Recently, ASGI issued the appeal “Care is not a crime” following an investigation involving doctors of the Infectious Diseases Unit of the Ravenna hospital who had issued medical certificates declaring migrants ineligible for detention in Centers for Permanence and Repatriation (C.P.R.). While judicial proceedings are ongoing, the case has renewed attention to the protection of the health of migrants detained pending the execution of expulsion orders.

Under Article 14 of the Immigration Act, detention in a C.P.R. is permitted only after a medical assessment confirming the migrant’s psycho-physical eligibility to remain in a restricted community. The certificate is therefore a necessary prerequisite for the validation of administrative detention and doctors play a decisive role in balancing the enforcement of migrants removals with the constitutional right to health (Art. 32 of the Italian Constitution).

Research conducted within our Legal Clinic and published in the Italian Journal of Legal Medicine (Rivista Italiana di Medicina Legale) highlights structural weaknesses in the current system. The regulatory framework is fragmented across primary legislation, ministerial directives, and local implementing acts, resulting in limited coherence and insufficient procedural safeguards, particularly regarding the independence and conditions of clinical assessments.

Interviews with healthcare professionals reveal practical difficulties: limited time, reduced access to specialist examinations, and inadequate knowledge of the actual conditions within C.P.R.s. Some doctors report ethical concerns, as certifying eligibility for detention may conflict with professional deontological principles, especially given that C.P.R.s are regarded as potentially harmful environments. Moreover, migrants declared unfit for detention often lack effective access to healthcare outside the centers.

Given the sensitivity of the issue, and the stance taken by the National Federation of the Orders of Medical Doctors and Dentists (FNOMCeO), a comprehensive reform is needed to establish clearer and more coherent rules; adequate safeguards for migrants’ health; and proper protection for medical professionals working in this delicate area.