Recent Canadian immigration reforms and their consequences for migrant children and families' health: the "globalization of indifference"?

Despite its reputation as a welcoming nation to refugees, Canada has enforced increasing restrictions on asylum, even in the face of evidence from the United States and around the world of the profound harm such restrictions cause. In this paper, we outline recent Canadian legal and policy reforms and their potential impacts on refugee health equity. Following Farmer's approach of ethnographic case narratives that aim to portray how current policy and legislation are embodied and felt in migrants' lives, we document avoidable harms to migrant children and families. Our data come from qualitative research with inadmissible asylum seekers and narrative pastiches from clinical encounters. We discuss the potential public health implications given the existing evidence on the social determinants of refugee mental and physical health. Given the global push towards increasing restrictions on migration and asylum, we ask what clinicians are to do when they are confronted by the social and political conditions that produce suffering for migrant children and families, but we also explore our clinical and political obligations to bring into view those who are rendered invisible by marginalizing policies. Ultimately, we call for a clinical ethics that resists the institutionalization and 'globalization of indifference'.