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The Mediterranean refugee crisis: ethics, international law and migrant health
  1. Sophie Brannan,
  2. Ruth Campbell,
  3. Martin Davies,
  4. Veronica English,
  5. Rebecca Mussell,
  6. Julian C Sheather
  1. Department of Medical Ethics, British Medical Association, London, UK
  1. Correspondence to Martin Davies, Department of Medical Ethics, British Medical Association, London WC1H 9JP, UK; mdavies{at}

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The Mediterranean refugee crisis: ethics, international law and migrant health

Europe is experiencing levels of forced migration not seen since the Second World War. Its sources lie in the fragile, strife-torn states of the Middle East and Africa: four million people have fled Syria since the conflict began; 12 million of those remaining require humanitarian assistance. Large numbers of people are fleeing violence in Iraq, Afghanistan and Eritrea. Although millions have been displaced by violence, others are seeking relief from endemic poverty and brutally restricted life-choices. Overwhelmingly their chosen routes into Europe are perilous—according to the UN High Commissioner for Refugees (UNHCR) over 590 000 people have arrived in Europe by sea this year.1 Nor do their difficulties end once they reach Europe. The asylum systems of the frontline countries, overwhelmingly Greece and Italy, never designed for such high levels of migration, are inadequate. In this thematic ethics brief we provide some background information to the crisis and raise a number of ethical issues it gives rise to.

The current situation

During the last 18 months the numbers of irregular migrants seeking access to Europe has escalated dramatically. Although exact figures are difficult to assess, in 2015 more than a million people are estimated to have arrived.2 This compares with 280 000 for the whole of 2014. The most popular route is by boat from Turkey to the Greek Islands. The journey is perilous. The International Organization for Migration (IOM) puts the total number of migrants drowned in the Mediterranean this year at 3138.3 Although there is intense media focus on irregular migrants in Europe, by far the largest number of Syria's displaced people are living in neighbouring states. Over two million are registered in Turkey and over a million in Lebanon. As there is very little prospect of integration or long-term security in these countries, many decide to continue to Europe.

The …

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.