Ethics of care in supporting disabled forced migrants: interactions with professionals and ethical dilemmas in health and social care in the South-East of England

This article explores the interactions between disabled forced migrants with care needs and professionals and the restrictive legal, policy and practice context that health and social care professionals have to confront, based on the findings of a qualitative study with 45 participants in the South-East of England. In-depth interviews were conducted with 15 forced migrants who had diverse impairments and chronic illnesses (8 women and 7 men), 13 family caregivers and 17 support workers and strategic professionals working in social care and the third sector in Slough, Reading and London. The legal status of forced migrants significantly affects their entitlements to health and social care provision, resulting in prolonged periods of destitution for many families. National asylum support policies, difficult working relationships with UK Border Agency, higher eligibility thresholds and reduced social care budgets of local authorities were identified as significant barriers in responding to the support needs of disabled forced migrants and family caregivers. In this context, social workers experienced considerable ethical dilemmas. The research raises profound questions about the potential and limitations of health and social care policies, provision, and practice as means of protection and support in fulfilling the human rights of forced migrants with care needs.

The social impacts of heat waves

The effects of the 2003 European heat wave have highlighted the need for society to prepare itself for and cope more effectively with heat waves. This is particularly important in the context of predicted climate change and the likelihood of more frequent extreme climate events; to date, heat as a natural hazard has been largely ignored. In order to develop better coping strategies, this report explores the factors that shape the social impacts of heat waves, and sets out a programme of research to address the considerable knowledge gaps in this area. Heat waves, or periods of anomalous warmth, do not affect everyone; it is the vulnerable individuals or sectors of society who will most experience their effects. The main factors of vulnerability are being elderly, living alone, having a pre-existing disease, being immobile or suffering from mental illness and being economically disadvantaged. The synergistic effects of such factors may prove fatal for some. Heat waves have discernible impacts on society including a rise in mortality, an increased strain on infrastructure (power, water and transport) and a possible rise in social disturbance. Wider impacts may include effects on the retail industry, ecosystem services and tourism. Adapting to more frequent heat waves should include soft engineering options and, where possible, avoid the widespread use of air conditioning which could prove unsustainable in energy terms. Strategies for coping with heat include changing the way in which urban areas are developed or re-developed, and setting up heat watch warning systems based around weather and seasonal climate forecasting and intervention strategies. Although heat waves have discernible effects on society, much remains unknown about their wider social impacts, diffuse health issues and how to manage them.