The recent investigation by the Ravenna Public Prosecutor’s Office into medical certificates declaring migrants unfit for detention in Italian Removal and Detention Centres (CPRs) provides an opportunity to reconsider the protection of health in these facilities, as well as the conditions under which physicians are required to assess migrants’ medical suitability for detention.

Under Article 32 of the Italian Constitution, the right to health is recognised as a fundamental right of the individual and as an interest of the community. In the context of immigration detention, this right entails the prohibition of admitting or keeping in a CPR individuals whose health conditions or particular vulnerabilities are incompatible with detention. Italian legislation therefore requires a medical assessment before admission, aimed at identifying diseases, psychiatric disorders, acute or chronic conditions, and forms of vulnerability that may make detention incompatible with the individual’s health and dignity.

Recent research conducted by the authors, based on an analysis of the relevant legal framework and interviews with healthcare professionals working in this field, has highlighted significant shortcomings in both the regulatory framework and its practical implementation. Medical examinations may be extremely brief, specialist assessments may be unavailable, physicians may lack adequate information about the conditions of the destination facility, and the presence of law-enforcement officers may interfere with the doctor–patient relationship. These factors may undermine the completeness and independence of the medical assessment and render the admission screening insufficiently effective in identifying vulnerable individuals.

Against this background, the proceedings initiated by the Ravenna Public Prosecutor’s Office against physicians who issued certificates of unfitness for detention raise fundamental questions concerning the relationship between medical autonomy, criminal liability and immigration detention. Without anticipating the outcome of the proceedings, the case provides a valuable starting point for examining the need to safeguard physicians’ professional independence when they are called upon to assess whether detention is compatible with an individual’s health and vulnerability.

The paper argues that effective protection of health in CPRs requires not only clearer and more adequate procedures for assessing fitness for detention, but also safeguards capable of ensuring the clinical autonomy and independence of the healthcare professionals entrusted with this assessment.