Immigration policy in the United States (US) continues to evolve, often presenting complex challenges for both nurses and patients. In January 2025, Executive Order 14159, Protecting the American People Against Invasion, rescinded prior guidelines that had restricted immigration enforcement actions near “sensitive locations” such as hospitals, schools, and places of worship (Center for Migration Studies, 2025; Collins & Patel, 2025; McAmis, 2025; Reinhart, 2025). This policy shift has introduced new uncertainties into the clinical environment, particularly in settings where ICE presence may occur. This change also raises ethical concerns for nurses, who are guided by the American Nurses Association (ANA) Code of Ethics to provide compassionate, equitable care to all individuals, regardless of immigration status. This article uses the ANA code of ethics as a guiding framework to examine the ethical responsibilities of nurses in responding to ICE in healthcare settings and in providing care for undocumented individuals.
Determining the validity of reports of ICE personnel detaining patients within hospitals remains difficult. The potential for ICE agents to arrive in healthcare facilities creates tension between protecting patient privacy and complying with law enforcement demands. As frontline providers, nurses must remain informed and prepared to navigate these changes while upholding ethical obligations to promote patient advocacy, safety, and trust. As with anyone from an outside agency, hospital staff should verify identification and credentials and follow the appropriate facility policy.
The ANA Code of Ethics offers clear guidance for such circumstances. Provision 1 of the Code emphasizes that nurses must “practice with compassion and respect for the inherent dignity, worth, and unique attributes of every person,” reinforcing a moral and professional duty to offer nonjudgmental care to all patients, irrespective of legal status (American Nurses Association [ANA], 2025, p. 1). Nurses must be aware of both their rights and their responsibilities in these encounters. According to the National Immigration Law Center (2025), patients in non-public hospital areas, such as patient rooms, are protected under the Fourth Amendment, which safeguards against unlawful search and seizure. In the presence of ICE, Provision 1 calls nurses to uphold their professional obligations and foster an environment where all patients feel safe seeking care.
While Provision 1 emphasizes dignity and compassion, Provision 2 of the ANA Code of Ethics states that “the nurse’s primary commitment is to the patient” (ANA, 2025, p. 5). Provision 2 emphasizes the obligation to prioritize the needs of those receiving care, regardless of immigration status or other social determinants (ANA, 2025, p. 5). This includes protecting patient confidentiality, minimizing harm, and ensuring access to essential and timely health services without fear or discrimination. Nurses can also play an instrumental role in creating and clarifying institutional policies and advocating for procedures that prevent disruptions in care delivery and guard against breaches of confidentiality.
Provision 8 expands this responsibility beyond individual encounters, stating that “the nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities” (ANA, 2025, p. 34). This provision calls nurses to engage in interprofessional collaboration, community education, and policy development that advance equitable care access for marginalized populations, including those without legal documentation. While nurses are not expected to resolve immigration policy issues, they are uniquely positioned to advocate for inclusive healthcare practices and help foster environments where all patients, regardless of background, receive respectful, evidence-based, and ethically sound care. By understanding the legal landscape, recognizing ethical obligations, and championing patient-centered approaches, nurses can uphold the core values of the profession while delivering care that meets the highest standards of justice and human dignity.
Additionally, Provision 3 calls on nurses to protect patients’ rights, health, and safety, while Provision 9 urges nurses to advocate for social justice through policy and practice. These guidelines provide a framework for nurses to comply with legal requirements while upholding the moral tenets of the profession (National Nurses United, 2025). As reinforced by National Nurses United (2025), nurses across the country have voiced concerns about the implications of rescinding protections for undocumented individuals in healthcare settings. These concerns are grounded not in political opinion, but in the profession’s ethical commitment to safeguarding the health and dignity of all people.
In an increasingly complex healthcare landscape, nurses must draw upon the enduring guidance of the ANA Code of Ethics to ensure that care remains patient-centered, equitable, and ethically sound. Upholding patient dignity, protecting privacy, and advocating for vulnerable populations are not just professional responsibilities; they are ethical imperatives grounded within our Code of Ethics. The presence of ICE in healthcare spaces raises valid concerns and underscores the critical role nurses play in upholding ethical standards, advocating for vulnerable populations, and promoting safe and inclusive care for all. As immigration policies continue to evolve, nurses must remain unwavering in their ethical commitment.
