Palliative Care for Prison Inmates

Linder, John; Meyers, Frederick J.

doi:10.1001/jama.298.8.894

Cited by 67 publications

(45 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prisoners can actually continue to receive disease-directed care while on hospice and do not have to meet the Medicare hospice requirement of having less than 6 months to live to qualify for hospice care. 12 Hoffman and Dickinson 15 report that many correctional facilities have/are developing palliative/hospice-based programs that are adapted to suit the unique circumstances of the prison environment.…”

Section: Discussionmentioning

confidence: 99%

The Hospitalized Prisoner With a Life-Threatening Illness

Badger

Ladd²,

Friedemann³

2012

JONA’S Healthcare Law, Ethics, and Regulation

View full text Add to dashboard Cite

It is generally accepted that the Patient's Bill of Rights applies to all patients including prisoners. Yet, a prisoners' incarcerated status generally prohibits inmates from making any decision that may shorten his/her life, and as such, the de facto medical decision maker becomes the medical director of the state correctional facility. This case study highlights the challenges that arise when the ethically appropriate response to a hospitalized prisoner's terminal medical condition warrants decisions that are in conflict with that advocated by the correctional facility.

show abstract

Section: Discussionmentioning

confidence: 99%

The Hospitalized Prisoner With a Life-Threatening Illness

Badger

Ladd²,

Friedemann³

2012

JONA’S Healthcare Law, Ethics, and Regulation

View full text Add to dashboard Cite

show abstract

“…Compassionate release policies are designed in recognition of the fact that an appropriate level of care for patients with severe or debilitating illnesses is difficult, and sometimes impossible, to achieve in the correctional setting [13,14]. For instance, the community standard for end-of-life care is to offer patients hospice [15]; however, prison hospices are available only at 69 of 1,719 state correctional facilities [9,16], and they often require patients to move farther away from family or friends at a time when maintaining social connections is a core component of quality care.…”

Section: Compassionate Releasementioning

confidence: 99%

“…These low rates stem in large part from state and federal policies with restrictive medical and criminological eligibility criteria for release, including mandated short-term "terminal prognosis" and exclusion of nonterminal but debilitating conditions [9,11]. These policy barriers are compounded by administrative barriers to release such as objections by a victim advocate or prosecutor, concerns about public safety (particularly for those incarcerated for violent crimes), and availability of suitable postrelease community care plans [6,12].Compassionate release policies are designed in recognition of the fact that an appropriate level of care for patients with severe or debilitating illnesses is difficult, and sometimes impossible, to achieve in the correctional setting [13,14]. For instance, the community standard for end-of-life care is to offer patients hospice [15]; however, prison hospices are available only at 69 of 1,719 state correctional facilities [9,16], and they often require patients to move farther away from family or friends at a time when maintaining social connections is a core component of quality care.…”

mentioning

confidence: 99%

Compassionate Release Policy Reform: Physicians as Advocates for Human Dignity

Mitchell¹,

Williams

2017

AMA Journal of Ethics

View full text Add to dashboard Cite

A rapidly aging correctional population has led to an increasing number of patients with serious progressive and terminal illnesses in correctional settings. "Compassionate release" describes a range of policies offering early release or parole to incarcerated patients with serious or debilitating illnesses. However, in many states that have compassionate release policies, few patients are actually granted release. We describe how the continued incarceration of patients with serious or debilitating illness can constitute a violation of human dignity if appropriate palliative care is unavailable. We argue that, given the importance in medical ethics of upholding dignity, physicians should advocate for the appropriate application and use of compassionate release. We describe several opportunities for physicians to take leadership on this issue. IntroductionIncarcerated patients are more likely to have severe or debilitating medical illnesses than the general population [1]. More than 4,000 people died in jails and state prisons annually from 2003-2011, with heart disease and cancer being major causes of death [2]. These illnesses disproportionately affect older patients, who make up an increasingly larger share of prison populations. From 1993 to 2013, the 55-and-older population in state prisons more than tripled, increasing from 3 percent to 10 percent [3]. "Compassionate release" policies have been designed to allow some of these patients to be released from prison or jail before sentence completion. However, few patients are actually granted compassionate release [4,5]. This article provides an overview of ethical principles used to justify compassionate release and explores how physicians can leverage their commitment to upholding ethical principles to advocate for more effective compassionate release policies. AMA Journal of Ethics, September 2017 855Compassionate Release For humanitarian, practical, and economic reasons, 47 states and the District of Columbia have some form of early release mechanism for seriously ill or disabled incarcerated patients [6][7][8]. "Compassionate release" is a broad term used to describe a range of these types of policies (including medical parole, emergency parole, and medical release). Most, if not all, share the requirement for a physician to determine medical eligibility for potential candidates, although medical eligibility differs by jurisdiction [9]. Nationwide, compassionate releases occur relatively infrequently. Out of 2,621 requests for compassionate release during a one-year span in the Federal Bureau of Prisons, only 85 (3.24 percent) were granted [10]. State prison systems are likely to have similar if not lower rates of release [11]. These low rates stem in large part from state and federal policies with restrictive medical and criminological eligibility criteria for release, including mandated short-term "terminal prognosis" and exclusion of nonterminal but debilitating conditions [9,11]. These policy barriers are compounded by administrative barriers t...

show abstract

“…The United Kingdom and the United States have begun to establish end-of-life care in prisons, collaborating with community services. 7,8 Yet, access to palliative care even in those countries remains limited. 9 Switzerland is still struggling to find viable solutions.…”

mentioning

confidence: 99%

“…This persistent respect for autonomy is, for example, acknowledged when a prisoner chooses to refuse life-saving treatment or to make an advance directive, such as in the case of hunger-striking prisoners, 12 or to issue do-not-resuscitate orders. 8 Conversely, the correctional system has a duty of care towards the persons it detains, securing their lives and ensuring the security of the persons placed under its care, including suicide prevention. 13 This duty should not impede the autonomy of prisoners in regard to existential questions, such as AS, as it is surely thought of as protection, but not as an absolute power of the correctional system over the prisoners and their decisions making about the end-of-life.…”

mentioning

confidence: 99%

Viewpoint: Will I stay or can I go? Assisted suicide in prison

Handtke

2014

J Public Health Pol

View full text Add to dashboard Cite

Assisted suicide (AS) is a controversial practice with which physicians and nurses are confronted more and more often. In Switzerland, it is available for Swiss residents and in certain cases for foreigners. Prisoners meet the same prerequisites for AS as the general population and should therefore be eligible for it. Ethical issues, such as informed choice and the autonomy of prisoners, and organizational questions need to be addressed. They must not lead to a denial of this practice. Even though prisons constitute a special area of work for medical staff, it is important to address the possibility of AS in prison openly. This can raise awareness of the difficulties health-care professionals face working in closed institutions.

show abstract

Palliative Care for Prison Inmates

Cited by 67 publications

References 43 publications

The Hospitalized Prisoner With a Life-Threatening Illness

The Hospitalized Prisoner With a Life-Threatening Illness

Compassionate Release Policy Reform: Physicians as Advocates for Human Dignity

Viewpoint: Will I stay or can I go? Assisted suicide in prison

Contact Info

Product

Resources

About