Remembering Francisco Castañeda

On Monday, we got a disappointing Supreme Court decision (PDF) that immunizes government doctors from personal liability for providing constitutionally inadequate medical care. But in that bad decision is an important acknowledgment that in Hui v. Castañeda "the Government filed a formal notice admitting liability with respect to...medical negligence." Francisco Castañeda lost his life at age 36 because of that negligence. The ACLU has been involved in the Castañeda case for more than three years. We urge that his memory be honored by Congress enacting reforms to the immigration detention system that caused his premature death.

A legal resident of the United States who fled civil war in El Salvador at age 10, Castañeda was placed in a San Diego immigration detention facility in 2006 after serving a four-month state sentence for a drug conviction. During his detention, Castañeda suffered from excruciating pain caused by a draining penile lesion and a lump on his groin. Despite repeated doctors' requests for Castañeda to have a biopsy, the Division of Immigration Health Services (DIHS) refused to approve it. Castañeda was told his treatment was unnecessary because it was "elective in nature." He was prescribed ibuprofen and antibiotics and given extra boxer shorts.

It took a fourth specialist's recommendation — 10 months after Castañeda first asked for attention and only with ACLU intervention — before the biopsy came close to happening. Even then, instead of giving Castañeda proper medical care, Immigration and Customs Enforcement (ICE) released him. One week later, a biopsy Castañeda arranged himself confirmed that he was suffering from penile cancer. The next day, Castañeda had his penis amputated. He started chemotherapy after learning that the cancer had spread to his groin. Treatment was unsuccessful, and Castañeda died in February 2008.

Francisco Castañeda made the most of his remaining year after being freed. He testified before Congress, alongside bereaved relatives of immigrants who had died in ICE detention, saying "I have a young daughter, Vanessa, who is only 14. She is here with me today because she wanted to support me — and because I wanted her to see her father do something for the greater good, so that she will have that memory of me. The thought that her pain — and mine — could have been avoided almost makes this too much to bear."

Castañeda implored Congress to act to repair the systemic problems that regularly lead to substandard medical care in immigration detention facilities: "It was routine for detainees to have to wait weeks or months to get even basic care. Who knows how many tragic endings can be avoided if ICE will only remember that, regardless of why a person is in detention...they are still human and deserve basic, humane medical care." (You can listen to a podcast of Castañeda describing his ordeal.) Castañeda's case received wide media attention as a tragic window into the immigration detention crisis, with the New York Times, 60 Minutes, and the Washington Post among others providing extensive coverage. Prodded by an ACLU Freedom of Information Act lawsuit, the government revealed that more than 100 detainees have died in ICE custody since October 2003. The documents released by the government also expose a health care system that places detainees at serious risk of harm and death.

The Supreme Court's decision in Hui v. Castañeda wrongly forecloses a vital way to deter unconstitutional conduct. The district court's observation that Castañeda's allegations, if proven at trial, describe "conduct that transcends negligence by miles" and present "one of the most, if not the most, egregious Eighth Amendment violations the Court has ever encountered" still holds true.

Congress should act promptly to realize Castañeda's dying wish to "do something for the greater good" of all immigration detainees. The ACLU supports fundamental reform of the immigration detention system. Reform must include robust and independent oversight of ICE detention facilities, which are vastly overused for individuals who are not dangerous or flight risks needing expensive incarceration. Pending before Congress is the Strong Standards Act, which would mandate ICE accountability by making humane immigration detention standards, including those governing medical care, binding and enforceable. Congress cannot forget our national shame that Francisco Castañeda was allowed to suffer and die: Immigration detention reform is an urgent priority that with each passing month sadly continues to be treated as elective in nature.