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Professional independence of health care workers in prison

Professional independence of health care workers in prison. Jörg Pont, Vienna. Bucharest 27.02.2013. The essence of medical ethics in prison. The primary task of the prison doctor and the other health care workers is the health and well-being of the inmates.

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Professional independence of health care workers in prison

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  1. Professional independenceof health care workers in prison Jörg Pont, Vienna Bucharest 27.02.2013

  2. The essence of medical ethics in prison • The primary task of the prison doctor and the other health care workers is the health and well-being of the inmates. • The 7 essential principles for the practice of prison health care, as set out by the CPT: • Free access to a doctor for every prisoner • Equivalence of care • Patient consent and confidentiality • Preventive health care • Humanitarian assistance • Professional independence • Professional competence Bucharest 27.02.2013

  3. Bucharest 27.02.2013

  4. International consenteddocuments on medicalethics in prison United Nations UNHRC Council of Europe, CPT World Medical Association International Council ofNurses Penal Reform International Physiciansfor Human Rights Bucharest 27.02.2013

  5. 73. A prison doctor acts as a patient‘s personal doctor. CPT standards Bucharest 27.02.2013

  6. prison‘sdoctor or prisoners‘ doctor? Bucharest 27.02.2013

  7. “ Confidence of prisoners in the health care of a prison can only be obtained if it is known to everyone in the prison that for a prison physician, nurse or health care worker the patient has to have and indeed has priority over order, discipline or any other interests of the prison.” Penal Reform International, Making Standards Work, 2001 Bucharest 27.02.2013

  8. Principle 3 It is a contravention of medical ethics for health personnel, particularly physicians, to be involved in any professional relationship with prisoners or detainees the purpose of which is not solely to evaluate, protect or improve their physical and mental health. UN Resolution 37/194, 1982 Principles of Medical Ethics relevant to the role of health personnel in the protection of prisoners Bucharest 27.02.2013

  9. The prison doctor‘s job profile • Individual medicalcareofprisoners • Inspectionoffood, hygiene, livingconditionsandphysical/mental exerciseofprisoners • Advicetoprisonmanagementandtrainingtoeverybody in prison in healthcarematters Bucharest 27.02.2013

  10. Professional independenceand mental health 43. A mentallyillprisonershouldbekeptandcaredfor in a hospitalfacilitywhichisadequatelyequippedandpossessesappropriatelytrainedstaff. 12.1 Personswhoaresufferingfrom mental illnessandwhosestateof mental healthisincompatiblewithdetention in a prisonshouldbedetained in an establishmentspeciallydesignedforthepurpose. The CPT Standards European Prison Rules Rec (2006)2 Bucharest 27.02.2013

  11. Professional independenceand mental health • Assessment of mental competenceforconsent • Nodisclosureofpatient-relatedmedicaldataorforensiccertificateswithoutpatient‘sconsent. • Noblood/urinechecksorparticipation in bodysearchesforsecurityreasons Bucharest 27.02.2013

  12. Professional Independence promotes the confidence of the inmates to the medical care in prison leaves no doubt as to the health care team’s medical professionalism and ethics prevents misunderstandings provides guidance in situations of ethical conflicts supports quality assurance of the medical work protects against legal appeals is internationally supported Bucharest 27.02.2013

  13. Dual Loyalty: theclinicalroleconflictbetween professional dutiestothepatientandobligations, express orimplied, totheinterestsof a thirdparty such astheprisongovernment. Physiciansfor Human Rights, 2002 Bucharest 27.02.2013

  14. 1. Awareness, training, support Awarenessandtraining in medicalethicsforhealthcare professionals and non-medicalprisonstaff Activesupportandoversightofprisonhealthcare professionals by national professional boardsandhealthauthorities Bucharest 27.02.2013

  15. 2. Reduce dual loyaltyconflicts • Uncompromisingseparationofmedicalroles in prison: Professionals caringforprisonersshouldadhereexclusivelytocaregivingin complete professional independence. Medical functions in theinterestofthestate, prosecution, courtorthesecuritysystemtobeperformedby professionals not involved in thecareofprisoners. • Prisonhealthcaretobeorganizedindependentofprisonauthorities. Bucharest 27.02.2013

  16. Integration ofprisonhealthcarewithinthecommunityhealthcaresystem Completed: Geneva, Wallis, Waadt; Norway, France, Australia: NSW; England + Wales, Scotland In transition/planning: Spain, Italy, Slovenia, Turkey, Georgia, Moldova, Russia • Improvedquality • Professional independence • Continuityofcare • Common resources • Completionofpublichealth initiatives andepidemiologicalsurveillance • Betterrecruitmentandlessisolationofprisonhealthcarestaff Bucharest27.02.2013

  17. 3. