The case of Patient A* — the 36-weeks pregnant Kuwaiti woman, who has pre-eclampsia, fibroid tumours, and a breech position pregnancy — is a further illustration of the new and lethal situation we have come to in the situation of mandatory detention and the camps.

For a month, the Immigration Department has been fighting to deny the medical evacuation of this woman to Australia, with both the department and the “Nauru Department of Health” denying that such a medivac is necessary. The situation, were it in a political satire, would be grimly funny. How many more birth complications would this woman need to have to make a medivac obviously necessary to the Immigration Department?

Each condition exacerbates the other: pre-eclampsia threatens blood pressure spikes and cardiac arrest, even in a normal pregnancy; a tumour threatens further difficulties even if she weren’t threatened with a breech birth. Nauru is a broke client state of 10,000 people thousands of kilometres from specialist equipment or staff. Immigration appears to be have been going for a first: an attempt to kill a single detainee three times over, through criminal neglect.

The case of Patient A comes after the 2014 death of Hamid Khazaei, the 24-year-old Manus Island detainee whose serious medical condition, and his howls of pain to medical staff, were repeatedly ignored. By the time he was medivacced to Brisbane, it was too late; sepsis had set in, and he died.

This death, and Patient A’s potential death, should make clear how depraved the operation of the camps has become. Their existence has done its work on the state that camps always do: make people first indifferent, then actively hostile, to the people within them. Nauru and Manus detention camps are concentration camps, literally, and in the tradition of concentration camps, from those used by the French against Algerians in the 1800s, through the British Boer War camps (which held blacks as well as Afrikaners) onwards.

The number of deaths is unimportant; what is crucial is the way in which official indifference to risk has been put at the centre of the process, as part of the carceral terror by which the camps operate. Both cases, had they occurred to travellers with travel insurance, would have ensured a medivac; in cases where an Australian was stranded, DFAT would bear the cost of the medivac. The failure to do this immediately, in both cases here, is murderous and exterminatory.

[Rundle: Don Dale, Nauru — this is who we are]

That is worth stopping to consider, because it is beyond all other operations of the camps — their use of despair and futility as a weapon of torture against boat-borne arrivals, as a way of terrorising others into not making the journey. It is one thing, and bad enough, to engineer a situation of despair, suicidality and self-harm. Death through lack of medical treatment is active killing.

The fact that this exists in the camps, and has now been revealed as such, seems to me to alter the moral and political limits of protest that have been self-imposed. As in the case of the Vietnam War, as it tipped towards a genocidal assault on a peasant nation using mass bombing and chemical warfare, so too this new stage of lethality (or its revelation) legitimates a more forceful form of protest. Civil disobedience that involves property damage that is more than merely symbolic now seems morally permissable — civil disobedience aimed at seriously interrupting the process of running the camps, supplying them with staff and supplies and other processes. Civil disobedience that courts significant prison time.

Whether such actions would be strategically wise — in light of the significant public disapproval they would court — is another question entirely, with good arguments on both sides. But it’s a question that comes after the question as to whether such actions are moral. I think that question has now been answered in the affirmative, by the actions of Immigration and the private camp administration (whatever they call themselves this week).

Besides, there comes a point where strategic thinking has its limits: there is a need to absolutely bear witness against such processes, to show the people in the camps that we regard the situation as a moral emergency of the highest order, for some few people to show that we aren’t damn consenting to this, to not let these things be swept up in the news stream. “We should be in the prisons,” the Berrigan brothers said, as Vietnam protests escalated, and they, priests and pacifists, had embarked on increasingly dangerous attacks on US military property.

But yes, who are we? The question of who, feeling the moral right of such acts, will stand up to do them, or can stand up to do them. Courage is not vainglory, or the desertion of people dependent on you in everyday life, or many other circumstances. The call to such action falls neither equally nor fairly, but fall it does. What one can say is that no one in the refugee movement should desert or disown anyone who feels called to such actions, who feels the moment when they must register their radical refusal of consent to a murderous state process that has been normalised. Someone, several people soon, will feel that call, I suspect. The courting of death will not stop. The camps corrupt everyone; from the top down, and from the bottom up, until the whole trunk of the body politic is rotten through. Emergency is the word, exact.

*I’ve called her that, for ease of referral, now and in the future.