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Health Care in Prison

Rebecca L. Keppler
Widener University

Health Care in Prison

In prisons across the world inmates are not receiving adequate health care. This could
cause many problems because if inmates are not receiving proper health care they will never get
better and it could cause them to die. Everyone deserves health care it does not matter what they
did to get them in prison. There are still people that think that people in jail do not deserve health
care because of whatever they did to get them put in jail. It is a nurses obligation and by law
they have to do everything that they know to make the patient better. The treatment of serve
illnesses can be very hard in prison. For example the treatment of cancer could be very difficult
because the environment of a prison is not that suitable for healing. A patient had a better chance
of getting better when they have a healthy environment to be recovering in. When a patient is in
prison there are a lot of differences between what they get treated and how a person family is
notified. Before they are allowed to call the prison and health care system has to have the
prisoner fill out a form so that the staff at the prison can release information on the patient in the
prison hospital (McNary 2010).
In 2000 reports show that there was 1.3 million inmates were being held in 1,668 federal,
state, and private correctional facilities (Conroy). In 2003 there was a study conducted by the
Centre for Policy on Ageing and charity the Prison Reform Trust that found that more than 80
per cent of male prisoners aged 60 and over had a chronic illness or disability (Duffin 2010). In
2006 the charity said that health care in prisons had improved, but when primary care trust took
over they found that health care was very poor in woman prisons. They also found that many
older peoples needs were not being met. With the average age of prisoners rising the health care
that is being provided is not increasing as well. One of the prisoner said he had to wait for a
friend on his wing to help him get a bath because there was no officer or nurse willing to help
(Duffin 2010). In 2008 the chief inspector of prisons Dame Anne Owers reported that a national

strategy for older prisoner carer schemes was needed (Duffin 2010). Dame Anne also said that
that each health unit should have a lead nurse or manager with responsibility for older prisoners,
and that all the nurses should receive training for treating older patients (Duffin 2010).
When looking at the health care system in federal prisons there are four levels in the
Bureau of Prisons (BOP) medical care level classification system (Ellis 2008). In care level one
the inmates are less than seventy years old, and are generally healthy but they suffer from mid
health care problems. Those problems can be treated in by clinicians and just need to be
examined every six months. Examples of these types of medical conditions are diet- controlled
diabetes, mild asthma and stable HIV patients. In level two are inmates that need a medical
evaluation every three months and could need an examination from a medical specialist. These
inmates could suffer from medication- controlled diabetes, epilepsy, or emphysema. In level
three inmates have to be diagnosed and placed into this level by the BOPs Office of Medical
Designation. They have the choice to let the inmate in or to say that they do not have a serious
enough medical condition. The inmates in this level require some assistance with everyday
living, for example dressing, bathing, or eating; but they do not need constant help. Examples of
illnesses that these inmates have are cancer in remission, advance HIV, end-stage liver disease, or
serve congestive heart failure. The inmates that are in the level four are the worst. As in level
three in level four the inmates also require the BOPs Office of Medical Designation. These level
four inmates have to be in the BOP Medical Referral center, the BOP Medical Referral center
provides significantly enhanced medical treatment. The most server medical condition could
require twenty four hour medical attention. Examples of inmates in this level are inmates with
cancer in active treatment, high-risk pregnancy, stroke or head injury patients, major surgery, or
inmates on dialysis (Ellis 2008).

The BOP has five levels of medical intervention which they use to define its scope of
medical services (Ellis 2008). The first level is medically necessary- acute of emergent, if the
patients in this level do not receive medical attention immediately their health will deteriorate
and it could be life threatening. The second is medically necessary- non-emergent. An inmate
that is classified in this level has a medical condition that is not immediately life-threatening, but
if it is left untreated it could cause the patient to not be able to heal fully and could cause a
premature death. The next level is medically acceptable- not always necessary, these are medical
conditions that are not necessary but would make the patients quality of life better. Examples of
this could be joint replacement, or non-cancerous skin conditions like skin tags, or lipomas. The
next level is limited medical value; in this level treatment would provide little to no medical
value. An example of this level would be cosmetic procedures like face lifts or implants. The last
level is extraordinary which are treatments that affect the life of another individual. An example
of this level is organ transplants. It is the policy that the BOP has to provide care to the inmates
that meet the requirements to be medically necessary (Ellis 2008).
People in prison deserve to have cancer. Many people believe this is true which makes
treatment of cancer in prison very difficult and very unlikely. People believe that if someone is in
prison that they should have cancer so they can suffer more. For example if a man killed
someone then that man deserve cancer as a payback for what he did. Everyone deserves
treatment and by law the nurses that work in prisons are obligated to provide care for the
inmates. Approximately 9% of U.S. inmates face cancer while in prison (U.S. Department of
Justice, 2006) Inmates that have cancer are very different from inmates that do not. After
treatment the patient has to go back to a cell and there is no happy outlook and all that they have
to look forward to is going back to their cell. There is also a different environment for the nurses

