Changes to immigration act fall well short, says U of T Scarborough expert

Section 38
CBC News reporters spoke to demonstrators gathered outside of the Toronto office of Immigration Minister Ahmed Hussen. (Photo by Laura Bisaillon)

Don Campbell & Joseph Burrell

This past Monday federal Immigration Minister Ahmed Hussen announced changes to the Immigration and Refugee Protection Act (IRPA).

The changes, which relate to Section 38(1) of the act, will ease some of the restrictions placed on immigration applicants to Canada based on illness and disability. Under the law these applicants can be deemed medically inadmissible on the grounds they would be costly to the public purse, including costs for care and treatment.

But advocates say the proposed changes don’t go far enough. They argue that a full repeal of the section is necessary since those with an illness or disability are still discriminated against.

Assistant Professor Laura Bisaillon is a social scientist at U of T Scarborough, whose work focuses on the sociology of health and illness. Over the last decade, she has dedicated herself to documenting the experiences of people disenfranchised by Section 38(1).

We spoke with Bisaillon about the recent changes to the act, including how they fall short.

Can you describe the mood among advocates who worked change the IRPA?

As individuals and members of various organizations across Canada, we were very disappointed with the Minister's announcement. The cooperative mobilization on this issue has accounted for thousands and thousands of working hours over years for those involved. The work done by these advocates and researchers helped inform the review of the act.

Soon after the announcement was made, we met by teleconference. We are from all walks of life – different ages, countries of birth, abilities, and professions. Some of us have personal experience with the implications of being made medically inadmissible, and we live with the consequences as part of our daily family life. Together we de-debriefed, discussed the announcement and its consequences, and issued a joint press release that day.

In your opinion, why do these changes to the section fall short?
I could offer a principle-based, cost-based, or human face argument as to why it’s necessary to fully repeal this section. I have worked on medical inadmissibility for over a decade. I have published scholarly articles on the issue. I also live with a health condition that would make me medically inadmissible if I were not already a citizen. This is a key motivator for my dedication.

On principle, we see health-based discrimination in Canadian law, and this is not okay. When it comes to cost, people with disease and disability contribute, measurably, to society. Period. As far as putting a human face on this issue, there are myriad examples.

The immigration system looks with particular focus at applicants with HIV. How and when did this happen?

Since 2002, Canada has mandated HIV testing, so people who want to come to Canada long-term are tested. HIV had become a manageable infection at the time.

I looked at the available research on medical inadmissibility, found disconnects, and investigated them. The lion’s share of immigration medical examinations happen outside Canada, and the state cannot know how testing happens in practice.

My job and passion, as a researcher, is to make sense of society’s institutions. I want us to understand them so that we can navigate rather than be confused by them. We have doctors medically screening applicants, but they are not doctoring in this instance. They detect pathology and produce a medical file that informs decision-making about exclusion. Doctors are being asked to practice in these unethical professional waters.

Laura Bisaillon
Laura Bisaillon, is an assistant professor in the health studies program of the department of anthropology at U of T Scarborough. (Photo by Ken Jones)

You mentioned putting a human face to this issue. Can you talk about instances of exclusion based on HIV status?

There is the case of one man who was sponsored by his Canadian daughters, but denied. The decision was based on assumptions about his morality and sexual practices. These assumptions, of course, are deeply problematic.

In 2010, I published an article and led with the words of a postdoctoral researcher from Brazil who came to work in Canada. While she tested negative for HIV through immigration, once in Canada, she spoke to colleagues from Scandinavia whom she discovered did not have to undergo HIV testing. From a prior career, I knew a Canadian woman who had been in a sexual relationship with a French national living in Canada. Since Canada does not test short-term residents from France for HIV, he did not know his positive status. Unwittingly, she was infected.

What’s the take-home from these cases? Policies and practices must apply equally. Right now, that’s not happening.

What are the next steps for those wanting full repeal? Can pressure be put on Minister Hussen to revisit the issue?

In alliance with one another, as individuals and groups across Canada, we will continue our legal reform work. I believe a full repeal of medical inadmissibility within the immigration system will happen. Look at it this way – between us, we have hundreds of years of experience doing social and legal reform work. We will continue to generate scholarly and experiential evidence to support full repeal. It is not a matter of if a full repeal will happen, but rather, a matter of when.