Prison Psychiatrists - A Survey of Ethical Guidelines

• NCJ Number: 75606
• Journal: Psychiatric Annals Volume: 8 Issue: 1 Dated: (January 1978) Pages: 63-77
• Author(s): F C R Chalke
• Date Published: 1978
• Length: 8 pages
• Publication Format: Article
• Language: English
• Country: United States of America
• Note: Adapted from a paper presented to the Plenary Session of the World Congress of Psychiatry, Honolulu, Hawaii, August 29, 1977

Annotation

Factors influencing the ethical considerations of prison psychiatrists are identitied, world standards are reviewed, and ethical problems for prison psychiatrists are discussed.

Abstract

Several factors influence the determination of ethical standards for psychiatrists working in prisons: (1) the rate of change in the field, (2) few publicly known rules governing behavior in this situation, (3) contradictions created by the pressures of reality and by codes and directives, and (4) the relatively unknown conditions influencing ethical practice in developing countries. The World Health Organization (WHO) recommends that all health professionals be trained solely to safeguard the health of their clients. This recommendation does not address the question of health professionals involvement in cases where, for example, physicians are asked to certify that practices are harmless when they may not be. WHO also recommends that practices such as torture participation be prohibited as a matter of national rather than individual health ethics. Questions for psychiatrists include (1) treatment of drug dependency, (2) the limits to which a prisoner may be required to go in submitting to medical examinations, (3) how much health care prisoners should receive, (4) the confidentiality of the physician-patient relationship, and (5) the extent to which physicians should intervene to prevent prisoner suicide. Other problem areas are the use of prisoners in medical and psychological experiments, the use of psychiatrists as assessment rather than treatment specialists, and psychiatrists' involvement in coercive correction activities. Questions related to forced treatment of mentally ill prisoners should be decided on prisoner competency, prognosis, and the probability of successful treatment. The paper states that national administrative bodies should be established to enforce health care standards, the courts should take a more active role in ensuring inmate rights, and international supervisory bodies should be established.