The Human Cost of Medical Neglect in ICE Detention

Mariee Juárez, a healthy 18-month-old, and her mother fled Guatemala in fear for their lives. They were detained at the South Texas Family Residential Center in Dilley, Texas, while awaiting approval of their immigration status. While there, they shared a single room with five other mothers and their children. Shortly after their detention began, Mariee developed a severe respiratory infection. Medical care at the facility was delayed and inadequate. Tragically, Mariee died from a catastrophic hemorrhage while in detention. Her story shows the human cost of medical neglect in ICE detention.

Marie's death is not an isolated incident. Medical negligence and malpractice have been documented at hundreds of ICE detention facilities, with news outlets regularly reporting similar cases. Thousands of people are detained daily, and face delayed medical care, insufficient medical staffing, overcrowded facilities, inhumane conditions, and delays that can sometimes be fatal.

Detainees' ability to hold accountable those who mistreat them is significantly affected by the facility type, their detention status, and the legal framework governing the system. Although medical maltreatment is documented across both public and private ICE detention facilities, the legal frameworks governing accountability differ substantially by facility type and detention status. These uneven legal regimes fail to prevent medical neglect and often limit detainees’ ability to seek redress after harm occurs.

Immigration and Customs Enforcement, widely known as ICE, was created in response to the terrorist attacks of 9/11 and has grown exponentially since then. The federal government chose not to bear the costs of creating and operating all these facilities itself, so it contracted with private companies to supply beds to house the growing number of detainees. This rapid historical growth and privatization set the stage for accountability concerns about the quality of medical care afforded to the growing number of detainees.

Not all detention facilities are held to the same standards. Public jails are considered state actors and must comply with constitutional rules. Private companies, even operating under federal contracts, do not have the same obligations. These differences can create accountability gaps and make it harder for detainees to enforce their rights. Detainees in private facilities often have even more limited legal avenues when their health is put at risk, leaving them vulnerable.

Ursula Border Patrol processing center in Clint, Texas, a U.S. Customs and Border Protection (CBP) facility. CBP and ICE work closely together within the Department of Homeland Security

ICE detainees are entitled to adequate medical care under the Constitution. Because immigration detention is civil rather than criminal, detainees are protected under the Fifth Amendment Due Process Clause. This clause guarantees that all detainees have a constitutional right to safe conditions and adequate medical care. So in theory, these protections should prevent medical neglect. In practice, however, they rarely do. Even when detainees experience serious harm, enforcing these rights is extremely difficult. Legal remedies are very slow and often unavailable when quick action is needed. By the time a lawsuit is possible, the damage has already been done.

Medical neglect in ICE detention facilities is systemic rather than exceptional. Overcrowding, lack of staff, poor infrastructure, and weak enforcement allow medical neglect to exist across both public and private facilities, leaving detainees with few realistic options when harm occurs.

To improve transparency and legal accountability in ICE detention centers, we need to expand the use of habeas corpus petitions to address medical neglect and make ICE’s Performance-Based National Detention Standards (PBNDS) legally enforceable. Habeas petitions can challenge not only the fact or duration of detention, but also its lawfulness when conditions pose a serious threat to health or life. Expanding judicial acceptance of habeas petitions challenging medical-based detention would provide detainees with a faster, more effective means of relief than the existing civil litigation options discussed above. Importantly, habeas does not replace other legal remedies but can quickly protect detainees from immediate harm, mitigating the effects of slow and ineffective lawsuits.

While habeas petitions can provide emergency protection against unlawful detention from medical neglect, enforceable PBNDS standards are necessary to prevent such conditions from arising in the first place. ICE’s Performance-Based National Detention Standards (PBNDS) are guidelines for detention centers to follow rather than legal obligations. Congress should turn PBNDS into a binding DHS law, which would allow ICE detainees to file their own lawsuits when their rights are violated (as they cannot now) and impose financial penalties for failure to conduct medical inspections (such as fining the operator or canceling contracts).

The problem of medical neglect in ICE detention exists whether a facility is private or public. Legal protections exist on paper, but do not protect detainees in practice. Without significant federal changes to accountability and enforcement, medical neglect will continue to define immigration detention in the United States.

By Stella Strassberg '26

Published on 12/22/2025