The systematic detention of migrants and asylum-seekers is increasingly used as a tool to restrict the influx of migrants and refugees, affecting hundreds of thousands of migrants in host and transit countries. Medecins Sans Frontieres (MSF) has worked in immigration detention settings and has exposed the detrimental impact of detention on migrants’ health. This work has also led to a series of ethical challenges related to working within an incarceration system that inherently limits efforts to alleviate suffering. The dilemmas faced by aid workers include issues of independent action, access, acceptance, and responsiveness to beneficiary needs. First, unrestricted access is impossible in prison-like facilities where daily operations are dependent on state consent. Secondly, when access is granted, MSF teams risk being perceived as part of the detention system, or at least seeming to collaborate with and accept it. Thirdly, the relevance and effectiveness of intervention is limited when the intervention setting is inherent to the suffering that humanitarian action seeks to alleviate. Such issues raise the question of when MSF’s “ethic of refusal” should apply, as well as illustrating the sacrifices aid agencies have to make in difficult and restrictive conditions.

中文翻译：

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拘留移民和寻求庇护者：人道主义行动者面临的挑战

对移民和寻求庇护者的系统拘留越来越多地被用作限制移民和难民涌入的工具，影响到东道国和过境国的数十万移民。无国界医生组织 (MSF) 曾在移民拘留场所工作，并揭露了拘留对移民健康的不利影响。这项工作还导致了一系列与在监禁系统内工作相关的道德挑战，该系统本质上限制了减轻痛苦的努力。援助工作者面临的困境包括独立行动、获取、接受和对受益人需求的响应等问题。首先，在日常运作取决于国家同意的类似监狱的设施中，不受限制地进入是不可能的。其次，当允许访问时，无国界医生团队有可能被视为拘留系统的一部分，或者至少似乎与它合作并接受它。第三，当干预环境是人道主义行动寻求减轻的痛苦所固有的时，干预的相关性和有效性是有限的。这些问题引发了无国界医生“拒绝伦理”何时适用的问题，并说明援助机构在困难和限制条件下必须做出的牺牲。