at work in a prison than in a normal hospital. In a prison the inmates go to the nurse in handcuffs
with a uniformed officer. The nurses also dont know what kind of mind set that the patient will
have when the go to hem for treatment, cancer patient normally only have bad days so they could
try to start trouble when they are going in for treatment. The inmate communicating with the
nurse could be the only communication that the inmate ever receives if the inmate is under
solitary confinement. The Texas Department of Criminal Justice Hospital, is a prison hospital
with maximum-security and the staff there cares for most prisoners in Texas. The facilitys a
general hospital with 172 inpatients beds, and a medical-surgical unit or every thirty-six beds.
These prisoners are treated as if they are not even locked up; they have an equal amount of care
provided to them as free people have, and they are not lied to about their treatment plans.
There are many differences between what the inmates treatment is like compared to the
patients that are not in prison. The first difference is that in the free world the patients family is
always up to date on how the patient is doing bit in prison the prisoners family may not be
notified and communication between the nursing and the family of the prisoner is limited
(Kwarciany 2010). Another difference between the two is that when a patient is in a normal
hospital they are allowed to have visitors whenever they want, but when the patient is in prison
the visitations that they are allowed are very limited, and in most cases the prisoners are not even
allowed to talk to their family and they have staff that will inform the family on how the patient
is doing. When the patient is well enough they are placed into a different area of the hospital
where they can be taken care of by physicians or nurse practitioners instead of doctors
(Kwarciany 2010). It is very important that the patients continue treatment of the cancer will
return and get worse. When the patient is being treated the nurses and doctors must remember
that they are criminals and that nothing should be left around the patient that the patient could

use as a weapon. The nurse also must never turn their back to patient because the patient could
use this time to harm the care giver in attempt to escape (Kwarciany 2010). Whenever the
prisoner is brought to get treatment they have to pass through a metal detector and they have to
also go through it on their way back to their cell (Kwarciany 2010). They do this because they
want to make sure that the prisoners are not stealing things that they could use as weapons to
harm people.
In some of the prison in cancer treatment centers in Texas some of their prisoners were
allowed to take part in new cancer research of treatment trials, but currently they are not
allowing their patients to participate in the cancer treatment trials (Kwarciany 2010). Reports
also say that women are treated in prison differently and that men normally have better treatment
(Law 2012). In most prisons they group groups of people with similar illnesses together. This
could be a good thing because they could all support each other while they recover.
There are many improvements that are needed with the health care system in prisons. The
amount of health care that is being given is not nearly as much as the nurses and doctors should
be doing, and it is affecting the outcome of the patient in a huge way. There are many differences
between how a patient in jail is treated in comparison to someone that is not in jail. When a
patient is in jail the nurse that is treating that patient has to be very careful because treating a
prisoner and a free person are very different and it could be very dangerous if the inmate chooses
not to cooperate. When an inmate is being treated at a prison hospital the contact that is made
between the patient and their family it is very different than it is in a normal hospital. In most
cases the prisoner is not allowed to even talk to family and they have a staff member at the prison
talk to their family to let them know how they are doing. There are a lot of problems that are

found in the prison health system across the United States, if these problems are not solved the
lives of many prisoners would be in trouble.

References

Conroy, C. (2008, April 24). Medical Conditions and Health Care in Prisons. CWRU. Retrieved
March 5, 2012, from www.cwru.edu/med/epidbio/mphp439/prisonhealthcare.pdf
Duffin, C. (2010). Doing Time: Health Care in the Criminal Justice System. Widener University
Library Catalog. Retrieved March 23, 2012, from http://0web.ebscohost.com.libcat.widener.edu/ehost/pdfviewer/pdfviewer?
vid=6&hid=108&sid=d04b34d9-c9e5-420c-b547-169d51ba6bd3%40sessionmgr115
Ellis, A. (2008). Health Care in the Federal Prison System. Federal Sentencing. Retrieved March
5, 2012, from www.alanellis.com/CM/Publications/ellisreprint.pdf
Kwarciany, G. (2010). Cancer Care Behind Bars. Onsconnect. Retrieved March 4, 2012, from
www.onsconnect.org/wp-content/issues/2010/08.pdf
Law, V. (2012, January 25). Breast Cancer Behind Bars: How a Prison Sentence Can Become a
Death Sentence. Truthout. Retrieved March 4, 2012, from truth-out.org/index.php?
option=com_k2&view=item&id=6097:breast-cancer-behind-bars-how-a-prisonsentence-can-become-a-death-sentence
McNary, S. (2010, August 23). Prisoner's wife talks about her husband's prison cancer treatment |
89.3 KPCC. Home | 89.3 KPCC. Retrieved March 4, 2012, from
http://www.scpr.org/news/2010/08/23/18344/prisoners-wife-talks-about-her-husbandsprison-can/

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