{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:19:44Z","timestamp":1787743184934,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Emergency departments (EDs) are increasingly sites of interaction between clinicians and federal immigration authorities. Recent shifts in federal enforcement policy have intensified these encounters. Patients now more frequently arrive in custody, accompanied by immigration enforcement officers who may assert control over communication, decision\u2010making, or access to patients. These circumstances introduce challenges for maintaining standard clinical practice. Clinicians may encounter situations in which patient confidentiality, informed consent, and independent medical judgment are difficult to operationalize in the presence of immigration enforcement officers. In addition to impacts on patient care, these encounters may contribute to clinician moral injury and distress, particularly when emergency medicine (EM) clinicians feel pressured to compromise patient privacy, deviate from standard practices, or navigate conflicts between enforcement priorities and patient care priorities. Uncertainty regarding institutional policy and the appropriate limits of immigration enforcement authority may exacerbate tensions related to liability and compliance. For patients, disruptions in care and delays in treatment may increase the risk of adverse outcomes. In response to these urgent concerns, the National Immigration Law Center (NILC), a leading advocacy organization in U.S. immigration, has developed Advocating On Behalf of Patients in ICE Custody: A Resource for Health Care Providers and Medical Staff, a national resource guide outlining practical considerations for clinicians and healthcare institutions caring for patients in immigration custody. In this commentary, we build on this resource to provide practical, bedside\u2010oriented guidance for EM clinicians when interacting with immigration enforcement officers or caring for patients in immigration custody. We examine the implications of immigration enforcement within healthcare settings while articulating a path forward that protects patient rights, clinical integrity, and the ethical foundations of medical practice. The following highlights clinical questions that EM clinicians may have when caring for patients in immigration custody or interacting with immigration enforcement officials in hospital settings.<\/jats:p>","DOI":"10.1111\/acem.70397","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:52:27Z","timestamp":1787291547000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Caring for Patients in Immigration Custody: Clinical and Legal Considerations for Emergency Medicine Clinicians"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1487-2446","authenticated-orcid":false,"given":"Ellen","family":"Shank","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine University of California Davis Health  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Whitlock","sequence":"additional","affiliation":[{"name":"National Immigration Law Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Lopas","sequence":"additional","affiliation":[{"name":"National Immigration Law Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Zeidan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"National Immigration Law Center Factsheet: Trump's rescission of protected areas policies undermines safety for allaccessed at May 18 2026 https:\/\/www.nilc.org\/resources\/factsheet\u2010trumps\u2010rescission\u2010of\u2010protected\u2010areas\u2010policies\u2010undermines\u2010safety\u2010for\u2010all\/."},{"key":"e_1_2_9_3_1","unstructured":"Transactional Records Access Clearinghouse Immigration detention quick factsaccessed at May 18 2026 https:\/\/tracreports.org\/immigration\/quickfacts\/."},{"key":"e_1_2_9_4_1","unstructured":"UCLA Law Behind Bars Data Project ICE Deaths in Custodyaccessed at May 18 2026 https:\/\/uclaprisondata.org\/ice\u2010deaths\u2010in\u2010custody."},{"key":"e_1_2_9_5_1","unstructured":"A.Kocher Substack Mapping 41 ICE Detention deaths during the\u00a0second Trump administrationaccessed at May 18 2026 https:\/\/austinkocher.substack.com\/p\/mapping\u201041\u2010ice\u2010detention\u2010deaths\u2010during."},{"key":"e_1_2_9_6_1","unstructured":"National Immigration Law Center Advocating On Behalf of Patients in ICE Custody: A Resource for Healthcare Providers and Medical Staff 2026Pending publication."},{"key":"e_1_2_9_7_1","unstructured":"SB 81 \u2013 Health and care facilities: information sharing 2025 Cal. Stat. ch. 123."},{"key":"e_1_2_9_8_1","unstructured":"45 CFR 164.502(a)."},{"key":"e_1_2_9_9_1","unstructured":"42 CFR 482.13(b)(3)."},{"key":"e_1_2_9_10_1","unstructured":"U.S. Immigration and Customs Enforcement Online Detainee Locator Systemaccessed at May 18 2026 https:\/\/locator.ice.gov\/odls\/#\/search."