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.
At their best, good systems allow space for the practical judgment of health care professionals to achieve justice in the particular actions of their daily practice.
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.
Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.
AMA J Ethics. 2018;20(8):E778-779. doi:
10.1001/amajethics.2018.778.
Giving undocumented immigrants and those with DACA status (DREAMers) access to health care and medical education enables them to contribute to these systems.
AMA J Ethics. 2017;19(3):221-233. doi:
10.1001/journalofethics.2017.19.3.peer1-1703.