BMC Medical Ethics
Volume 19, Issue 1, 2018

Screening for infectious diseases of asylum seekers upon arrival: The necessity of the moral principle of reciprocity (Article) (Open Access)

Beeres D.T.* , Cornish D. , Vonk M. , Ravensbergen S.J. , Maeckelberghe E.L.M. , Boele Van Hensbroek P. , Stienstra Y.
  • a Infectious Disease Unit, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
  • b Babylon Primary Health Care Services, Elst, Groningen, Netherlands
  • c Department of Infectious Diseases, Regional Public Health Service Groningen, Groningen, Netherlands
  • d Infectious Disease Unit, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
  • e Institute for Medical Education, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
  • f Faculty of Philosophy, Department of Ethics, Social and Political Philosophy, University of Groningen, Groningen, Netherlands
  • g Infectious Disease Unit, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands

Abstract

Background: With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to timely and appropriate statutory health services. This paper explores the potential role of the principle of reciprocity, defined as the disposition 'to return good in proportion to the good we receive, and to make reparations for the harm we have done', as a mid-level principle in infectious disease screening policies. Main text: More than half of the European countries implemented screening programmes for newly arrived asylum seekers. Screening may serve to avoid potential infectious disease risks in the receiving countries as well as help identify health needs of asylum seekers. But screening may infringe upon basic rights of those screened, thus creating an ethical dilemma. The use of the principle of reciprocity can contribute to the identification of potential improvements for current screening programmes and emphasizes the importance of certain rights into guidelines for screening. It may create a two way moral obligation, upon asylum seekers to actively participate in the programme, and upon authorities to reciprocate the asylum seekers' participation and the benefits for the control of public health. Conclusion: The authors argue that the reciprocity principle leads to a stronger ethical justification of screening programmes and help achieve a balance between justifiable rights claims of the host population and the asylum seekers. The principle deserves a further and more thorough exploration of its potential use in the field of screening, migration and infectious diseases. © 2018 The Author(s).

Author Keywords

Screening Migration Reciprocity Asylum seeker Infectious diseases

Index Keywords

Vulnerable Populations vulnerable population morality refugee mass screening Europe human Refugees ethics Moral Obligations Principle-Based Ethics human rights Humans migrant Emigrants and Immigrants communicable disease control European Union patient attitude infection Patient Acceptance of Health Care Delivery of Health Care vaccination Health Services Accessibility public health health care delivery

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85042861297&doi=10.1186%2fs12910-018-0256-7&partnerID=40&md5=5b640938edb30b7563a7aacbb78eef94

DOI: 10.1186/s12910-018-0256-7
ISSN: 14726939
Cited by: 1
Original Language: English