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Bioethics Forum Essay

New York City’s Innovative Approach to Helping Unaccompanied Minors

New York City Mayor Bill de Blasio recently announced a plan to connect unaccompanied minors who have arrived in the city from Central America with public education and health care through the legal system. Between January 31, 2014 and August 31, 2014, 4,799 children have been released to sponsors (usually family members) in New York State. Sponsors are responsible for ensuring that the children appear at all scheduled immigration court dates and comply with any related court orders. The City’s Department of Education and Department of Health and Hygiene will station representatives at Federal Immigration Court to provide children and their sponsors with information on enrolling in the public school system and the state-funded public health insurance program Child Health Plus, for which undocumented immigrants under the age of 19 are eligible.

The Bush-era William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 offered considerable new legal protections to unaccompanied minors emigrating from countries that do not border the US. This act mandates adjudication for unaccompanied minors’ asylum claims and recommends access to legal services; however, New York City has received an infusion of private funds directed at increasing access to qualified legal counsel for unaccompanied minors in order to make these rights real.

Could New York City’s plan represent a shift towards a more sustainable ethical and legal framing of the challenge of providing for the health and well-being of child migrants? In June the Obama administration described the increase in unaccompanied children crossing the border as an “urgent humanitarian situation” and invoked the Federal Emergency Management Agency to provide for the children’s needs. The language, provisions, and principles of emergency and disaster aptly respond to the vulnerability and suffering experienced especially by children seeking to escape from countries such as Honduras that are wracked by violence. However, the funds and resources allocated for emergency humanitarian aid are exceptional and temporary in nature; they are not sustainable in the long run. New York City has potentially resolved this problem by treating immigration court as a space for long-term interventions, where unaccompanied children can begin to gain access to social goods such as education and health care.

Dan Brock suggested that American political culture has given equality of opportunity a central place in theories of justice, and, for that reason, an account of justice and children’s health must respond to the special vulnerability of children. Children are typically not in a position to recognize their own health needs, and, even when they can, they are often not in a position – financially, mentally, or emotionally – to seek out and acquire the services that would address those needs. “These various aspects of children’s vulnerability bear on the special concern justice requires for the worse off,” Brock wrote in Journal of Medicine and Philosophysince this vulnerability burdens their ability to pursue a full range of opportunities in life. Unaccompanied children are particularly vulnerable, since many face incredible risks in order to leave behind home lives scarred by extreme gang violence, domestic abuse, and resource scarcity. To cross the southwest border, many of these children are smuggled or trafficked.

Government representatives, social justice advocates, and educators have been commending New York City’s leaders for recognizing the special vulnerability of unaccompanied children and for creating a mechanism for exercising a right to health care and education. Although undocumented immigrants are not eligible for federally funded public health insurance, including Medicare, Medicaid, and the Child Health Insurance Program (CHIP), New York State does use state funds to offer coverage to undocumented children and recognizes that these children are due access to health care. Such a use of state funds does not recognize a universal right to health care, but instead realizes a special right to health care for a vulnerable group.

Chelsea Jack is a research assistant at The Hastings Center.

Posted by Susan Gilbert at 10/08/2014 02:25:22 PM |

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