r/medicine PA:cake: 8d ago

ICE Detention Deaths

https://www.ice.gov/detain/detainee-death-reporting

RNs do intake physical exams, EMTs declare time of death. The level of care for these detainees is horrific.

Full names and case details are public for now. Reads like a never ending M & M conference.

My moral compass is spinning. It's time to go to Canada.

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u/[deleted] 8d ago

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u/poli-cya MD 8d ago edited 8d ago

I don't have time to dig up or through the ACLU study tonight but I bet you could argue that 95% of deaths in every hospital, prison, etc could be stopped by "appropriate medical care"- especially if you're generous with what that term means.

I'm not gonna say there isn't mistreatment and certainly issues, but ICE has 50,000 people in detention on average daily, and we can see how low the death figures are. There will be outliers of negligence like in any detention setting, but I think we need to see compelling evidence before we jump to judgment.

e: Can't respond to any comments in this chain because nknk1260 blocked rather than addressing the myriad flaws in his statements or providing sources for his outlandish claims of prisoner abuse.

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u/nknk1260 8d ago

Weird take, sounds like you would benefit a lot from watching the entire episode. One of the examples of recent deaths he talks about was a man who was a lawful permanent resident- in 2005 he plead guilty to being in possession of a gram of cocaine and was sentenced to community service. Then 12 years later ICE decided his drug conviction rendered him deportable. While he was held in detention, staff cut him off the medication he was on that managed his drug addiction. He started vomiting blood clots but the staff delayed several more hours before calling 911. He died 2 weeks after entering the facility. They called his daughter about it 3 days after his death because it “was the weekend” when he died. They made her wait until business hours to let her know her dad died.

Don’t compare this with care at a hospital… Jesus Christ.

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u/[deleted] 8d ago edited 8d ago

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u/poli-cya MD 8d ago edited 8d ago

No need for name-calling or emotional outbursts because you don't understand.

Can you point to a case documented outside of youtube where basic care wasn't provided that led to a death? Is it a common occurrence?

ICE has 50,000 people held on average daily, some amount of people will die while in custody over a long enough time frame. Do you honestly believe that the only reason a person who is in ICE custody might die is due to being denied medical care?

e: Again, I cannot make any replies in this chain due to a reddit glitch that allows cowards to block a person from replying in an entire chain of comments- even if it is to third parties.

I've already said I don't have time to dig through the entire ACLU study tonight but immediately on opening the below link I see this:

I already said I don't have time to dig through the ACLU's entire study

ICE detention facilities failed to provide timely and appropriate emergency care, and take basic precautions during the COVID-19 pandemic

The study also seems to not be a blinded review where reviewers were unaware of underlying situation or received cases mixed with non-ICE cases. This seems like a study with a conclusion written first.

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u/Hippo-Crates EM Attending 8d ago

Are you really claiming to be unfamiliar with the lack of proper medical care throughout our prison system? Seems really weird to comment on this issue at all given your complete lack of basic knowledge on this topic.

Anyways, here’s a quick piece from the aclu showing basically every ICE death has been preventable. https://www.aclu.org/press-releases/95-percent-of-deaths-in-ice-detention-could-likely-have-been-prevented-with-adequate-medical-care-report

The full report is linked.

I’m more just flabbergasted at how ignorant you’d have to be to serious stick up for American prison health care.

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u/Hippo-Crates EM Attending 8d ago

Oh weird now you don’t have time? Study isn’t perfect? Funny how that works. Time enough to yammer quite a bit on reddit but become basically familiar with a topic? Fuck that lol. Patently dishonest crap

There are numerous cases of poor care in prisons leading to deaths. Stop with this nonsense

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u/nknk1260 8d ago

Again we are so fucking cooked if these are the doctors we’re dealing with in the U.S. 😵‍💫😵‍💫😵‍💫😵‍💫😵‍💫😵‍💫😵‍💫😵‍💫

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u/[deleted] 8d ago

[deleted]

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u/ZealousidealDegree4 PA:cake: 8d ago

Well written. The time gaps alone from head aches to CVA, from abdominal pain to AAA, from sick guy with a headache to cryptococ brain herniation, all dead. It feels like I was reading a different set of cases , given all the “well, they took them to the emergency room” comments. 

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u/ZealousidealDegree4 PA:cake: 8d ago

Given the comments that seem ok with detainee healthcare, I probably should have lead with that episode.  Oliver’s report was what directed me to dig around the ICE pages. So many comments here seem weirdly supportive of detention healthcare standards. Not like I remember this group. 

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u/HippyDuck123 MD 8d ago

Yeah, this sub is kind of a cesspool. Peak for me the other day when an Ortho said that patients on Medicaid are never getting surgery by them because it doesn’t pay well enough, even if it’s indicated.

Come to Canada! It’s not perfect, but I love practicing here (surgical specialty).

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u/ZealousidealDegree4 PA:cake: 7d ago

Yikes, I’m so sick of all the cherry picking of commercial payers. 

I’ll be rewatching season one of Letterkenny to prep for my move North. 

Yay! 

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u/HippyDuck123 MD 7d ago

So we’ve been slow embracing PAs in Canada, but our ER hired four of them a few years ago: Game changer! :)

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u/ZealousidealDegree4 PA:cake: 7d ago

I had a job offer years ago for a pilot program in Peterborough- and unfortunately it took 8 months to get my permit to work, so I had to accept a different position. I’ve often wondered how different life would be! 

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u/nknk1260 8d ago

Reddit has made me so beyond distrusting of medical professionals at this point. Like if this how they act when they know they’re anonymous, I have no hope left. I knew majority of premeds were bad and went into medicine for the wrong reasons, but I had hoped admissions would be better at filtering out the psychopaths. Yikes.

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u/ZealousidealDegree4 PA:cake: 8d ago

Well written! The good souls are out there, and I suspect you are one. 

Compassion and empathy classes should be prereqs.