Comply with Fear or Stand Up for Patients?
In this episode of Poppies & Propofol, Alyssa Burgart, MD, MA [https://substack.com/profile/12165426-alyssa-burgart-md-ma] speaks with Mark Kuczewski [https://substack.com/profile/290903053-mark-kuczewski], PhD, Professor of Bioethics and Health Policy [https://www.luc.edu/stritch/bioethics/aboutus/facultydirectory/profiles/kuczewskimark.shtml] at Loyola University Chicago and Director of the Neiswanger Institute for Bioethics. Kuczewski has been a national leader in advocating for immigrant health access and creating the framework for “Sanctuary Doctoring”—an approach that ensures undocumented and mixed-status patients receive care without fear.
He shares the pivotal stories that inspired his work, including helping launch Loyola as the first U.S. medical school to openly admit DACA students. Together, Alyssa and Mark tackle the current climate of immigration enforcement, hospital overcompliance with ICE, and the moral obligations of healthcare professionals to protect vulnerable patients.
If you’ve ever wondered what healthcare can and should do to shield patients from fear and injustice, this episode is for you.
I encourage you to check out and share these resources:
* The Loyola University Chicago Sanctuary Doctoring Toolkit [https://www.luc.edu/stritch/bioethics/medicaleducation/sanctuarydoctor/], available in Spanish [https://www.luc.edu/stritch/bioethics/medicaleducation/sanctuarydoctorspanish/] and English.
* Good Sanctuary Doctoring for Undocumented Patients [https://journalofethics.ama-assn.org/article/good-sanctuary-doctoring-undocumented-patients/2019-01] by Drs. Kuczewski, Johana Mejias-Beck, and Amy Blair.
Additional Resources and References
Department of Homeland Security Sensitive Locations Memo [https://www.dhs.gov/publication/enforcement-actions-or-near-protected-areas]
* DHS rescinded protections in sensitive areas: churches, schools, and hospitals.
American Immigration Lawyers Association (AILA) [https://www.aila.org/]
* Immigrants are at risk of being scammed for fake legal services. This organization pairs people with vetted immigration attorneys [https://ailalawyer.com/].
National Immigration Law Center
* Factsheet: Trump’s Rescission of Protected Areas Policies Undermines Safety for All [https://www.nilc.org/resources/factsheet-trumps-rescission-of-protected-areas-policies-undermines-safety-for-all/]
American Academy of Pediatrics (AAP)
* AAP calls for end of family detention [https://publications.aap.org/aapnews/news/31703/AAP-leading-health-groups-call-for-end-of-family]
* AAP Guide to Immigrant Child Health [https://www.aap.org/en/patient-care/immigrant-child-health/]
* Detention of Immigrant Children [https://publications.aap.org/pediatrics/article/139/5/e20170483/38727/Detention-of-Immigrant-Children]
Catholic organizations, including Catholic Health Association of the U.S., U.S. Conference of Catholic Bishops, and Catholic Charities speak out against ICE in hospitals
* Noted for being one of the only organizations to speak out after the rescinding of the Sensitive Locations Memo. You can read the organization’s letter to the House and Senate here [https://www.chausa.org/docs/default-source/advocacy/021025-cha-supports-the-protecting-sensitive-locations-act.pdf?sfvrsn=f4f2c27a_3].
* CCUSA, USCCB, CHA emphasize need for protected areas for immigration enforcement [https://www.catholiccharitiesusa.org/2025/01/23/ccusa-usccb-cha-emphasize-need-for-protected-areas-for-immigration-enforcement/]
Reagan’s 1986 Amnesty Act - Immigration Reform and Control Act [https://immigrationhistory.org/item/1986-immigration-reform-and-control-act/] (IRCA)
DACA (Deferred Action for Childhood Arrivals)
* Stritch pioneers the education of DACA physicians-in-training [https://www.luc.edu/stritch/admissions/daca/]
AMA Code of Ethics [https://code-medical-ethics.ama-assn.org/principles]
* Principle III of the code states: “III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.”
* Despite the AMA speaking out against ICE patrolling in hospitals back in 2017, the organization has remained silent in 2025 [https://www.motherjones.com/politics/2025/02/im-a-doctor-and-im-appalled-at-the-silence-from-the-american-medical-association/].
UN Convention on the Rights of the Child [https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child]
* Part 1, Article 9: “States Parties shall ensure that a child shall not be separated from his or her parents against their will, except” in rare circumstances where “such separation is necessary for the best interests of the child.”
Low Crime Rates Among Immigrants
* Debunking the Myth of the ‘Migrant Crime Wave’ [https://www.brennancenter.org/our-work/analysis-opinion/debunking-myth-migrant-crime-wave]
Child Labor Law Rollbacks
* Despite hazardous working conditions, many states are rolling back child labor laws [https://abcnews.go.com/US/despite-hazardous-working-conditions-states-rolling-back-child/story?id=107209273]
* 2022 US Department of Labor statement [https://www.dol.gov/newsroom/releases/whd/whd20220729] on child labor protections
* Economic Policy Institute: Child labor laws are under attack in states across the country [https://www.epi.org/publication/child-labor-laws-under-attack/]
Healthcare workers as a source of patient criminalization
* A 2022 study by If/How/When [https://www.ifwhenhow.org/] indicated that healthcare workers were the most likely to report patients [https://www.poppiesandpropofol.com/i/107206299/who-is-turning-in-the-most-patients-to-the-cops-its-healthcare-providers] after self-managed abortions.
Disease Outbreaks in Detention Facilities
* Mass incarceration leads to serious individual and public health consequences.
* Seven suspected tuberculosis cases at Tacoma ICE processing facility [https://www.king5.com/article/news/investigations/investigators/seven-suspected-tuberculosis-cases-tacoma-ice-processing-facility/281-0479f854-14c3-413d-ac54-09bc28e80fb6]
* Man Held by ICE Was Jailed in Alaska for Weeks. Now He's in the Hospital Battling Tuberculosis [https://www.latintimes.com/man-held-ice-was-jailed-alaska-weeks-now-hes-hospital-battling-tuberculosis-586499]
Thank you j.e. moyer, LPC [https://substack.com/profile/6212213-je-moyer-lpc], Lauren, Esq. [https://substack.com/profile/288439467-lauren-esq], Yes I care. [https://substack.com/profile/111500710-yes-i-care], Jenny Schiff [https://substack.com/profile/287552006-jenny-schiff], and many others for tuning into my live video with Mark Kuczewski [https://substack.com/profile/290903053-mark-kuczewski]! Join me for my next live video in the app.
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