals and clinics. We call on JAMA to be more conscientious when giving corporations unfiltered access to its readership. We call on JAMA’s readers to hold organizations like The GEO group accountable for their disregard of basic human rights. Finally, we call on all health care providers to remain loyal to their patients and protect the sacred patient-physician relationship.
Author’s note: The authors would like to acknowledge Leah Stinson, Calla Brown, Karina Romo, Benjamin Katz, Saida Yassin and Maggie Eckerstorfer for their assistance with this manuscript.