Public Health Ethics - Global Cases, Practice, and Context, 2016a

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230 A. Wrigley and A. Dawson World Health Organization (WHO). 2008. Addressing ethical issues in pandemic infl uenza planning: Discussion papers. http://www.who.int/csr/resources/publications/cds_flu_ethics_5web. pdf . Accessed 8 May 2013. World Health Organization (WHO). 2010. Pandemic infl uenza preparedness and response: A WHO guidance document. http://whqlibdoc.who.int/publications/2009/9789241547680_eng. pdf . Accessed 8 May 2013. 7.11 C ase 5: Can Asylum Seeking Be Managed Ethically? Karin Johansson Blight The Policy Institute Kings College London London , UK e-mail: karin.johansson_blight@kcl.ac.uk This case is presented for instructional purposes only. The ideas and opinions expressed are the author ’ s own. The case is not meant to reflect the official position , views , or policies of the editors , the editors ’ host institutions , or the author ’ s host institution . 7.11.1 Background Migration is a challenge managed against the backdrop of international accords and the social and historic circumstances peculiar to each country. The 1948 Universal Declaration of Human Rights (UDHR) states “everyone has the right to seek and to enjoy in other countries asylum from persecution” (United Nations 1948 , Article 14). In 1951, the newly established International Organization for Migration (IOM) began promoting “humane and orderly migration for the benefit of all,” affirming that all migration can be managed (IOM 2013 ). The United Nations (U.N.) estimated 221 million migrants worldwide in 2010 (U.N. 2013 ). EUROSTAT estimated 1.7 million immigrants, including forced migrants, in the European Union (EU) in 2011 (EUROSTAT 2014 ). Sweden , a Nordic country that joined the EU in 1995, has a long tradition of monitoring the health of its residents. For example, its National Institute of Public Health, the National Board of Health and Welfare, and Statistics Sweden monitor public health trends, and a national center monitors suicide and mental illness (the National Centre for Suicide Research and Prevention of Mental Ill-Health). “Health on equal terms” is a political priority in Sweden that aligns with the country’s strongly egalitarian and multicultural traditions dating back more than 300 years (Linell et al. 2013 ; Westin 2000 , 2006 ). However, social contingencies throughout Sweden’s history have put pressure on these values and traditions. For example, poor harvests and famine in the mid- to late-1800s triggered extensive emigration , virtually closing borders when
7 Vulnerability and Marginalized Populations 231 emigration ended in the 1930s. In the 1940s, the borders reopened first for refugees from neighboring countries, then, in the 1950s–1960s, for labor immigrants from European countries. From the 1970s onward, the focus shifted to family reunification of migrants and refugees from outside the EU. According to Statistic Sweden’s figures from 2012, of its 9.6 million population, about 15 % are foreign born (Statistics Sweden 2013 ). The S wedish Migration Board (SMB) suggests that 16 % of residencies granted in 2012 were on refugee, protection, humanitarian, or similar grounds (including temporary grounds) (SMB 2014 ). The term migration management (MM) was coined in the 1990s, although the MM field originated in the 1950s (Widgren 1994 ). The rise of MM coincided with a time when several factors, including the mechanisms of colonialism and the Cold War , worked to control and minimize global migration . But other factors also influenced MM, such as resettlements after World War II; efforts to safeguard rights of refugees and migrant workers rights led by international organizations (e.g., the International Labour Organization, the United Nations High Commissioner for Refugees and the International Organization for Migration ); and regional initiatives that removed immigration barriers to improve national economies (e.g., the Organis ation for Economic Co-operation and Development and the Treaty of Rome). In the mid-1970s to mid-1980s, Western countries jointly attempted to harmonize entry controls, efforts that the third pillar of the EU’s 1993 Maastricht Treaty later incorporated (Maastricht Treaty 1992 ). Policies enacted since this treaty have focused on deterring unwanted migrants, arguably to the detriment of human rights and refugee protections (Fekete 2001 ). By 2002, experts suggested that reducing unwanted and unauthorized immigration could increase public support for integration assistance for foreign residents in Western countries (Martin and Widgren 2002 ). But this focus on reduction had the side effect of criminalizing “unwanted” migrants. By implying that unwanted migrants could pose a national security threat, policy instruments such as the 2006 Schengen Borders Code may have fed xenophobic tendencies (Schengen Borders Code 2010 ). Article 5 in the code includes, for example, a statement about entry conditions for short- stay, third-country nationals, that they are not “… considered to be a threat to public policy, internal security, public health, or the international relations of any of the Member States.” At any rate, such increased deterrence and control measures do restrict access to work, housing, health care, and independent legal advice, and even separates families (Johansson Blight et al. 2009 ). Not