The new nine-story patient tower at Banner – University Medical Center Tucson on April 03, 2019. The $446 million tower features 228 private rooms, 20 new operating rooms, new diagnostic imaging and cardiac catheterization labs and large windowns to let in natural light with views of Tucson and the Santa Catalina mountains.

The following column is the analysis and opinion of the writers.

A New York Times article from June 10, 2019, describes inhumane practices permitted by Banner-University Medical Center in Tucson: the handcuffing of migrant patients in the hospital, the presence of armed Border Patrol agents in patient rooms, and the violation of patient confidentiality during conversations with their health-care providers.

As per the Times article, Banner-UMC even allowed Border Patrol agents to determine whether a mother could visit her newborn baby. These practices violate ethical principles of patient care and we must raise our voices and express that health-care institutions must place patient care first.

As public-health and health-care professionals who are part of an interprofessional team responding to the need for health services for migrant families in Tucson, we provide medical screenings, health care, and public health services to migrant families, our practices are guided by our professional code of ethics to treat all human beings with dignity and respect.

The majority of families we see at the Tucson migrant shelters are from Central America, predominantly Guatemala and Honduras. Our work at the shelter confirms the research that the decision to migrate from Central America is based on the fundamental human right to live a physically and psychologically safe and secure life.

Many families (and children traveling on their own) are leaving their home countries and seeking refuge in the United States, because they fear for their lives. The right to seek asylum is well established and protected by both domestic and international law.

The journey to seek safety in the U.S. presents well-known dangers for migrants. These dangers include threats to safety from groups and individuals that seek to harm and exploit them, particularly women and children.

The harm faced by migrants on their journey is also created by policy decisions like the Border Patrol’s Prevention Through Deterrence policy: a policy that continues to drive migrants to cross through the deadliest parts of the Sonoran desert.

Between 1998 and 2013, the remains of 6,029 migrants were found in the Southwest border region. The actual number of deaths is likely higher.

Once in the United States, the systematic harm faced by migrants is a part of the U.S. immgration system. This includes sometimes violent interactions with Border Patrol agents, lack of timely medical care, and substandard conditions in detention including overcrowding and poor quality food and water.

Conditions in adult and family ICE detention facilities are equally troubling: We have increasing evidence of lack of access to medical care and lapses in care within the detention system for migrant children. The combination of a dangerous journey to the United States and substandard treatment in the U.S. immigration system leads many migrants into our health-care facilities.

The practices permitted by Banner-UMC protocols disregard professional ethical duty to patient care and create additional vulnerability for patients. These practices violate patient privacy and inappropriately shift the control away from the relationship between the trained health-care professional and the patient.

Together these practices create potential harm and violate patient autonomy and ethical decision making. The ethics of patient care are not, nor should they be, dependent on an individuals’ immigration status. As a nonprofit hospital and academic health center, Banner-UMC has the obligation to change its practices.

Border Patrol agents should not be permitted in patient rooms. Border Patrol agents should not be allowed to influence patient care. Banner-UMC should follow the Joint Commission’s hospital quality accreditation standards and insist on the least restrictive intervention focusing on patient health and stop the practice of shackling refugee patients.

Banner-UMC should take action now to revise their policies, supporting providers as they fulfill their professional ethical duty to put patients first. Also signed by: Laura Coco, AuD; Elizabeth Hall-Lipsy, JD; Anna Landau, MD, MPH; Patricia Lebensohn, MD; Cecilia Rosales, MD; Audrey Russell-Kibble, DNP, FNP-C, FAANP; Kathryn Tucker, MPH; Richard Wahl, MD. The expressed in this guest column does not necessarily reflect the opinion of the authors’ employers.

By Jill Guernsey de Zapien, BA; Lisa Kiser, DNP, CNM, WHNP; and Bryna Koch, MPH.