Criminalising care? Doctors and medical certificates in Italy’s CPRs.
On the morning of September 16, 23 local, personal and computer searches were carried out against as many doctors, in nine Italian cities, from Bologna to Livorno, and as far as Bari. The operation was conducted by the State Police, with the Rome Operational Service and the Ravenna Mobile Squad.
This is not an isolated case, but an extension of the investigation launched in Ravenna in March 2026 against eight doctors from the Infectious Diseases department, who are charged with the offences of continued ideological falsification and interruption of public service in relation to 34 certificates declaring people unfit for detention in the Detention Centres for Repatriation (CPRs).
Among the 23 doctors involved in the September operation, Nicola Cocco, the only one formally under investigation in the new operation, is reportedly under investigation on suspicion of criminal association aimed at producing false certificates.
The case raises at least three questions: the limits and methods of investigative action against professionals who are not formally under investigation; the living and health conditions inside CPRs; and, more fundamentally, the relationship between the professional autonomy of doctors and a migration policy that entrusts medical certification with a decisive role in determining whether a person can be detained.
The first point concerns the 22 people who, at the time of the searches, were not formally under investigation. The legal system nevertheless allows a search to be carried out even against a person who is not under investigation, where there are reasonable grounds to believe that things or data relevant to the offence may be found in their possession, as provided for by Article 247 of the Code of Criminal Procedure. However, the grounds, necessity and proportionality of the methods of execution must still be assessed.
According to what was reported by lawyer Fabio Anselmo, who represents five of the 23 doctors, his clients were allegedly woken up before six in the morning, taken to the police headquarters and had their mobile phones and computers seized. The lawyer denounced treatment which, in his view, was disproportionate, comparing it to that reserved for people involved in organised crime.
The question this raises is significant: when investigative activity concerns professionals who, in the course of their work, are called upon to make decisions concerning the health and personal freedom of migrants, where are the boundaries between investigative necessity and the risk of producing an intimidating effect on their professional autonomy?
This is where the second element of the case comes into play: what does it mean to declare a person fit for detention in a CPR?
The question cannot be separated from the material conditions in which that person will be placed. The National Guarantor for the Rights of Persons Deprived of Personal Liberty, civil society organisations and other actors have documented, over the years, critical issues concerning material conditions, healthcare, the management of critical incidents and the protection of the rights of detained people.
The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) of the Council of Europe has likewise highlighted critical issues concerning the material conditions and prison-like character of some facilities, the scarcity of meaningful activities, the management of critical incidents and healthcare.
It is therefore difficult to consider the medical assessment of fitness as an abstract medical examination, separate from the place in which the person will be detained, which is undoubtedly pathogenic. Health does not depend solely on the absence of a specific pathology, but also on individual conditions, possible vulnerabilities and the environment in which the person will be placed.
To this material dimension must then be added the constitutional one. In judgment no. 96 of 2025, the Constitutional Court identified a deficiency in primary legislation concerning the definition of the concrete conditions of the deprivation of personal liberty in CPRs, referring to the guarantees provided for by Article 13 of the Constitution.
This legislative gap was subsequently addressed by judgment no. 7839 of 2025 of the Council of State, which stressed the importance of a thorough investigation and of the involvement of administrations possessing specific expertise in the matter, referring in particular to the Ministry of Health and the National Guarantor.
If the State deprives a person of their liberty, therefore, it cannot simply establish that detention is possible, but must adequately understand and regulate the conditions in which that deprivation of liberty takes place.
It is within this framework that the role of the doctor assumes particular importance. The healthcare professional is called upon to assess whether the concrete conditions of the Centre are compatible with the protection of the person’s health and vulnerabilities.
And it is precisely here that the ethical dilemma emerges. As Nicola Cocco has observed, referring to Article 32 of the Code of Medical Ethics, doctors have a duty to protect the health and dignity of the person, particularly when that person is in a condition of vulnerability. From this perspective, the assessment of medical fitness for detention in a CPR may come into tension with the doctor’s professional responsibility: how can one certify a person’s fitness for an environment that is pathogenic and presents conditions detrimental to the person’s physical and psychological health?
Medical certification is formally a medical act. But when it determines whether or not a person may be deprived of their liberty inside a CPR, it also produces consequences that are directly relevant to migration policy. What happens when a medical decision that protects the health of a migrant produces an effect contrary to the objective of the detention policy?
And, furthermore, how far can criminal and investigative action go without producing, beyond the investigation of possible offences, a deterrent effect on the clinical decisions of professionals?
The issue therefore concerns the complex interaction between medicine, deprivation of liberty and migration policy. If a medical assessment can determine the very possibility of depriving a person of their liberty, the doctor’s autonomy becomes a central issue: when the protection of health comes into conflict with the requirements of migration policy, how much room remains for the doctor’s autonomy?
written by Costanza Luciani
Comments