Care Alternatives in Prison Systems: Factors Influencing End-of-Life Treatment Selection

• NCJ Number: 227321
• Journal: Criminal Justice and Behavior Volume: 36 Issue: 6 Dated: June 2009 Pages: 620-634
• Author(s): Laura L. Phillips; Rebecca S. Allen; Karen L. Salekin; Ronald K. Cavanaugh
• Date Published: June 2009
• Length: 15 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study examined the impact of age, physical health, emotional health, attitudes toward death, and religiousness/spirituality on end-of-life treatment preferences for inmates whose sentence would end after the age of 75 (lifers) and those who would be released prior to age 75 (nonlifers).

Abstract

Support was found for the hypothesis that inmates whose sentence would end after they turned 75 years old would express less desire for life-prolonging treatment than those who would be released prior to becoming 75 years old; however, inmates' age at the time of the interview was unrelated to any of the posed end-of-life medical treatment preferences, i.e., CPR, feeding tube, and palliative care (relief for pain/discomfort without life-sustaining measures). Support was also found for the hypothesis that members of a minority racial group would have a greater desire for life-sustaining treatments and a lower desire for palliative care than Caucasian. Specifically, members of minority racial/ethnic groups were more likely to prefer feeding tubes; whereas, Caucasians were more likely to express preferences for palliative care. Unexpectedly, there was no significant link between physical or emotional health measures and the desire for end-of-life medical treatments; however, as expected, inmates with high levels of anxiety about death reported greater preference for life-sustaining measures. There was limited support for the influence of religious or spiritual variables on desires for specific end-of-life medical treatments. Of the 73 male inmates in the sample, 28 were nonlifers, and 45 were lifers. All were housed in the Alabama Aged and Infirmed Correctional Facility. One of the instruments used in the study was the Life-Support Preferences/Prediction Questionnaire, which describes nine illness situations that vary in the severity of illness, prognosis, and level of pain. Only four of the nine scenarios were used, however; Alzheimer's disease, emphysema, and cancer with and without pain. 6 tables and 48 references