Men and women in U.S. prisons have a constitutionally protected right to medical care. Though some claim this is unjust, it doesn’t take too much thinking to realize that a civilized society could hardly allow infectious disease, acute injury, or severe mental illness to go untreated among those it holds in custody. (The unfairness, of course, is that America’s nonincarcerated residents are not guaranteed care.) Assuring access, however, says nothing about the quality of care prison patients receive, and that is the subject of this month’s issue.
Some patients who have been injured or had back or lower extremity surgery while incarcerated require temporary use of a wheelchair. At times, getting these inmates to return to the general ambulatory population can be a challenge.
Those in prison are less healthy than the general population, are far more likely to have engaged in high-risk behaviors that can result in organ damage, disease and disability, and age more rapidly than nonincarcerated individuals do.
Prison patients are never alone and never without supervision and rules, and the medical staff is always negotiating its power with the adminsitration. The patient-doctor relationship can become distorted in this setting.