Abstract
We write in protest about the Australian and New Zealand Journal of Psychiatry carrying an advertisement for the health advisory panel in immigration detention (2004: 38; May) and the College inviting Fellows to join the panel in letters sent out by the College.
The RANZCP has had a sustained and outspoken stance criticizing current immigration detention policies through its spokespeople, and through a number of its members and associates, who have supported this position by making public statements and writing papers on this issue. The College explicitly warned Fellows to carefully consider the ethics of entering into employment contracts with the Government or detention providers in view of the grave ethical and human rights issues involved. The College also has repeatedly called for an independent review of the conditions in detention centres and their impact on detainees' mental health, an appeal that consistently has been ignored.
The College position is founded on the grounds that indefinite immigration detention violates human rights and jeopardises the mental health of detainees, especially children. These abuses, which violate many of Australia's international treaty commitments, are comprehensively and systematically documented in the 900-page HREOC report A last resort: national enquiry into children in immigration detention (April, 2004).
There is also ample evidence from the specifics of the detention environment in Australia and from similar settings worldwide that doctors, and particularly psychiatrists, face grave ethical and professional risks if they do not maintain their full independence from the authorities administering centres so that their integrity is not compromised and their standing wins the respect of their patients.
Despite the HREOC report, and the calamitous effects of detention on children and their families, the Federal Government maintains the existing policy with impunity, and continues to detain asylum-seeking children and their caregivers. The public justification for this by Minister Vanstone has been that detention is necessary for the purposes of deterrence (of people-smugglers and of others in the countries of origin who might plan to come to Australia). It is morally reprehensible to use children as a means to an end in this way.
There is a risk that the RANZCP will be seen to be colluding with the Federal Government's continuing violation of human rights by carrying such advertisements. Over the last three years, there has been no indication that the Federal Government has listened to the advice of any RANZCP member or other health representative about their concerns regarding immigration detention. It seems fanciful that a new health advisory panel will be any more independent or effective than the old Immigration Detention Advisory Group in protecting the health and human rights of this group. It is much more likely that the presence of College Fellows on the panel will be seen as a rubber-stamp, and an endorsement of existing policy.
We urge the College and the Journal to withdraw the advertisement and letters and to publicly reaffirm its core policy statements on this issue. We fully endorse the need for detainees to have access to the highest quality psychiatric care (albeit generally for iatrogenic distress caused directly by the policy of detention). Psychiatrists providing assessment and intervention to detainees should be entirely independent of government and administering authorities.
We have also asked for an urgent response from the Ethics Committee.