NCJ Number
115285
Date Published
1988
Length
276 pages
Annotation
This analysis of prison medical services focuses on the paradox of having the same institution meting out punishment and providing care for health problems and on the effects of the prison environment on the ability of health care professionals to make appropriate medical decisions.
Abstract
The analysis considers the treatment of specific disorders found in prisons, including AIDS, venereal disease, alcohol and drug abuse, liver disease, and neurologic and psychiatric disorders. It emphasizes the differences in these ailments and their treatment inside and outside prisons. Ethical dilemmas involved are the separation of medical values from the legal and correctional functions of a correctional institution, the evaluation of the quality of medical care, and the forced examination of body cavities for evidence of contraband drugs. The discussion also focuses on two reform projects in Massachusetts. One of the authors led the Prison Health Project from 1972-74. The project was led by well-intentioned but ineffective people and failed. A decade later a successful health reform movement took place at Walpole State Prison. It involved the courts and the privatization of prison care. The different results suggest that reforms established solely through the zeal of strong reformers are not lasting, that courts have effectively served as overseers to guarantee the civil rights of inmates, that professional societies have established standards that have helped upgrade prison health care, and that standards have more lasting effects than accreditation in improving prison medicine. Findings also indicate that although privatization is attractive in theory, it is unclear whether private profits and public savings are possible and whether other social costs might make privatization unworkable. Chapter notes and index.