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2016 ; 44
(ä): 72-78
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"An absolutely necessary piece": A qualitative study of legal perspectives on
medical affidavits in the asylum process
#MMPMID27639654
Scruggs E
; Guetterman TC
; Meyer AC
; VanArtsdalen J
; Heisler M
J Forensic Leg Med
2016[Nov]; 44
(ä): 72-78
PMID27639654
show ga
A key challenge for asylum seekers in the United States is being able to provide
evidence of prior persecution in their home countries. Medical/psychological
affidavits corroborating applicants' accounts often make the difference between
successful and unsuccessful applications. The purpose of this study was to
identify the unmet demand for and features of effective medical/psychological
affidavits in the asylum process, as well as the personal and systemic barriers
for asylum seekers. This is a qualitative study of semi-structured interviews
with legal professionals who work in asylum law. Sixteen asylum lawyers and one
Board of Immigration Appeals accredited representative practicing in the state of
Michigan, United States, participated in this study. All participants noted that
a vast majority of their asylum cases would benefit from a medical affidavit but
that they have difficulty finding qualified physicians with experience writing
such affidavits and testifying as expert witnesses. The major barriers to
obtaining medical/psychological evaluations included inability to pay for
services, lack of practitioner availability, and lack of practitioner training.
The participants reported that features of a strong medical affidavit included
clear, concise, and corroborative accounts that supported the applicant's story
from a diagnostic perspective and forensic descriptions that reinforced the
credibility of the applicant. Several also noted that medical/psychological
evaluations frequently would reveal additional details and incidents of trauma
beyond those stated in the applicant's preliminary statement. The study results
suggest substantial unmet need for trained physicians to perform medical and
psychological evaluations on a pro bono basis. Lawyers' recommendations regarding
effective medical affidavits and necessary ongoing support for asylum applicants
should inform current efforts to improve physician and lawyer collaborations on
asylum cases.