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 or 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.” 5

The Medical Affidavit 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 on 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/ - Explanation of how injuries correlate to the facts of the asylum Impression seeker’s case - Provider’s opinion on causes of physical or psychological injuries Recommendations - Explain ongoing symptoms or disabilities 5/15/2020 Presentation or Section Title 6 - Recommendations for further evaluation/care

Creating a clinic 7

Creating a clinic 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? 8

Ethical Frameworks 9

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 of 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. 11