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Washington Post Detainee Health Care Series – Day 4

The Washington Post began a four part series on Sunday, May 11th on detention health care.  The fourth article in the series focuses on the practice of chemically sedating deportees.

If you are reading this series, you may also be interested in the following:

Myths vs. Facts regarding the May 14, 2008, article:

Myth:  The article’s discussion regarding the scope of the use of chemical sedation.  ICE has injected more than 250 cases without medical reason since 2003. In the article, the practice is described as a human rights violation, comparing the practice to the Soviet Union’s use of Haldol on political prisoners.  

Fact:  Prior to June 2007, the involuntary sedation of detainees for removal purposes was authorized only after consultation with medical professionals and in cases where the detainees posed a threat to themselves, the passengers, the crew and the transporting officers.  Voluntary sedation was also allowed in certain circumstances if a detainee requested medication in order to stay calm on a flight and under the care of a medical professional.   
In June of 2007 and again in January 2008, ICE issued policy requiring a Federal court order in order to utilize involuntary sedation as part of the removal process.  Under both the June 2007 and January 2008 policy, medication administered consistent with treatment of a diagnosed mental condition is appropriate. 

Myth:  The government's forced use of antipsychotic drugs, in people who have no history of mental illness, includes dozens of cases in which the "pre-flight cocktail," as a document calls it, had such a potent effect that federal guards needed a wheelchair to move the slumped deportee onto an airplane. 

Fact:  The policies for DIHS Aviation Medicine reflect the intent to protect the detainee and those doing the escort at all times.  The aviation medicine providers are trained to use de-escalation techniques and use the administration of medication safely, and as a last resort.

It is well established that by combining two mediations, augmentation of the desire effect can be obtained with a lower dose of each.

 

Myth: The article’s discussion of ICE’s policy/procedures for sedating deportees on the flight.  Repeatedly, documents describe immigration guards "taking down" a reluctant deportee to be tranquilized before heading to an airport. 

Fact:  When an alien has exhausted all legal challenges, ICE is required to carry out his removal.  The vast majority of individuals are removed from the United States without issue.  A small number of individuals, however, attempt to affirmatively physically obstruct their removal.  In these very few cases, ICE policy permits its officers, in conjunction with the Department of Justice, to seek a court order to involuntarily sedate an individual to facilitate removal. 

Myth: The article’s discussion of traditional medical uses, and the inference that ICE goes against such use.  For people who are not psychotic, said Philip Seeman, a University of Toronto specialist in psychiatry and pharmacology, "prescribing Haldol . . . is medically and ethically wrong."  Seeman studied the drug in the 1960s and later discovered the brain receptors on which several antipsychotic drugs work.  The only circumstances in which small amounts of Haldol are appropriate for non-psychotic people, Seeman said, are when a person comes into a hospital emergency room violent and agitated from an overdose of a drug such as PCP, or when someone with severe dementia is delusional or combative.
Fact:  The medications used by Aviation Medicine are widely used in psychiatry and their use is in compliance with the DIHS “Practice Guidelines for the Management of Combative Detainees”.
Myth: The article’s discussion of the litigation surrounding this issue.  The government has routinely ignored its own rules, which allow deportees to be sedated only if they have a mental illness requiring the drugs, or if they are so aggressive that they imperil themselves or people around them.  In at least one instance identified by The Post, the agency appears not to have followed those rules.

Fact:  As of June 2007, ICE policy requires that a Federal court order will be obtained before an individual is involuntary sedated.  Prior to January 2008, the policy allowed an emergency exception when the individual represented a threat to self or others.  Since January 2008, the policy requires a court order without exception. Under both the June 2007 and January 2008 policy, medication administered consistent with treatment of a diagnosed mental condition is appropriate. 

The Post’s choice of rhetoric and specific language misleads the reader into believing that the “government has routinely ignored its own rules, which allow deportees to be sedated only if they have a mental illness requiring the drugs, or if they are so aggressive that they imperil themselves or people around them.”  It is in the next sentence that The Post then states that “In at least one instance identified by The Post, the agency appears not to have followed those rules”.  There have been no violations of the government’s policy as written.  In fact, The Post made no reference to the January 2008 policy, again misleading the viewer into believing that the government uses involuntary sedation without a court order.

 

 

 

# ICE #
U.S. Immigration and Customs Enforcement (ICE) was established in March 2003 as the largest investigative arm of the Department of Homeland Security. ICE is comprised of five integrated divisions that form a 21st century law enforcement agency with broad responsibilities for a number of key homeland security priorities.