What Are the Rules for Ethical Medication of Migrant Kids?

With Arthur L. Caplan, Ph.D., NYU School of Medicine

Reports that migrant children held by the Office of Refugee Resettlement are being drugged require an immediate and unambiguous response by the Trump administration. According to court filings, the drugs that are alleged to be among those given to children without their parents’ consent include Clonazepam, Duloxetine, Guanfacine, Geodon, Olanzapine, Latuda and Divalproex.

Drugging children without consent or adequate follow-up is a gross violation of their rights and welfare. The effects of these powerful psychotropic medications must be carefully monitored, especially in children whose reactions may be unpredictable and whose medical histories are unknown.

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The government has a special moral burden to take extreme care in these cases because the children have been forcibly separated from their parents, their natural protectors and surrogate decision-makers. At the very least, before any drug is given a local magistrate should appoint a legal guardian to represent the child’s best interests and a psychiatrist should be consulted, and approve and monitor the child’s care. This must not be merely a paper process. The guardian and the psychiatrist must actually interview and observe the child. They are accountable for the child’s welfare.

Too often mental health care drugs have been used to make the job of caregivers easier rather than in the service of the patient’s best interest. Especially when children are isolated from their families, that balance must be carefully and independently assessed.

In a situation in which the local caregivers are not even allowed to physically comfort very young children, some younger than four years old, they are put in a morally unacceptable position and require the assistance of a legal guardian and qualified physicians in making medication decisions.

The greatest fear of any parent is that their child is being neglected or subjected to dangerous conditions. All parents can easily identify with those fears.

Beyond the moral and humanitarian issues, if adequate medical and psychological safeguards are in place to protect these children and minimize the emotional damage to which they have already been subjected American taxpayers deserve to know what they are.

These innocent victims of adult politics deserve protection from a confusing and often cruel world they didn’t create. The President and his administration should step up and make sure that these children are not being mistreated or abused.