Skip to main content

Should Medical Societies Boycott Arizona?

Roughly 150 members gathered last week at a Town Hall meeting at last week's annual meeting of the Society of General Internal Medicine (SGIM). This meeting was put together by the SGIM Council to discuss member's opinions about holding the 2011 annual meeting in Phoenix, Arizona, in the light of the new immigration legislation recently passed by the state.

Arizona's new immigration law, SB-1070, dominated news headlines for about two weeks straight, at least up until the growing disaster with the Deepwater Horizon. SB-1070, the nation’s most stringent state-mandated immigration measure, was approved by the Arizona State legislature and signed by the Governor Jan Brewer. It is aimed at curbing undocumented immigrants from living and working in Arizona. The law makes the failure to carry immigration documents a crime and gives police broad power to detain anyone suspected of being in the country illegally. Proponents call it a necessary response to a growing crisis. Opponents call it discriminatory, leading to open harassment against Hispanics regardless of their citizenship status.

What we learned from the SGIM town hall, and from an email to the society's members today, is that members had diverse opinions on what to do, highlighting the complexity of this issue. Many members thought it was a good idea to boycott Arizona, despite the fact that SGIM would lose most of its $500,000 cash reserves due to contractual obligations. Many members felt SGIM should hold the meeting in Arizona as a time to "engage" the community about the issues with the new legislation. Some wanted to protest in Phoenix, wearing white coats and stethoscopes in a march to the capitol. One person suggested that we should chain ourselves to buildings and get arrested. Another person was concerned that the law was being dismissed out of hand by the society without attempting to address the underlying issues that led to the law’s passage. There were also members who commented by email who thought anything like a boycott should be abandoned as it is peripheral to the main goals of the society.

Maria Hinojosa, host of NPR's Latino USA, recently gave an editorial that best encapsulates the complexity of these discussions:
"Now if anyone part of you thinks that this is a simple issue, we are going to ask you to rethink that view - it's not. There is nothing simple about what is going on here. In the balance are human lives. Some will cross the Frontera tonight. Some are hiding in safe houses on their way to agricultural work in Georgia. Some are angry that they are targets of police interests. Some are angry that the police are not doing enough. Some want to the border closed down, locked like a garden gate with some inside and some outside. Some see a political struggle. Some see a human rights struggle. Some see a family issue. And some see a law enforcement issue"... "And, so we pause for a moment to say "amaze me America".

So now I say amaze me medical societies. I don’t know what the right answer is. I don't know if this is something that is even within the mission of our medical societies. I also don't know whether any planned economic sanctions will hurt the very people it plans to protect.  I do know that it is important enough of an issue that it needs to be discussed in an open, honest, and respectful way. I also know that this is not just an issue for SGIM. Many medical societies are beginning to plan for their 2013, 2014, and 2015 annual meetings, and picking the candidate cities to hold them in. It is time these other medical societies taking a cue from SGIM by opening up the discussion.

I look forward to hearing AGS, AAHPM/HPNA, NHPCO, ASA, GSA, AMA, and AAHCP with an answer to the question: how should professional societies react to what is happening in Arizona?


Alex Smith said…
One of the most poignant comments at the SGIM town hall meeting was from the lone physician from the state of Arizona. She said that she works with undocumented immigrants on a daily basis, and these are the taxi drivers, cooks, and bellhops who would be hurt most by boycotting Arizona.
Patrice Villars said…
In general, I don't think that disagreement with policy necessitates action that harms the people. I do like the idea of keeping the conference in Arizona and staging passionate, well organized protests in support of and with the support of the people effected.
Anonymous said…
I favor a boycott. Money is the only thing that people and politicians respond. As a point of interest it was boycotts that feuled the civil rights efforts of the 1950's and 1960's. It was the local boycot of the bus system that forced the city bus system to allow Blacks to sit anywhere on city buses. In fact in recent years it was boycotts in Arizona especially the threat by the NFL to force the issue on the King holiday.