surprisingly, detention policies harm health with disproportionately high rates of poor mental health , suicide, and self-harm amongst detainees (Silove et al. 2000 ; Cohen 2008 ). Moreover, evidence suggests that such controls have resulted in the rejection of asylum claims of torture survivors and people with severe health problems (Steel et al. 2006 ; Migration Court of Appeal 2007 ; Johansson Blight 2015 ). The evidence also suggests that controls led to children suffering due to exacerbated vulnerability in detention and to unaccounted deaths of forced migrants at Western country borders (Grewcock 2009 ; Steel et al. 2011 ). These injustices prompted repeated appeals to national law , the UDHR, and the Convention on the Rights of the Child and calls for change to relevant World Medical Association (WMA) documents such as the Geneva and Lisbon declarations (Hunt 2007 ; Bodegård 2014 ; Johansson Blight 2014 ; Johansson Blight et al. 2014 ).
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Public Health Ethics Analysis 3 Ser
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During the 21st Century, public hea
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Editors Drue H. Barrett Office of S
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Pref ace Public health ethics can b
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Preface ix This casebook is written
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xii Contents 3.4 Decision-Making Pr
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xiv Contents 6.6 Case 3: Safe Water
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Contributors Rima Afifi , PhD, MPH
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Contributors xix Dora M. Dumont , P
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Contributors xxi Juan Laguna-Sorina
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Contributors xxiii Babette Rump , M
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Section I Introduction to Public He
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Chapter 2 Essential Cases in the De
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62 N. Daniels risks matters, not ju
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64 N. Daniels It is then possible t
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66 N. Daniels The case Guzmán brin
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68 N. Daniels The conflict between
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82 N. Daniels between the health de
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86 N. Daniels infant mortality pers
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90 N. Daniels Ministerio de Salud.
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92 N. Daniels morbidity and mortali
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94 N. Daniels Childress, J. F. 2004
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96 M.J. Selgelid In public health,
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100 M.J. Selgelid course of antimic
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104 M.J. Selgelid Miguel Angel Royo
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108 M.J. Selgelid Moran, N.E., S. G
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110 M.J. Selgelid However, it can b
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112 M.J. Selgelid This case is pres
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116 M.J. Selgelid 4.12 Case 4: Deco
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118 M.J. Selgelid 4.12.2 Case Descr
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120 M.J. Selgelid Tiwari, D. 2013.
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122 M.J. Selgelid law does not disc
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124 M.J. Selgelid 5. Given the many
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126 M.J. Selgelid 4.14.1 Background
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128 M.J. Selgelid 4.14.3 Discussion
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130 M.J. Selgelid This slowing resu
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132 M.J. Selgelid References Códig
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134 M.J. Selgelid 4.16.2 Case Descr
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136 M.J. Selgelid Kemetzhofer, P.,
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138 H. Schmidt 6 and 19 years of ag
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140 H. Schmidt borough as a child o
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142 H. Schmidt lack of evidence. Th
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144 H. Schmidt and fluoridation of
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162 H. Schmidt Ogden, C.L., M.D. Ca
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164 H. Schmidt the overall decline
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172 H. Schmidt annexes. Geneva: WHO
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176 H. Schmidt Vassilevsky, N., L.
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178 B. Jennings the domain of chron
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322 Index Fairness , 28 , 44 , 47 ,
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328 Index Stakeholder(s) , 4 , 10-1
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