The American College of Physicians (ACP) strongly endorses the need for congressional oversight of the impact on children’s health of family detention practices, as called for in a letter written by physicians Dr. Scott Allen and Dr. Pamela McPherson, who serve as medical and psychiatric subject matter experts for the Department of Homeland Security. In their letter, Drs. Allen and McPherson have urged Congress to conduct oversight of the negative health implications that children and their families face from the continuation, and proposed expansion, of family detentions.

Dr. Allen and Dr. McPherson have attested that their call for oversight is based on 10 investigations they conducted of several detention facilities, where they documented practices harmful to the health of children. The harmful practices that they cite occurred in facilities operated by both the Obama and Trump administrations. The risk of harm to children is compounded by policies of the current administration to expand greatly the number of children, and families, being detained for entering the border outside of legal entry points.

ACP agrees with their observation that “the problem with family detention is not the failure of the many good people who have labored tirelessly to make the existing centers better, with improvements in access to health and mental health services, educational, and social programs. The fundamental flaw of family detention is not just the risk posed by the conditions of confinement—it’s the incarceration of innocent children itself.” We concur that there is no amount of programming that can ameliorate the harms created by the very act of confining children to detention centers.”

In an ACP statement released by ACP on July 3, we noted that evidence? shows that prolonged family detention is harmful to the health of children and their families, and is not an acceptable alternative to family separation, which ACP also strongly opposes because of the adverse impact on the health of children and their families. Both of these situations can lead to negative health outcomes that will last an individual’s entire lifespan.

As physicians, Dr. Allen, a fellow of the American College of Physicians, and Dr. McPherson are acting in accord with their ethical obligation to speak out on issues affecting the health of these children and their families, a responsibility supported by the ACP’s Ethics Manual. ACP’s Ethics Manual states that physicians have a “…collective responsibility to advocate for the health, human rights, and well-being of the public.”

ACP urges congressional leaders to conduct oversight hearings on the impact family detention has on the health of the children and families who are being detained, including the impact of detention over an affected child’s lifetime, how they are being treated and cared for in the existing detention centers, and the implications for health of the administration’s planned expansion of family detention. Congress and the administration should focus on how to reunite families, how to keep them out of detention, and how to ensure their health and well-being, while still exercising appropriate and necessary control over who enters US borders in accordance with current law.