March 08, 2016
In the midst of an election season dominated by headlines about torture and refugees, medical practitioners at the University of Pennsylvania have called for doctors to do more to aid asylum seekers.
"In thinking about our privilege as physicians, we often have more power than we realize to help people in ways beyond medicine," said Dr. Jules Lipoff, co-author of a letter published Monday in the JAMA Internal Medicine.
The authors argue that physicians play a key role in helping asylum seekers prove that they were victims of torture. They can write medical affidavits to support their patient's case, and may even be asked to testify in court as an expert witness.
One study found that having a formal medical evaluation doubles the odds for an asylum applicant, taking their probability of success from 37.5 percent to 89 percent.
"If there's any medical documentation of any kind at all of physical findings, they're twice as likely to get asylum in the U.S. It adds credibility to their case," said Lipoff.
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This medical evidence is critical because a U.N. convention forbids nations from deporting people to a country where they are at significant risk of being tortured.
While often confused with refugees, asylum seekers are different because they apply for refuge after they have already arrived in the United States. In contrast, refugees apply from abroad and may spend several years waiting for permission to enter the country.
But like refugees, asylum-seekers may bear clear and gruesome signs of abuse. A 2013 study found that 69 percent had scars on their head and neck, 10 percent had scars on their genitals, seven percent had bone fractures and six percent had burn marks.
Dr. Lipoff met victims of torture who fled from the Democratic Republic of Congo while he was working in Uganda. The most shocking thing, he said, was how stoic patients appeared after they had been whipped and beaten.
"It was horrible to see that, but what was almost worse was that the patients did not seem that distressed by it ...What I thought would have been a horrific event for someone else or anyone I know didn't seem unexpected," he said. "It really makes you take a moment to consider how lucky we are and how we take for granted our safety and security for basic things in our life."
Co-author Jenna Peart, a recent graduate of Penn's medical school, helped found the university's Human Rights Clinic. She wrote in the letter that "physicians should consider this a unique opportunity to defend human rights."
The authors' comments stand out in light of recent comments from presidential candidate Donald Trump that he would support the use of torture in the fight against ISIS and would ban Syrian refugees from entering the country.
Dr. Lipoff declined to comment on the political situation, only saying this: "All lives are deserving of safety and they're all deserving of security, and no one — no matter [who] they are, what ethnicity, background, religion, sexual orientation, political orientation — deserves to be treated this way."