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Preventing Human Rights Violations in Prison – The Role of Guidelines

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Emerging Issues in Prison Health

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Abstract

It is common knowledge that the human rights of prisoners are often not respected. But can guidelines help to prevent such violations? In this chapter we explore this topic and examine how to help healthcare professionals navigate the conflicts of interest that can make it difficult to ensure that patients’ rights are respected. To do so, we explain the role of guidelines – both clinical and ethical – for non-incarcerated patients outside prisons and for those within prisons. Within such institutions, the main challenges are ensuring that patients receive healthcare that is equivalent to that available outside prison, and ensuring patient autonomy in healthcare decisions. Despite the good practices set out in many national and international guidelines, physicians (both inside and outside prisons) are often unfamiliar with this guidance. Both greater awareness of existing guidelines and development of further guidelines are required.

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Notes

  1. 1.

    The term ‘prison’ is used to indicate any place of detention; ‘prisoner’ or ‘detainee’ means any person who is deprived of his or her liberty.

  2. 2.

    Pretest Probability is important for the interpretation of the results of diagnostic tests and for the decision regarding which diagnostic test should be selected. It is defined as the ‘probability of the target disorder before a diagnostic test result is known’ and ‘represents the probability that a specific patient [e.g. a 50 year old prisoner], with a specific medical history [e.g. drug abuse and hypertension], who presents to a specific clinical setting [e.g. an emergency consultation in a prison health service], with specific symptoms, say retrosternal chest pressure, dyspnoea and diaphoresis, has a specific diagnosis, such as acute myocardial infarction’ (CEBM 2013).

  3. 3.

    International organisations have been very active in producing clinical guidelines. For drug abuse in prison, see United Nations Office on Drugs and Crime (UNODC): http://www.unodc.org/unodc/en/hiv-aids/prison-settings.html; for WHO guidance on prisons and health, see: http://www.euro.who.int/en/what-we-do/health-topics/health-determinants/prisons-and-health; for WHO general clinical guidance that should be used in prisons in line with the principle of equivalence of care, see the Evidence for Action Series: http://www.who.int/hiv/pub/idu/evidence_for_action/en/. This chapter does not provide exhaustive references concerning clinical guidelines; for evidence based guidance concerning specific health topics in prison see the other chapters in this volume.

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  1. Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland

    Bernice S. Elger & David M. Shaw

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  1. Bernice S. Elger
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  1. Institute for Biomedical Ethics, University of Basel, Basel, Switzerland

    Bernice S. Elger

  2. Federal Office of Public Health , Bern, Switzerland

    Catherine Ritter

  3. Faculty 'Health and Social Work', Frankfurt University of Applied Sciences, Frankfurt, Germany

    Heino Stöver

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Elger, B.S., Shaw, D.M. (2017). Preventing Human Rights Violations in Prison – The Role of Guidelines. In: Elger, B., Ritter, C., Stöver, H. (eds) Emerging Issues in Prison Health. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7558-8_13

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