380 “I am a physician and not a border guard”: physicians’ experiences in response to the Swedish state mandating their involvement in border control

Abstract OP 15: Exclusion and Discrimmination 1, B308 (FCSH), September 3, 2025, 17:00 - 18:00 Aim With increased global securitisation of borders, the presence of border enforcement agents in healthcare contexts has been on the rise over the past decades. Yet, healthcare professionals have not commonly been expected to directly participate in border control. In recent years, the Swedish right and far-right government coalition has taken active steps toward legislating physicians’ duty to report to law enforcement and migration authorities when they encounter undocumented patients in practice. As part of the Boundaries Longitudinal Study, this research aims to illuminate physicians’ lived experiences, responses, and reactions to their expected involvement in border enforcement. Method Based on a multi-sited ethnography, data was generated through constructivist interviews in conventional healthcare and ethnographic fieldwork in humanitarian contexts. Results Physicians broadly refused their expected involvement in border enforcement practices. They perceived their mandate involve medical decision-making, and strongly objected to political involvement in the clinic. Many reported being willing to go to great lengths in their refusal to participate, including accepting losing employment or spending time in prison. While most believed their colleagues shared their objections, several feared that instilling mandatory reporting would lead to increased distrust among professionals in the workplace, and a deterioration of the collegial glue. They also worried that undocumented patients would avoid seeking healthcare altogether. In humanitarian care, prospect of mandatory reporting led to grave concern, shock, and disbelief. Expected impacts on patients was troubling, igniting several forms of questioning and resistance. Physicians also felt their identity was shaken, along with their views on the society they lived in. Conclusion This research advances knowledge on physicians’ experiences, responses, and reactions to their expected involvement in border control practices, and the extent of their refusal to participate. Broad resistance to enacting migration control policies was observed, particularly when these interfere with medical decision-making and patient rights.