Objectives This study examined the extent, range and nature of the published literature, prison policies and technical guidance relating to the ethical conduct of health research in prisons in low- and middle-income countries (LMICs). Study design Scoping Review. Methods We adhered to the five stages of the scoping review iterative process: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing and content analysis of polices. Disagreements around allocation of content were resolved through team discussion. We also appraised the quality of the included articles. Results We included nine records that examined the ethical aspects of the conduct of health research in prisons in LMICs; eight of these were peer-reviewed publications, and one was a toolkit. Despite the unique vulnerabilities of this group, we could find no comprehensive guidelines on the ethical conduct of health research in prisons in LMICs. Conclusions The majority of the world's imprisoned populations are in LMICs, and they have considerable health needs. Research plays an important role in addressing these needs and in so doing, will contribute to the achievement of the Sustainable Development Goals. With regards to health research, imprisoned people in LMICs are ‘left behind’; there is a lack of clear, prison-focused guidance and oversight to ensure high quality ethical health research so necessary in LMICs. There is an urgent need for prison health experts to work with health research ethics experts and custodial practitioners for procedural issues in the development of prison-specific ethical guidance for health research in LMICs aligned with international standards.
Addressing another aspect of the heritage of incarceration, Tomoko Ako’s study of the gate of Nakano Prison in Tokyo—the only remaining vestige of this infamous prison’s original structure—deals with an attempt to suppress an aspect of Japan’s difficult pre-1945 past, and local efforts to resist this suppression. As one of the local activists resisting efforts to remove this landmark, Ako argues that preservation of the gate allows the history of the prison to be openly debated and reflected upon. However, her experience shows that the forces in Japanese society ranged against such openness remain formidable.
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