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Penn Law & Free Migration Project report reveals ongoing unreported violations of patient rights with medical deportations

June 10, 2021

The authors of the report include Toll Public Interest Fellow Erica V. Rodarte Costa L’22, Jacqueline Monnat L’21, and Free Migration Project’s Executive Director David Bennion and Program Coordinator Adrianna Torres-García.

Researchers in the Legislative Clinic at the University of Pennsylvania Carey Law School and Free Migration Project have released a new report on the use of medical deportations in the United States, revealing a routine, yet often unreported, practice of medical deportation of undocumented immigrants.

Medical deportation is the physical removal by a non-government entity of an immigrant patient who is critically injured or ill from one country to another without the informed consent of the patient or the patient’s authorized caretaker. The report, “Fatal Flights: Medical Deportation in the U.S.,” unpacks the complexities surrounding medical deportation, identifies potential levers for change in the systems that have produced the issue, and proposes legislative advocacy to help bring this practice to an end.

The authors, which include Toll Public Interest Fellow Erica V. Rodarte Costa  L’22, Jacqueline Monnat L’21, and Free Migration Project’s Executive Director David Bennion and Program Coordinator Adrianna Torres-García, write that the practice of medical deportation is usually not in the patient’s best medical interests and typically results in poorer health outcomes – or even death – for the transported patient. These deportations often happen without any involvement by immigration courts or the Department of Homeland Security, and once undocumented immigrants leave the U.S., it can be difficult or impossible to return.

“Medical deportation is an issue that sits at the intersection of healthcare and immigration policy,” said Rodarte Costa. “It strips immigrant patients of the dignity and autonomy to make their own healthcare-related decisions, due in large part to their lack of health coverage, and plays off a power differential that causes immigrants to fear the intervention of government authorities.”

The authors found that not only do most medical deportations go unreported, but also hospitals, doctors, and medical transport companies are exacerbating the issue by violating their ethical obligations to patients and profiting from it. Further, they revealed that hospitals often disguise the practice as medical repatriation, which is when a patient who is traveling or working abroad wants to return to their home country to receive medical care. This, however, is not medical repatriation.

They point out that in the U.S., there are more than 350 airplane ambulances in operation that have the capacity to medically deport people. One company alone has transported over 6,000 patients to more than 100 countries. To combat this problem, the authors say the healthcare system must acknowledge the complexity of immigration policy in the United States. To combat this problem, the authors urge legislators to acknowledge the practice of medical deportation and work towards implementing reporting and sanctioning mechanisms to end the practice.

“Hospitals should not be in the business of sending their patients somewhere else to die because they don’t want to pay for care,” said Bennion. “The government should take steps to prevent hospitals from deporting their own patients to their deaths and should also extend healthcare coverage to all noncitizens.”

Based on the data collected, the authors recommend advocates and policymakers take a stand against medical deportation and consider solutions such as providing universal health care coverage, implementing regulations to curb the practice, expanding the breadth of coverage under emergency Medicaid, pushing localities to unequivocally oppose medical deportation, and engaging in further research and advocacy efforts.

“Medical deportations are certain to continue as long as most noncitizens remain ineligible for comprehensive healthcare coverage, and as long as medical transport companies are able to profit off medical deportations, operating unchecked,” added Rodarte Costa. “Ending the process is possible – but it will take collective action from immigration and healthcare advocates and policymakers to make it reality.”

While comprehensive healthcare and policy measures would help solve the issue of medical deportation, the report suggests that there are more immediate solutions as well, such as community organizing.

“This report is important because it will help people obtain knowledge about what to do in case someone in their family or someone they know is in danger of medical deportation”, said Claudia, niece and advocate for A.V., a member of the Philadelphia community who was almost medically deported last year after he suffered catastrophic brain injuries from a motorcycle accident. “If I had not had the support of community organizations and people such as the Law School’s Child Advocacy Clinic, Free Migration Project, students and others, my uncle’s medical deportation would have been carried out and he would not be alive right now. It is very important to investigate and inform the entire community about possible solutions in cases of medical deportation. Most people have no knowledge of what to do and how to help in these situations. So, if we don’t talk about this, no one will know that lives can be saved through community organizing and people who fight for the welfare of others.”

Read the full report.