The biggest bioethics story this month, and likely the Summer of 2018, involves the physical and emotional trauma being inflicted on children at the U.S. border as a result of a Trump Administration policy of child separations at the border. This was a new policy in which the children of asylum seekers arriving at the U.S. border were being removed from their parent(s), and sent to U.S.-created internment sites that are run by HHS, while the parent is held in custody awaiting either deportation or an immigration hearing. Although these child internment sites have been described in reports as “humanely run,” since the policy of separating children from their parents is not humane, the moral harms are self-evident. Notwithstanding, there have been reports by that conditions are unacceptable and alarming. (See: https://news.sky.com/story/hundreds-of-lone-children-kept-in-cages-in-us-border-patrol-prison-11408321.) 

Whistleblowers have also made some material available for the public interest, including an audio recording released by ProPublica that demonstrates the emotional trauma of the separated children: (See: https://www.propublica.org/article/children-separated-from-parents-border-patrol-cbp-trump-immigration-policy.)

By mid-June, an American pediatric ethics tragedy was in plain view, particularly in light of news that babies and toddlers are being interred in “tender age” facilities (See: https://apnews.com/dc0c9a5134d14862ba7c7ad9a811160e.) Seasoned reporters, in fact, became “unglued” with moral distress when they read the Associated Press report on-air.

To any pediatric healthcare provider, the pediatric healthcare issues are well-known. In the field of pediatric endocrinology, the effects of stress hormones on children are well known and documented. (See, for example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574783/  or http://stke.sciencemag.org/content/5/248/mr1.full.) When children suffer emotional trauma, there are irreparable physiological changes and changes to the brain.

The American Association of Pediatrics published the following statement: https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/StatementOpposingSeparationofChildrenandParents.aspx

The American Psychological Association published this statement: http://www.apa.org/news/press/releases/2018/05/separating-immigrant-families.aspx

The American Psychiatric Association published this statement, along with several other mental health organizations: https://www.psychiatry.org/newsroom/news-releases/apa-statement-opposing-separation-of-children-from-parents-at-the-border

The Bioethics community published this statement: http://www.bioethics.net/2018/06/child-abuse-as-immigration-policy-has-america-lost-its-moral-compass/

The current Attorney General of the United States has defended the policy as being sanctioned by the “bible”. (See: https://www.washingtonpost.com/politics/sessions-cites-bible-to-defend-separating-immigrant-families/2018/06/14/7b20b9fa-7014-11e8-b4d8-eaf78d4c544c_story.html?utm_term=.4ea07ec68e7f.) The White House architect of the child separation policy, boasts that it is a “deterrent” for immigration and proof that the Trump Administration is strong on border security. (See: https://www.bostonglobe.com/opinion/editorials/2018/06/19/stephen-miller-architect-family-separation-border-must/q7u4GAtQUdbrs1DSMgx0MI/story.html.)

Due to mounting public pressure, an Executive Order to halt separation of families was signed by President Trump, but there is no plan to reunite the children already separated from their families, and confusion over how track them (See: https://www.nytimes.com/aponline/2018/06/22/us/ap-us-immigration-separating-families.html.)

It is difficult to assess the long-term consequences of what can only be called a pediatric ethics catastrophe created by the U.S. government.