Some Public Health Service officers deployed to detention centers suffer ‘moral distress’ : NPR
The Growing Ethical Crisis Within U.S. Immigration Healthcare
As immigration arrests by U.S. Immigration and Customs Enforcement (ICE) continue to rise, a critical strain is being placed on healthcare professionals tasked with providing medical care within detention facilities. Recent reports reveal a growing number of clinicians are grappling with ethical dilemmas and, in some cases, leaving the U.S. Public Health Service (USPHS) due to concerns about the quality of care and the overall humanitarian impact of detention practices.
Demand for Healthcare Professionals Surges
In 2025, the demand for healthcare providers to staff ICE detention centres increased significantly. To meet this need, nearly 400 USPHS officers were deployed for month-long tours to facilities nationwide, according to a USPHS employee. These officers include nurses, doctors, pharmacists, and other medical professionals. However, this surge in deployment is coinciding with increasing reports of moral distress among these professionals.
Concerns Over Conditions and Care
Inspectors for the Department of Homeland Security have identified dangerous problems in immigration detention facilities. Reports detail delays in providing necessary medical care, chaotic screenings, and overcrowded, understaffed conditions. A 2017 Human Rights Watch report highlighted that medical care providers vary from facility to facility, with the Immigrant Health Service Corps (“IHSC”) often providing care. A 2024 report indicated that in 40 percent of 52 death cases reviewed, ICE facilities failed to provide timely emergency health care.
Moral Distress and Departures
Many USPHS officers are finding these assignments conflict with their professional ethics. Clinicians have reported life-threatening delays in getting medicine and care to detainees. One nurse practitioner who resigned from the USPHS in October stated, “We have been tasked with protecting and promoting health, and instead, we are being asked to facilitate inhumane operations.” Approximately 340 USPHS officers left the service in the past year, with a significant number citing concerns related to ICE deployments.
The USPHS Role and Its Challenges
The USPHS, comprised of around 5,000 uniformed health professionals, typically responds to crises like natural disasters and disease outbreaks. However, deployments to ICE facilities are proving particularly challenging. Some officers feel their skills are being used to support a system they believe is inherently harmful. The agency’s mission includes providing care to vulnerable populations, but the current situation presents a conflict for many.
Reports of Abuse and Neglect
Multiple reports detail concerning conditions within ICE detention centres. Interviews with detainees at Fort Bliss in December 2025 revealed instances of physical and sexual abuse, medical neglect, and other inhumane treatment. These conditions are further exacerbated by obstacles to accessing care, with some facilities reportedly delaying or denying appropriate medical and mental health services.
Lack of Transparency and Access
As of February 1, 2026, attorneys and relatives are struggling to locate hospitalized ICE detainees, with reports of individuals being held under pseudonyms and staff prohibited from contacting family members. This lack of transparency raises further concerns about accountability and the well-being of those in custody.
Ethical Implications for Nurses
The ethical responsibilities of nurses within the immigration detention system are under scrutiny. A 2019 article in the Online Journal of Issues in Nursing highlighted the pattern of dehumanization and grossly inadequate medical and mental health care experienced by detainees.
The Impact on Public Health
The departure of experienced USPHS officers raises concerns about the nation’s overall public health capacity. These officers often fill critical roles during emergencies and contribute to various federal agencies, including the Indian Health Service, the Food and Drug Administration, and the centres for Disease Control and Prevention. A loss of personnel could weaken the country’s ability to respond to future health crises.
Did you know? The U.S. Public Health Service Commissioned Corps has been in existence since 1798.
Frequently Asked Questions
- What is the role of the USPHS in ICE detention facilities?
The USPHS deploys healthcare professionals to provide basic medical care to detainees in ICE facilities, often filling gaps in staffing.
- What are some of the concerns raised by USPHS officers?
Officers have expressed concerns about delays in care, overcrowded conditions, and the ethical implications of providing care within a system they view as inhumane.
- How many people are currently in ICE detention?
As of February 2, 2026, approximately 71,000 people were held in 225 facilities nationwide.
Explore further: Learn more about immigration detention conditions at Human Rights Watch.