},{"key":"e_1_2_9_11_1","unstructured":"PBNDS Standard 4.7 Terminal Illness Advance Directives and Death NDS 2025 Terminal Illness and Death Std. 4.6."},{"key":"e_1_2_9_12_1","unstructured":"NDS 2025 4.3 Medical Care."},{"key":"e_1_2_9_13_1","unstructured":"42 U.S.C. 1395dd; 42 C.F.R. 489.24."},{"key":"e_1_2_9_14_1","unstructured":"42 U.S.C. 1396b(v); 42 CFR \u00a7 440.255."},{"key":"e_1_2_9_15_1","unstructured":"ICE National Detention Standards Standard 4.6 Terminal Illness and Death 2025Available from https:\/\/www.ice.gov\/doclib\/detention\u2010standards\/2025\/nds2025.pdf."},{"key":"e_1_2_9_16_1","unstructured":"Oregon S.B. 1570 83rd Leg. Assemb. (Or. 2026)."},{"key":"e_1_2_9_17_1","unstructured":"Mass. Exec. Order No. 650 Protecting Access to Essential Services and Keeping Massachusetts Communities Safe (Jan. 29 2026)."},{"key":"e_1_2_9_18_1","unstructured":"8 CFR \u00a7 287 5(a)&(c)."},{"key":"e_1_2_9_19_1","unstructured":"42 USC \u00a7 1320d et seq.; 45 CFR \u00a7 164.502."},{"key":"e_1_2_9_20_1","unstructured":"65 Fed. Reg. 82462 82471."},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","unstructured":"Youngberg v. Romeo 457 U.S. 307 322 (1982).","DOI":"10.1056\/NEJM198207293070523"},{"key":"e_1_2_9_22_1","unstructured":"Federal courts have ruled that the care of immigrant detainees held pursuant to administrative law be assessed under a Fifth Amendment due process standard rather than the Eighth Amendment. [See Jones v. Blanas 393 F.3d 918 933\u201334 (9th Circ. 2004) cert denied 546 U.S. 820 (2005). R.I.L\u2010R v. Johnson 80 F. Supp. 3d 164 187 (D.D.C. 2015)]."},{"key":"e_1_2_9_23_1","unstructured":"8 CFR sec.287.8 (d)."},{"key":"e_1_2_9_24_1","unstructured":"42 CFR 382.13(b)(2)."},{"key":"e_1_2_9_25_1","unstructured":"Reader Supported News ICE Released sick and dying detainees avoiding responsibility 2022accessed at May 18 2026 https:\/\/www.rsn.org\/001\/ice\u2010released\u2010sick\u2010and\u2010dying\u2010detainees\u2010avoiding\u2010responsibility.html."},{"key":"e_1_2_9_26_1","unstructured":"U.S. Immigration and Customs Enforcement ICE Health Service Corps 2026accessed May 18 2026 https:\/\/www.ice.gov\/detain\/ice\u2010health\u2010service\u2010corps."},{"key":"e_1_2_9_27_1","unstructured":"22 CCR 71517 (California Hospital Regulations) 10 NYCRR 405.9 (New York State Hospital Regulations) Texas Health & Safety Code 263.084 Texas Administrative Code 306.202; NJ State Ann 26:2H\u201012.21 26:2H\u201012.22 NJAC 8:43F\u20101.1 et seq; R.I. Gen Laws 23\u201317.14\u20106(b) & RI Dept of Health Rules and Regulations for Hospitals."},{"key":"e_1_2_9_28_1","unstructured":"PBNDS 4.3 medical care J. Medical and Mental Health Screening of New ArrivalsAvailable from https:\/\/www.ice.gov\/detain\/detention\u2010management\/2011."},{"key":"e_1_2_9_29_1","unstructured":"S.Ossoff Sen. Ossoff's Ongoing Investigation Uncovers Credible Reports of Medical Neglect Denial of Adequate Food or Water in Immigration Detention 2025accessed at May 18 2026 https:\/\/www.ossoff.senate.gov\/press\u2010releases\/sen\u2010ossoffs\u2010ongoing\u2010investigation\u2010uncovers\u2010credible\u2010reports\u2010of\u2010medical\u2010neglect\u2010denial\u2010of\u2010adequate\u2010food\u2010or\u2010water\u2010in\u2010immigration\u2010detention\/."},{"key":"e_1_2_9_30_1","unstructured":"U.S. Government Accountability Office Immigration Detention: Additional Actions Needed to Strengthen Management and Oversight of Detainee Medical Care 2016accessed at May 18 2026 https:\/\/www.gao.gov\/products\/gao\u201016\u2010231."},{"key":"e_1_2_9_31_1","unstructured":"U.S. Department of Homeland Security Office of Inspector General Issues Requiring Action at the Essex County Correctional Facility in Newark New Jersey 2019accessed at May 18 2026 https:\/\/www.oig.dhs.gov\/reports\/2019\/issues\u2010requiring\u2010action\u2010essex\u2010county\u2010correctional\u2010facility\u2010newark\u2010new\u2010jersey\/oig\u201019\u201020\u2010feb19."},{"key":"e_1_2_9_32_1","doi-asserted-by":"crossref","unstructured":"D.Colby E.Shank T.Cheng andM.Singh Operationalizing California Hospital Responses to Immigration Enforcement: A Two\u2010Site Implementation Report 2026 Submitted for publication May 13 2026.","DOI":"10.1186\/s12889-026-29124-z"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70397","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.70397","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:32:57Z","timestamp":1787740377000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.70397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":31,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/acem.70397"],"URL":"https:\/\/doi.org\/10.1111\/acem.70397","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-06-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70397"}}