According to the U.S. Federal Bureau of Investigation (FBI), human trafficking encompasses four sub-categories: domestic sex trafficking of adults; sex trafficking of international adults and children, forced labor; and domestic servitude. Human trafficking is a profitable business – it's also illegal. According to The United Nations Children's Fund (UNICEF), an estimated 21 million people are trafficked annually worldwide, profits generated from trafficking are approximately $32 billion, and 29 countries have not yet joined the Palermo Protocol to combat trafficking. Needless to say, individuals who are victims of human trafficking often utilize the U.S. healthcare system.
The American Medical Association's (AMA) policy, H-65.966-Physicians Response to Victims of Human Trafficking, encourages raising awareness about human trafficking. Specifically, that "physicians should be aware of the definition of human trafficking and of resources available to help them identify and address the needs of victims." The AMA's policy has been cited by governments throughout the United States and around the world.
Physicians and citizens alike, may be surprised to learn that Houston, Texas is the number one city in the United States for human trafficking. In turn, it serves as a conduit to the rest of the country; thereby, making this an issue for all physicians.
In light of the significant prospect that a physician will come in contact with a human trafficking victim, it is important for physicians to have a basic understanding of their obligations. Therefore, I have teamed up with Jessica Roberts, JD, and colleague of mine at the University of Houston Law Center's Health Law and Policy Institute (UofH HLPI) to provide some fundamental information.
RR: Thank you, again, for sharing your insights. Please tell us a bit about UofH HLPI and the human trafficking problem here in Houston.
JR: The Health Law & Policy Institute (HLPI) at the University of Houston Law Center is the number three health law program in the country, according to US News and World Report. HLPI provides a venue for students, faculty, legal and medical professionals, and community members to explore cutting edge issues in health law and policy. In addition to being home to the largest medical center in the world, Houston is also tragically one of the largest hubs for human trafficking in the United States and the largest human trafficking hub in Texas. HLPI wants to do our part to help combat the human trafficking epidemic in our hometown.
RR: What obligations do medical professionals have to report suspected human trafficking victims? And, is there a difference if it is a child versus an adult?
JR: Human Trafficking is a crime in the state of Texas. The Texas Family Code requires mandatory reporting for child abuse, including human trafficking. Similar reporting requirements exist for other vulnerable populations, such as the elderly and people with disabilities.
RR: What are the main federal laws that address human trafficking and where should physicians go to know their obligations under state laws?
JR: The primary federal law governing human trafficking is the Trafficking Victims Protection Act. Because human trafficking victims may seek healthcare, it is crucial that physicians be able to identify the signs of trafficking. Polaris, an anti-trafficking advocacy organization, regularly publishes surveys of state trafficking laws.
In closing, there are several takeaways for physicians.
•As an initial step, physicians should educate themselves on patient signs.
•The clinical aspects of care and reporting should be considered.
•Legal, professional standards, such as the AMA, and ethical considerations dictate certain courses of action that a physician is required to follow.
The University of Houston Law Center is hosting a free community event, tentatively scheduled for September 22, 2017, to discuss the legal and social issues related to human trafficking.