Is a full-fledged informed consent viable in prison environments?

Dermengiu, D.; Hostiuc, Sorin; Simionescu, Mihaela; Marcus, I.; Asavei, Victor; Gherghe, E.V.; Bădilă, Elisabeta

doi:10.4323/rjlm.2015.143

Cited by 2 publications

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“…Only in situations that are medical emergencies and the patient does not have the capacity to partake in the decision-making process and surrogate informed consent cannot be obtained, due to the nature of the patient’s condition, urgent medical treatment can be initiated without prior informed consent; however, informed consent will be obtained by the physician as soon as possible in order to continue providing medical care [ 3 , 17 ].…”

Section: Consent and Confidentiality In Prison Health Carementioning

confidence: 99%

“…In order to comply with these goals, medical staff need to properly understand the characteristics of the patient, taking into account the aspect of detention. The overlapping of inmate and patient implies some aspects referring to the person’s psycho-social background, such as social marginalization, a very low socioeconomic level, a low level of schooling, reduced intellectual efficiency, aggression, impulsivity, reduced tolerance to frustration, personality disorders, and disorders resulting from substance use [ 3 , 18 ]. All these characteristics, particularly in the context of custodial measures, emphasize the patient’s need to have their autonomy respected within the patient–physician relationship to obtain their compliance and their trust in the physician.…”

Section: Consent and Confidentiality In Prison Health Carementioning

confidence: 99%

“…Consent and confidentiality are among the basic elements of medical practice, which can become problematic for inmate patients [ 3 ]. In accordance with General Assembly resolution 37/194 of the United Nations, ”Health personnel, particularly physicians, charged with the medical care of prisoners and detainees have a duty to provide them with the protection of their physical and mental health and treatment of disease of the same quality and standard as is afforded to those who are not imprisoned or detained” [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Elements of informed consent which, in theory, are well-regulated both legally and morally can, in practice, present contextual discriminations given the freedom deprivation measures that have the potential to cause the patient to resort to aggression, dissimulation or simulation, lack of interest in the medical information, autolytic attempts, etc. [ 3 ]. Thus, informed consent can have questionable validity, with consequences on the medical act.…”

Section: Introductionmentioning

confidence: 99%

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Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality

Isailă

Hostiuc

2022

Healthcare

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Respecting the consent and confidentiality of a patient is an underlying element in establishing the patient’s trust in the physician and, implicitly, obtaining the patient’s compliance. In particular, cases of inmate patients require increased attention in order to fulfill this goal against a background of institutional interferences, which, in certain situations, may endanger the autonomy of the physician and their respect for the inmate’s dignity. The purpose of this article is to depict the characteristics of consent and confidentiality in a prison environment, in special cases, such as hunger strikes, violent acts, HIV testing, COVID-19 measures, and drug use, bringing into focus the physician and the inmate in the context of the particular situation where the target is disciplining someone in order for them to conform to social and juridical norms. Respecting the dignity of the inmate patient requires an adequate approach of informed consent and confidentiality, depending on each case, considering the potential unspoken aspects of the inmate’s account, which can be key elements in obtaining their compliance and avoiding malpractice claims.

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Section: Consent and Confidentiality In Prison Health Carementioning

confidence: 99%

Section: Consent and Confidentiality In Prison Health Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality

Isailă

Hostiuc

2022

Healthcare

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“…Correctional medicine is associated with unique medical ethics issues that are often difficult to interpret using fundamental ethical principles from clinical medicine [14]. One aspect that needs special attention in reference to medical expertise requests is the high number of cases when the commission conducting the expertise indicated that the disease could safely be treated within the NAP sanitary network and declined to recommend sentence postponements or interruptions.…”

Section: Ethical Issues: Commission Members Vs Patientsmentioning

confidence: 99%

The Ethics of the Relation Between the Convicted Patient and the Physician

Gherman

Chiroban

Perju-Dumbravă

2016

Medicine and Pharmacy Reports

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Background and aimApproaching the convicted patient is a topical issue in terms of alignment with EU provisions and recommendations, more so in the context of year by year increase in the number of convicts and consequently, prison patients. The prison patient exhibits increased vulnerability in regard to the rest of the convicts due to his/her medical status overlapping personality changes induced, while coping with a new environment. This represents a challenge for the physicians involved in the expertise process, which must act objectively within the limits and by the principles of professional ethics, while confronting a patient influenced by the prison environment.MethodsWe studied the existing legal and ethical framework concerning the expertise in view of sentence postponement/interruption on medical grounds and made a comparison between the theoretical information available and the “real life” situations encountered in our experience at the Institute of Legal Medicine Cluj-Napoca. Following this step we tried to establish some principles needed to optimize health care in the penitentiary system by detecting and sanctioning situations of deceptive behavior, doubled or not by simulation and over-simulation.ResultsConvicts present pathologies documented in medical records, but accuse new symptoms that could suggest a new pathological condition. During the expertise, convicted patients emphasize their symptoms and/or claim new symptoms unrelated to their documented medical condition. Convicts submit repeated requests for which treatment solutions within the NAP healthcare system had been already formulated.ConclusionThe patient must be properly informed about the steps to be taken and duration expected in performing a legal medicine expertise in pursuit of sentence postponement or interruption for the treatment of a medical condition that cannot be properly addressed within the NAP sanitary system. Information should come from authorized sources. Efforts to determine unauthorized sources (mainly “experienced” detainees with records of unsubstantiated demands) are surely beneficial.

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Is a full-fledged informed consent viable in prison environments?

Cited by 2 publications

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Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality

Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality

The Ethics of the Relation Between the Convicted Patient and the Physician

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