Why Does This Hit So Hard in the ED?
As an emergency physician with a public health lens, I want you to imagine this scenario: a man showing up at 3 a.m., shirt still stained from drywall dust. He’s been hiding a deep cut from a power tool for several days because he heard ICE raided the job site next door. By the time he comes in, the wound is swollen, streaked with infection, and his hand barely moves. He’s now septic with an untreated open fracture. He tells you — through an interpreter — that he’d rather lose a limb than be deported. But now, he requires emergent surgery.
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ACEP Now: January 2026That’s the avoidable burden that I have seen.
In the emergency department, we are trained that time equals tissue. Whether that tissue is myocardium or bacteremic bone — delay costs. And when avoidance is driven not just by lack of resources but also by fear of deportation, we’re facing a social determinant of health in real-time. Moreover, when ICE agents show up in health care spaces (or are perceived to), trust evaporates. One hospital reported agents entering patient care areas without warrants, refusing to identify themselves, restraining detainees in cuffs while medical decisions were being made, and preventing doctors from contacting families.4 That undermines confidentiality, trust, and physician-patient autonomy — everything we rely on for safe, high-quality care.
This is no longer just an immigration issue. It is a public health issue. The rippling effects impact all of us. A study in New York reported that patients who feared ICE were three times more likely to delay care for tuberculosis (TB), even though untreated TB threatens the broader public.10 When fear prevents community members from seeking care, communicable diseases spread, ED volumes grow, hospitals’ resources become strained, and patient outcomes worsen.
We should call for hospital-level data surveillance linking enforcement events with care avoidance and injury trends, including use of force by law enforcement. We need hospital staff training and policies to handle these interactions ethically, in a way that protects all patients regardless of immigration status. And we must demand that agents should not be allowed to undermine physician treatment or patients’ access to care. Because, as much as I love the drama of a trauma bay, the quiet ones scare me more — the person who avoided coming in until it was too late, the parent who skipped their child’s follow-up appointment because ICE might show up at the clinic, the hospital corridor where patients glance over their shoulder and wonder if someone in uniform will step through the door.
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4 Responses to “The Chilling Effect of ICE Raids on Emergency Medicine”
January 18, 2026
James E Boland MDIt is fashionable these days to criticize ICE for every misfortune that befalls anyone in vicinity of an ICE raid I think a corollary study of the trauma caused by criminal illegal aliens would be in order here. Maybe we could start with the trauma caused by debt collection practices of Tren de Aragua where first they cut off the debtors finger, then a hand, then murder the debtor. I could go on and talk about what happens in the basements of the CCP’s secret police stations in many American cities but, you get the picture.
The actions of ICE are protecting vulnerable immigrant populations legally present or otherwise just as much as they are American citizens.
February 1, 2026
Charles Akin, MDI agree.
February 1, 2026
Charles AkinOur Immigration Control and Enforcement (ICE) officers are simply enforcing immigration law as spelled out in the 1996 ILLEGAL IMMIGRATION REFORM AND IMMIGRANT RESPONSIBILITY ACT OF signed into law by President Bill Clinton
and the Secure Fences Act signed into law in 2006 by President George W. Bush.
The chaos we are all witnessing today is the direct result of four years of the Biden Administration’s reckless open borders policy which allowed up to twenty million foreign nationals to illegally enter into our country between lawful ports of entry and to file bogus asylum claims. When this many people invade our country it stands to reason that a whole bunch of dangerous people will come with them. It stands to reason when millions of illegal migrants embed themselves into the lawful population any attempt to detain these illegal migrants will impact innocent people.
When sanctuary city policies prevent local police forces from releasing the jailed criminals to federal officers where arrests can be carried out in controlled environments then we have even more chaos. The downside of all this stuff is being felt everywhere in our country, and our emergency departments are not immune.
February 13, 2026
William Allen MDThis kind of article is the exact reason I surrendered my FACEP/ACEP membership.