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Posted on June 21, 2019 at 3:13 AM

by Craig Klugman, Ph.D.

A controversy last week erupted out of freshman New York Congressperson Alexandria Ocasio-Cortez’s Instagram Live appearance and follow-up tweet saying that the facilities where the federal government is keeping detained children are “concentration camps.”

The Border Patrol Chief immediately called Ocasio-Cortez’s use of the term, “offensive”. The Israeli Holocaust Museum Yad Vashem, Senator Bernie Sanders, and New York Mayor Bill de Blasio felt the term was not appropriate and diminishes what happened in the Holocaust. Others have stated that the correct term is “detention center” since these are people alleged to have broken the law. The funny thing about laws is that when wielded unjustly they can be immoral, dehumanizing, and cruel.

As we all know, good bioethics starts with (a) good facts and (b) defining your terms.

The Facts

The United States has detained immigrant children in facilities located in border states. Beginning officially in the Spring of 2018 (and unofficially since 2017) children have been separated from their parents upon trying to

Art by Craig Klugman

enter the United States through unofficial channels, or being given a deportation order by a court. This is part of a zero-tolerance policy for immigration offenses in an attempt to dissuade people from coming to the U.S. Official reports hold that fewer than 2,800 children were separated and detained during the official dates of the program (a court order halted the program in June 2018, though reports are that it has continued). The reality, according to the Office of Inspector General of the U.S. Department of Health and Human Services is that no one actually knows how many children are in immigration detention. Other groups have estimated the number of minor detainees to be at least 15,000.

The Definitions

Journalist and writer Andrea Pitzer is the author of One Long Night: A Global History of Concentration Camps. Pitzer differentiates between concentration camps and extermination/death camps. She defines concentration camps as, “mass detention of civilians without trial”. According to the Oxford English Dictionary, a concentration camp is “A camp in which large numbers of people, esp. political prisoners or members of persecuted minorities, are deliberately imprisoned in a relatively small area with inadequate facilities, sometimes to provide forced labour or to await mass execution”. The term was first applied in the Cuban War of Independence of 1895-1898.

Historian Anna Lind-Guzik says we need to call these detention centers what they are, concentration camps. She says this does not diminish the reference to the Nazi atrocities, but reminds us of where current actions may lead: “Applying the term “concentration camp” to the indefinite detention without trial of thousands of civilians in inhumane conditions — under armed guard and without adequate provisions or medical care — is not just appropriate, it’s necessary.Invoking the word does not demean the memory of the Holocaust. Instead, the lessons of the Holocaust will be lost if we refuse to engage with them.”

Actor and activist George Takei who spent some of his childhood in U.S. internment camps for people of Japanese descent during World War II, believes that concentration campis the proper term for the detention centers: “I know what concentration camps are. I was inside two of them, in America. And yes, we are operating such camps again.”

Besides the large number of detainees and the lack of access to a real legal process for them (oftentimes toddlers appearing alone in courts), the definition also requires “inhumane conditions without adequate provisions or medical care”. The U.S. Department of Justice argued before the 9thCircuit that children in detention do not need toothbrushes nor soap.  Many of the children lack beds or cots, instead sleeping on concrete floors. The government has cut funding and canceled education classes, sports, and even legal aid for the children. From October 2014 to July 2018 there were 4,500 filed complaints of sexual abuse of immigrant children in federal detention facilities. Who knows how many more were assaulted but no complaint was filed. Statistically in the general population only one-third of sexual assaults in children are reported. The prisons are overcrowded, under supervised, and unsanitary. Children are often kept in solitary confinement and medical needs go unmet.

The Debate

Whether one calls these facilities concentration camps, detention centers, internment camps, prisons, or processing centers, the truth is that an unknown number of children have been removed from their families, placed against their will and without any relative’s knowledge in cages and fenced in areas (which they are not free to leave), and are treated poorly. While language and naming are important for political purposes (consider pro abortion, anti life, pro choice, pro life, anti choice), the reality is simple: Children are being held in inhumane conditions for being alive and for being in the United States. These are conditions worse than what we would permit for any criminal prisoner, for any prisoner of war, or any animal.

Approximately five children have died in detention and a flu outbreak in one facility has led to a quarantine. Psychologically, what the U.S. government is doing to children is destructive and is creating stress and trauma that will follow these children their entire lives. The physical and psychological effects on children is well documented and violates policy recommendations from the American Association of Pediatrics.

The reason for these draconian policies that have created inhumane conditions are stated as (a) deterrence (rarely works and has failed in this case), (b) racism, (c) negotiation tool, (d) politics (anti-immigration positions are popular with the Trump base), and (e) profit. Yes, profit is a large motivator in filling these camps. Most of the centers are actually owned by private companies that are paid a fee (approximately $750 per day per child) by the federal government for each child they hold. This is a nearly billion dollar a year business.

What can we in bioethics do to stem this tide of cruelty? We can seek the truth and espouse the facts. We can offer ethical analyses that show what is legal is not always ethical or moral. We can talk about how separation violates autonomy, beneficence, nonmaleficence, justice, procreative liberty, parental rights, natural law, moral law, and the greatest good. We can write to our elected representatives, pen Op-eds, march in protests, and teach in our courses. Even when it feels like the problems are overwhelming and that our voices are drowned by the sea of injustice crashing down, we must hold firm, we must speak up, and we must increase justice in the world.

 “The opposite of love is not hate, it’s indifference. The opposite of art is not ugliness, it’s indifference. The opposite of faith is not heresy, it’s indifference. And the opposite of life is not death, it’s indifference. Because of indifference, one dies before one actually dies. To be in the window and watch people being sent to concentration camps or being attacked in the street and do nothing, that’s being dead’ – Elie Wiesel, 1986


If you are a medical/bioethicist and wish to sign a petition protesting the treatment of children in these camps, you can sign this letter (by Tuesday, June 25, 2pm EDT). https://forms.gle/VXrDmdp66dicto4cA

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