Questionable Medical Practices: The Case of Unnecessary Hysterectomies on Immigrants in ICE Custody

Questionable Medical Practices: The Case of Unnecessary Hysterectomies on Immigrants in ICE Custody

In recent years, there have been disturbing allegations of questionable medical practices in immigration detention centers in the United States. A report by the Department of Homeland Security’s Office of Inspector General (OIG) revealed that two immigrants in Immigration and Customs Enforcement (ICE) custody underwent hysterectomies without the procedure being necessary.

These unnecessary surgeries have sparked a debate about the rights of migrants and the quality of medical care in detention centers.

Background

The OIG conducted an audit of fiscal years 2019 through 2021 to investigate surgical interventions performed by the ICE Health Services Corps (IHSC).

After reviewing medical records, an OB/GYN physician contracted by the OIG concluded that two of the six hysterectomies performed in that period did not demonstrate that they were the most appropriate and medically necessary treatment for female detainees. This raises serious doubts about the appropriateness and necessity of these surgical procedures.

Lack of proper authorization and review

OIG report notes that both ICE and IHSC do not always adequately process and authorize major surgical procedures for noncitizens in custody. Under current regulations, only regional clinical directors or clinical directors are qualified to review and approve medical necessity authorizations and major surgical procedures performed by outside providers.

However, the OIG found that in a statistical sample of 227 cases, 32% of major surgical procedures were reviewed and approved by IHSC staff other than clinical or general directors.

This lack of proper authorization and review is due to vague IHSC guidelines, which do not include clearly defined requirements for approval of major surgical procedures. The authorization process for a major operation provides no description or additional guidance, which led to approvals being granted in a lax manner, including by email or verbally, according to the OIG report. As a result, IHSC cannot guarantee that all major surgeries performed from 2019 through fiscal year 2021 were medically necessary.

Past cases and repercussions

These allegations of unnecessary hysterectomies on immigrants in ICE custody are not an isolated case. In 2020, a group of organizations submitted a 28-page complaint to the OIG documenting cases of uterine or fallopian tube removal on immigrant detainees at an ICE facility in Irwin County, Georgia. These practices have raised serious concerns and have led to questions about the conditions and rights of migrants in custody.

ICE’s response to these allegations has been to take them “seriously,” while dismissing the anonymous and unproven allegations. However, these allegations have highlighted the need for greater oversight and regulation of immigration detention centers, as well as a guarantee of adequate medical care and respect for human rights.

Conclusions

Case of unnecessary hysterectomies on immigrants in ICE custody highlights the urgency of addressing questionable medical practices in detention centers. It is critical that clear and rigorous protocols be established for the authorization and review of major surgical procedures, ensuring that they are based on sound medical and ethical criteria.

Greater transparency and oversight of immigration detention conditions is also required, as well as effective protection of their human rights. Allegations of unnecessary hysterectomies and other questionable medical practices should be thoroughly investigated and measures should be taken to prevent future occurrences.

It is the responsibility of the competent authorities to ensure that medical care in immigration detention centers meets the highest standards of quality and respect for human rights. Only in this way can the dignity and well-being of migrants in ICE custody be guaranteed.