US Treatment of Migrant Children Falls Under UN Definition of 'Torture,' Doctors Say

A new paper, published on the website of the medical journal "Pediatrics" on Tuesday, calls the federal government's handling of migrant children at the border "consistent with torture" and recommends that pediatricians and child health care professionals take action.

"There's been a really active dialogue across the country with child health professionals about the difference between: 'Is this child abuse and neglect that's going on in detention centers and foster homes related to those detention centers, or is it torture?'" said Coleen Kivlahan, a family medicine doctor at UCSF and the co-chair of the UCSF Health and Human Rights Initiative who co-authored the paper.

The conclusion, according to the paper, is that the "treatment of children at the border constitutes cruel, inhuman, or degrading treatment that rises to the level of torture."

The United Nations Convention against Torture defines torture as follows:

Any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.

The paper argues that the government's treatment of migrant children falls under three criteria from this definition, as well as the Rome Statute of the International Criminal Court.

Researchers argue that actions like family separations caused "severe pain and suffering" and were inflicted with a specific purpose and with the consent of government officials — oftentimes by order from the president himself.

"I would describe cages and sleeping on the floor and being forcefully separated from their parents as severe pain or suffering. No different than I would if someone was beaten with a truncheon," Kivlahan explained.

"'Did in fact that occur for a purpose?' Of course it occurred for a purpose. And there are public statements regarding the purpose, and that is to deter people from crossing the border, and especially from [bringing] your children across. And ... it absolutely is done by people working in an official capacity."

In 2019, the American Academy of Pediatrics reported that family separation can cause toxic stress in children and can damage their developing brains.

Dr. Zarin Noor, who also co-authored the paper, has seen these impacts firsthand. A pediatrician in Oakland, Noor said toxic stress can cause medical issues in children like speech delay, anxiety, aggressive behavior and depression, as well as long-term health impacts like diabetes.

And it's not just children who are impacted by these policies. According to Kivlahan, who practices family medicine at UCSF, the impacts can be intergenerational.

"This becomes a multigenerational story of loss and trauma ... that impacts entire populations and is completely avoidable and preventable by making sure that we never engage in policies like this that can have this level of long-term impact," she said.

A February study from the nonprofit Physicians for Human Rights found that parents who'd been separated from their children at the border often experienced “pervasive symptoms and behaviors consistent with trauma,” and most met the conditions for “at least one mental health condition,” like post-traumatic stress disorder (PTSD) or major depression.

Dr. Noor also pointed out that the stress families are experiencing didn't necessarily start at the U.S. border – what happens there may be adding to an already stressful situation.

"Families and children who are fleeing their country ... We know that they're leaving traumatic things. They're fleeing from violence or things that are harmful to them and their family ... so that's one part of the trauma," she said. "And then they have the trauma that they are facing during migration, whether it's walking four miles, whatever it is to get to the border. And then they're dealing with another trauma of being separated from their family."

In the paper, the authors calls on pediatricians and child health professionals to take action to combat this treatment of children, including by:

• Training in "forensic assessments to identify, document, and disseminate the effects of severe ill treatment on migrant children"
• Using the conventions of international law, including the UN Conventions on the Rights of the Child and against Torture, to frame advocacy
• Collaborating with families and cross-disciplinary groups, like Doctors Without Borders and Human Rights Watch, to develop programs, policies and systems "related to children on the move at the border and globally"

The paper also calls on the American Academy of Pediatrics (AAP) to immediately demand worldwide reunification of separated families, issue a policy statement on torture and child rights and initiate or support a case against the United States in the Inter-American Commission on Human Rights, in collaboration with other organizations.

"They're just children. And I think that we just need to remember that, that they are children and they need our protection," Noor said.

"They need ... pediatricians and child health providers, but also [they need] the public to really look at them and say, 'these are children, these are children just like our children, and they need our protection and they have rights just as we do.'"