Clinician Moral Injury and Immigration Policy

Since January 2025, this country has undertaken what is likely among the most expansive immigration enforcement agendas in modern US history. Immigration policy has focused on aggressive enforcement tactics rather than integration and immigrant well-being. This policy agenda and its enforcement have resulted in fear, isolation, and decreased health care utilization among those with immigrant backgrounds. Additionally, the provision of health care has been affected by policies allowing Immigration and Customs Enforcement (ICE) agents to enter previously protected locations including hospitals, and sharing data between the Centers for Medicare & Medicaid Services and Department of Homeland Security. A less well-known effect of the increased immigration enforcement is the harm experienced by those clinicians caring for immigrant populations, through moral injury and vicarious traumatization. This issue of JAMA Internal Medicine includes 2 articles exploring the moral injury experienced by clinicians caring for immigrant patients in the US during the recent, and ongoing, surge of immigration law enforcement action.