As Asylum c clini nics: s: Establishing a legal, medical, and - - PowerPoint PPT Presentation

As Asylum c clini nics: s:

Establishing a legal, medical, and ethical framework for the global healthcare practitioner’s role

Charlotte Campbell Northwestern Global Health Clinical Scholars Certificate Program

5/15/2020 2

The Process of Asylum Applications

PHR and Asylum Clinics

• What is an Asylum Clinic?
• “At its core, an asylum clinic housed at a medical

school is a student-run program that connects Physicians for Human Rights (PHR)-trained clinicians to political asylum seekers and their

• attorneys. These clinicians conduct forensic medical
• r mental health evaluations to uncover signs and

sequelae of torture or trauma and document their findings in affidavits that serve as evidence in the client’s legal application for asylum.”

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The Medical Affidavit

5/15/2020 Presentation or Section Title 6

Key Components of the Medical Affidavit Provider Qualifications

• Educational & professional qualifications
• Prior forensic experience
• Relevant coursework or participation in training
• Prior testimony in immigration court

Background

• Date, time, duration, location of meetings
• Demographic information
• People present during evaluation
• Use of an interpreter
• Documents reviewed prior to evaluation

Story Summary

• General information about the asylum seeker
• Summarize the story and facts used to reach conclusions (focus
• n abuse/torture)
• Summary of the asylum seeker’s current state

Examination

• Usually superficial skin examination w/ documentation of any

prior signs of trauma

• Basic assessment of psychiatric health determinants: affect,

mood, language Assessment/ Impression

• Explanation of how injuries correlate to the facts of the asylum

seeker’s case

• Provider’s opinion on causes of physical or psychological

injuries Recommendations

• Explain ongoing symptoms or disabilities
• Recommendations for further evaluation/care

Creating a clinic

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Creating a clinic

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STAKEHOLDERS:

• University/Hospital
• Students
• Clinician volunteers
• Local health clinics
• Social workers, mental health providers
• PHR
• Lawyers
• Asylum seeker
• Families of asylum seekers
• Future asylum seekers
• Community
• Immigration judges
• ….international communities?

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Ethical Frameworks

Special Thanks

• My advisor Dr. Ashti Doobay-Persaud
• Sara Caudillo
• Lida Zheng
• Medical student and undergraduate PHR

collaborators: Sofia Sami, Danish Majid, Sofia Sami, and Natalie Smith

References

References

• 1. Koplan, J.P., et al., Towards a common definition of global health. The Lancet, 2009. 373(9679): p. 1993-1995.
• 2. Rowthorn, V., Global/Local: What Does It Mean for Global Health Educators and How Do We Do It? Annals of Global Health, 2016. 81(5): p. 593-601.
• 3. Council, A.I., Asylum in the United States. 2018.

4.(Physicians for Human Rights), P.H.R. Examining Asylum Seekers: A Clinician’s Guide to Physical and Psychological Evaluations of Torture and Ill Treatment. 2012 2020]; Available from: https://phr.org/our-work/resources/examining-asylum-seekers/. 5.Asgary, R. and C.L. Smith, Ethical and Professional Considerations Providing Medical Evaluation and Care to Refugee Asylum Seekers. The American Journal

• f Bioethics, 2013. 13(7): p. 3-12.
• 6. Nzelibe, U. Overview of Asylum Law. [Lecture] 2019 [cited Nov 9, 2019].
• 7. Lustig, S.L., et al., Asylum Grant Rates Following Medical Evaluations of Maltreatment among Political Asylum Applicants in the United States. Journal of

Immigrant and Minority Health, 2008. 10(1): p. 7-15.

• 8. Praschan, N., R. Mishori, and N. Stukel, A Student-Run Asylum Clinic to Promote Human Rights Education and the Assessment and Care of Asylum Seekers.

Journal of Student-Run Clinics, 2016. 2(2).

• 9. Asgary, R., & Segar, N, Barriers to Health Care Access among Refugee Asylum Seekers. Journal of Health Care for the Poor and Underserved, 2011. 22(2): p.

506-522.

• 10. Simpson, S.A. and J.A. Long, Medical student-run health clinics: important contributors to patient care and medical education. Journal of general internal

medicine, 2007. 22(3): p. 352-356.

• 11. Beauchamp, T.C., J, Principles of Biomedical Ethics. Sixth ed. 2009, New York, New York: Oxford University Press.
• 12. Silva, D.S., Powers and Faden’s Concept of Self-Determination and What It Means to ‘Achieve’ Well-Being in Their Theory of Social Justice. Public Health

Ethics, 2013. 6(1): p. 35-44.

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