What physicians should know about sanctuary cities

“Philadelphia is a sanctuary where we can live in peace,” said Mrs. Lopez, a patient at a local clinic caring for the undocumented. “It wasn’t always this way, and we lived in constant fear,” she added, referring to Philadelphia’s recent adoption of “sanctuary city” policies, adopted also by dozens of other cities and counties across the country. What exactly are these “sanctuaries”? Whom do they protect? And why should physicians care about these policies?

The notion of “sanctuary” primarily comes into play when an undocumented person comes into contact with a law enforcement officer through various relatively commonplace occurrences: either through a speeding ticket, a situation where an immigrant calls the police to their house (to report a rape or robbery, for example), police checkpoints, suspected drug usage, a car accident and many more.

Once the undocumented immigrant is arrested, their demographic information is input into a federal database that links with Immigration and Customs Enforcement (ICE), and the case proceeds as with any other lawful resident of Philadelphia — namely, he or she is detained until charges are cleared. Holding an immigrant in custody for a longer period of time after their charges are cleared to detain him or her for ICE has been deemed to not amount to the “probable cause” required by the Constitution for people to be kept in jail. If an undocumented immigrant has committed a serious or violent crime, or is suspected to have engaged in terrorist activity, he or she can be kept in jail once the police files charges or if ICE presents the police with a warrant.

The city of Philadelphia, which has a population of over 12 percent that is foreign-born, has been a leader in protecting immigrants’ constitutional right from detainment with probable cause and their right to due process, with Mayors Nutter and Kenney signing “sanctuary city” status into law and vocally enforcing it as part of their vision for a united and safe Philadelphia. Their argument is that sanctuary cities create an environment where police can focus their attention and resources on serious crime.

In order to create a safer city, police officers have cited their need for testimonies, witnesses, and tips from members of their community, who would be hesitant to cooperate if they feared the interaction would lead to deportation. Sanctuary cities are vital for the safety of our undocumented patients. Without these protections, Ms. Lopez would not be able to report sexual assault, or report being in a motor vehicle accident without fear of being apprehended by law enforcement officials, putting the public health of our communities at risk.

Sanctuary cities’ ability to protect vulnerable immigrant populations has been threatened continuously by the Trump administration with Attorney General Jeff Sessions stating in October 2017 that “jurisdictions that adopt so-called ‘sanctuary policies’ also adopt the view that the protection of criminal aliens is more important than the protection of law-abiding citizens and of the rule of law” and issuing a warning to these jurisdictions that federal grant money, often at the backbone of local law-enforcement tactics, could be taken away. Recently, Senator Pat Toomey introduced an amendment to attempt to strip away this funding from sanctuary cities, including Philadelphia. The amendment was summarily rejected in the Senate.

There is no current evidence suggesting that sanctuary cities result in more violent crime at the hands of undocumented immigrants, and no evidence that it’s linked to increased risk for terrorist acts. As physicians protecting the safety of our patients, we should ensure that local police not be misused as branches of federal immigration enforcement, lest our patients become more afraid of reporting crimes in their communities, or presenting to places where ICE could be present, including places of employment, places of worship as well as clinics and hospitals. Our voices as physicians and as spokespersons on behalf of the public health of all of our patients matter. We must use these voices to speak out against policy that will further marginalize an already very vulnerable community.

Isha M. Di Bartolo is an internal medicine resident.

Image credit: Shutterstock.com

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