I am ashamed of the MLB for not proceding with a boycott. The have stood up for civil rights starting with Jackie Robinson.

The issue with the border is 3 fold. 1. Immigration 2. Drug 3. Non National security

Truly an imigration problem and a drug problem. The drug problem is the key. Few of those coming across are involved in drug. It my be simple but if Americans were not such drug users then there would less problems at the border. We are feuling the problem.

As for security every one who has hurt or tried to hurt us had a legal visa at one time. We need to do a better job of screening the legal be coming.

We need to take owership of the real issues
Judy Dobson said…
Those of us who do not live there should think twice about what our role should be in conference decisions. The good people in Arizona are doing the best they can to serve immigrants when they need emergent care or hospitalization, jobs, or services. We don't know the financial impact this state has experienced being so close to the border, nor are we experiencing the violence that comes with those who are selling drugs. To withdraw finances by way of conferencing in this state would make it more difficult for those working in those venues to support their families, whether legal or illegal.
Is this decision supposed to be a focus of palliative care or geriatric care?
Think about the current political situation and indeed,many of the decisions of the past 40 years in this country. We may not have agreed with legal PAS or abortion, but we work within to still maintain the dignity of all human beings.
Do we take our toys and go home? And tell Arizona "Take that!", or do we try to help find solutions that respect all?
libhom said…
I wouldn't go to a meeting in Arizona. I don't want to be surrounded by all the racist sociopaths that live there.
Eric Widera said…
Great point Judy. The very hard thing about a boycott is that it wouldn't hurt the hotel chain or the convention center - they will get their money anyways. It will hurt the waiters, housekeepers, janitors, taxi cab drivers, etc.

I did think it was important enough of an issue to discuss, as did the SGIM leadership. Even though we may disagree about topics like PAS, we still discuss it (there was a symposia on PAS at the annual meeting of AGS today).

I would disagree with libhom too. This is too complex of an issue just to make a blanket statement that Arizona is racist. This type of protest will accomplish nothing, and will only increase the divide between opposing camps. What we need is open, honest discussion about the issues (immigration, cross-border crime, civil liberties, state vs federal rights). What I liked most about Maria Hinojosa's editorial is that she was able to see the strong viewpoints on all sides. We should do the same, and then decide what we want to do about it.

Popular posts from this blog

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Dying without Dialysis

There is a terrific article in this weeks Journal of Pain and Symptom Management by Fliss Murtagh of King's College in London about the epidemiology of symptoms for patients with advanced renal failure who die without dialysis.  This study is important because while we know that patients with advanced renal failure have a limited life expectancy and the average age of initiation of hemodialysis is increasing, we know little about the alternatives to hemodialysis.  Specifically, we know nothing about symptoms affecting quality of life among patients who elect not to start dialysis (so called "conservative management" - is this the best label?).  This article provides a terrific counterpoint to the article in last years NEJM showing that nursing home residents who initiated hemodialysis tended to die and decline in function (see GeriPal write up here). 

The study authors followed patients with the most advanced form of chronic kidney disease (the new name for renal failu…

Survival from severe sepsis: The infection is cured but all is not well

Severe sepsis is a syndrome marked by a severe infection that results in the failure of at least one major organ system: For example, pneumonia complicated by kidney failure. It is the most common non-cardiac cause of critical illness and is associated with a high mortality rate.

But what happens to those who survive their hospitalization for severe sepsis? An important study published in JAMA from Iwashyna and colleagues provides answers and tells us all is not well. When the patient leaves the hospital, the infection may be cured, but the patient and family will need to contend with a host of major new functional and cognitive deficits.

Iwashyna examined disability and cognitive outcomes among 516 survivors of severe sepsis. These subjects were Medicare enrollees who were participants in the Health and Retirement Study. The average age of patients was 77 years.

When interviewed after discharge, most survivors were left with major new deficits in their ability to live independently. …