President Donald Trump's second term is ushering in an era of fear and danger for many immigrants. With the administration deporting people at a rapid clip, undocumented immigrants and people with temporary authorization to be in the country are worried they will be swept up in the administration's mass deportation efforts. Many are afraid to leave their homes and some are avoiding areas that used to be protected locations but may no longer be: health care facilities, schools and churches.
This is according to medical ethicist Mark G. Kuczewski of Loyola University Chicago, who told attendees of an April 2 CHA webinar that amid these changes, it is important for Catholic health care facilities to remain a welcoming, safe environment for these immigrants and to take steps to protect and support them. He said that working within the law, they should ensure they have policies in place to keep enforcement officers out of spaces they legally may be stopped from entering. These facilities also should educate employees about how to welcome the stranger and teach immigrants how to protect themselves.
Health care facilities also should work to change the prevailing narrative in the U.S. today, said Kuczewski. He is the Fr. Michael I. English, S.J., Professor of Medical Ethics and director of the Neiswanger Institute for Bioethics and Health Policy at Loyola Chicago.
"The media narrative says that there is a 'migrant crisis,' and that migration is a problem and an issue to be solved … and that migrants are different from 'us,'" said Kuczewski. "In reality, they are a blessing. Is education and formation on this our highest duty? Can we use this as a teachable moment? Can we change hearts and minds?"
Kuczewski's webinar, "Ethics, Immigration and Health Care" was part of the ongoing CHA series, "Emerging Topics in Catholic Health Care Ethics."
Duty to respond
Between Jan. 20 and mid-March, the U.S. Immigration and Customs Enforcement department had deported more than 28,000 immigrants, according to a March 19 Newsweek story and had plans to continue ramping up the efforts on an ongoing basis.
During the Biden administration, certain "sensitive locations" including hospitals, schools and churches had been protected from immigration enforcement, but on Jan. 20, the Trump administration rescinded that protection. Kuczewski said that the changes had left immigrants fearful and stressed. He said some immigrants have been avoiding health care facilities for fear of deportation.
He said Catholic health care facilities should respond to the situation by remaining safe, trusted locations for immigrants. He said that at a bare minimum, health care facilities have a duty to respond to people's medical needs. It is a violation of patient privacy protections for individual staff members to contact authorities on people they suspect are in the country illegally, he said.
But Catholic social teaching challenges ministry providers to go beyond this basic level of protection, Kuczewski said. They should make immigrants feel welcome. They should recognize that undocumented people's immigration status is a social determinant of health and so, as a matter of community and public health, protection of their health should be a priority for ministry sites.
Counter narrative
He said it is incumbent upon ministry facilities to recognize that Catholic social teaching is counter to the prevailing narrative about immigrants in the U.S. today, and he called upon those facilities to put forth a very different narrative.
Whereas many people today criticize undocumented immigrants because of their status, Kuczewski said the church says those immigrants have innate value and dignity, regardless of their status. And while many today may ask what right undocumented people have to enter the U.S. without proper papers, he said the church recognizes a "right to migrate," based on the concept that many migrate based on threats in their homeland. "By what right do we keep them out?" Kuczewski asked.
And while many view undocumented people as "the other," and as "freeloaders," that narrative ignores that many migrants come to the U.S. for a better life and want to work. They are part of communities, part of the culture in their new home and often are part of families in the U.S.
And, he said that many people may hear media stories about immigrant gang activity around groups like MS-13 and Tren de Aragua, and they fear immigrants. But he said that stereotype does not hold true when it comes to most immigrants.
"Some people see them as the problem," he said. "But they bring gifts. They contribute to our culture. They are a blessing, and we need them."
He said that counter to the negative perceptions people may hold, research has shown that undocumented people contribute economically to the U.S.; they have lower rates of crime than native-born people; and they are helping to bolster the nation's tax revenues, social security and Medicare funds.
Practical steps
Kuczewski said Catholic organizations, including CHA, are voicing their objections to Trump administration moves. CHA, the United States Conference of Catholic Bishops and Catholic Charities penned a letter opposing the removal of protected status for sensitive locations, including hospitals. Some churches have entered into a lawsuit to challenge the policy. Some Catholic facilities have endorsed legislation to protect undocumented immigrants.
He noted that individual Catholic health systems and facilities can and should take many steps to protect and support undocumented immigrants. He said he did not endorse lawbreaking. "It's about how we can fulfill our mission, working within the law."
He said that ministry facilities should update their nondiscrimination statements to include immigration status. And they should live out the heart of this statement by positioning themselves as an environment that embraces all people.
Ministry facilities also should develop and educate employees on "front door" policies. Such policies should make clear that immigration enforcement officers may not go beyond publicly accessible areas like lobbies to seek out undocumented people. Only if these officers have a warrant or if there is an immediate public danger posed by the immigrant should they be allowed beyond public areas, he said. Staff at the front door should be trained to call upon a hospital representative with in-depth knowledge of the law if there is a potential policy violation.
Additionally, Catholic health facilities should find ways to reach out to and help educate and empower people at risk for deportation. This can include providing them with information on their rights, connecting them with reputable attorneys and educating them on how to protect themselves. Kuczewski noted that he has created wallet cards, buttons and QR codes that health care staff can provide and display to let undocumented immigrants know that those staff can provide help. The materials are available in English and Spanish.
"Some of this has to do with how you form your employees — and some of you may have a tall order," Kuczewski said. "You can remind them of our values as Catholic health care facilities, and you can remove the barriers to trying to live up to those values."