Doctors say handcuffed asylum seeker patients are being “paraded like criminals” through hospital wards and humiliated as they sit shackled in doctors’ waiting rooms.
The practice of handcuffing asylum seekers while escorting them to external medical appointments is now the subject of a federal court test case, launched by the Public Interest Advocacy Centre (PIAC), which alleges it is unlawful under the Migration Act and a form of disability discrimination to those with histories of mental illness, trauma and torture.
The unnecessary use of handcuffs has also been the subject of criticism from the commonwealth ombudsman and the Australian Human Rights Commission, the latter finding last year that asylum seekers were being restrained in a way that breached their right to be treated with “humanity” and “inherent dignity”.
Now, the advocacy group Doctors for Refugees has issued a damning rebuke of the practice. The group says shackling asylum seekers not only obstructs proper medical examinations but also causes extreme humiliation.
“The patients don’t like going to a hospital and waiting in handcuffs,” the group’s founder, Dr Barri Phatarfod, told the Guardian. “Everyone stares at them, mums hold their kids a little bit closer. It’s awful, it really is.”
Phatarfod said there was often no clear and obvious reason why asylum seekers were handcuffed. It was not proportionate to the risk, she said.
In an open letter published this month, Doctors for Refugees urged paramedics and others involved in pre-hospital care to use their judgment and insist on handcuffs being removed, should they deem the individual not to require them.
In many cases, accompanying security would remove the restraints at the request of medical practitioners.
“The use of handcuffs has had a deleterious effect on the psychological health of your patients who reportedly feel like they were being paraded like criminals in public,” the open letter says. “Some patients refused necessary appointments as a result. For others, the use of handcuffs has impeded medical treatment as well as being the cause of some injuries.”
The Australian Medical Association said it had no direct policy on the use of restraints. But its position statement on the health care of asylum seekers and refugees says they have a right to “be treated with compassion, respect and dignity”.
“The use of mechanical restraints in any circumstance can be a traumatising experience that can also discourage people from seeking health care,” an AMA spokeswoman said. “The commonwealth ombudsmen has previously raised concerns about the use of mechanical restraints on asylum seekers and it is clear that they should only be used as a measure of last resort.”
The PIAC case is being launched on behalf of an asylum seeker, given the pseudonym of Yasir, who has been in immigration detention. Yasir told the Guardian that he has been repeatedly handcuffed while being escorted to medical appointments, despite having a childhood history of abuse, trauma and torture.
“I can never forget the things that happened to me as a child prisoner,” he said. “I fled to Australia to seek protection but detention is a new nightmare when I got here.
“Being constantly handcuffed here is doing more and more damage to my mind.”
The Australian Border Force said in a statement to SBS that it could approve the use of restraints where risk assessments suggested it was “appropriate and proportionate to the identified risk”.
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“An assessment of whether to approve the use of restraints is undertaken on a case-by-case basis, following a risk assessment in consultation with health professionals who consider known medical or mental health issues, including torture and/or trauma,” the border force said.
“All detainees in immigration detention have access to health care comparable to that available to the Australian community, including access to psychiatry, psychology and counselling services.”
The border force was approached for further comment.