Decarcerating Immigrant Detainee Medical Care: A Path to Doctrinal Redemption

Kieran Dosanjh

B.A. 2019, University of California, San Diego; J.D. Candidate 2024, The University of Chicago Law School.

I would like to thank Professor Nicole Hallett and the editors and staff of the University of Chicago Law Review for their thoughtful advice and insight. I would also like to credit Dr. Christine Montross, whose work sheds a much-needed interdisciplinary light on this topic. Finally, I would like to acknowledge the countless immigrants with whom I grew up in central California. You remain a constant source of strength in our community.

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Government detention is a quid pro quo: the government may deprive persons of their physical liberty, but in exchange, it owes them a level of care. The critical question is, how much care does the Constitution require the government to provide? In a series of federal judicial decisions (collectively, the detainee medical care doctrine), courts have found that the Constitution requires different standards of care for different classes of government detainees. These courts’ standard of care for immigrant detainees is erroneous. Modern U.S. immigration detention’s descriptive resemblance to criminal confinement has prompted courts to (wrongly) find that immigrant detainees are constitutionally entitled to the same standard of medical care as pretrial criminal detainees. Yet, the constitutionally civil status of immigration detention distinguishes it from pretrial criminal detention in doctrinally salient ways such that the Constitution entitles immigrant detainees to a higher standard of medical care. This Comment charts a path to conforming the immigration detention jurisprudence within the doctrine to what the Constitution requires by answering this question of law, which was recently unsettled by the Supreme Court’s 2015 decision in Kingsley v. Hendrickson and the Fourth Circuit’s 2021 decision in Doe 4 ex rel. Lopez v. Shenandoah Valley Juvenile Center Commission: What adjudicatory standard should govern immigrant detainees’ claims of constitutionally inadequate medical care? After devising a doctrinal test and applying it to immigrant detainees, this Comment concludes that the Constitution entitles them to “medical professional judgment”: medical care must not substantially depart from accepted medical standards.

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