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Confidentiality in Prison Health Care – A Practical Guide

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Emerging Issues in Prison Health

Abstract

Medical confidentiality is universally recognized as an essential component of healthcare. However, preserving and protecting the confidentiality of prisoner patients is challenging in several ways. In this chapter we explore the general importance of medical confidentiality, and some of the challenges that arise in the wider context, before explaining and discussing some of the particular dilemmas that arise in the context of providing healthcare for prisoners. Overall, although healthcare professionals have the same obligations regarding confidentiality in the context of prisons, the conflicts of interest posed by their competing obligations to prison authorities often make it very difficult to strike the right balance between respecting patient confidentiality and protecting prisoners and others. We conclude by suggesting potential solutions for some of these difficult situations.

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Notes

  1. 1.

    The word prison is used in a global sense in order to indicate any kind of detention facility such as jails, prisons, police custody (etc.). Similarly, ‘prisoner’ refers to any person detained in such facilities.

  2. 2.

    For more information, see the Chap. 13, pp. 201–215.

  3. 3.

    As detainees share cells – which regularly do have toilets in the room without further shielding - and eat together and many of their activities are supervised by prison guards it is almost impossible to hide medication intake or disease symptoms.

  4. 4.

    See, Art. 364 Swiss criminal Code.

  5. 5.

    The aim of the study was to explore health professionals’ experiences with confidentiality. After approval by the competent research ethics committee, 24 mental health professionals working in Swiss prisons were interviewed in 2008 and 2009. They were selected from different regions and backgrounds, and varied in nationality, gender, professional experience, therapeutic orientation and cultural context. Interviews were transcribed and anonymised. At the beginning of the interview, participants were asked to describe difficult cases they had experienced and if cases similar to those discussed below were not spontaneously mentioned, the interviewer described them and asked how the heath professional would react and why.

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Authors and Affiliations

  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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  2. David M. Shaw
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Correspondence to Bernice S. Elger .

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Editors and Affiliations

  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). Confidentiality in Prison Health Care – A Practical Guide. 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_12

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  • DOI: https://doi.org/10.1007/978-94-017-7558-8_12

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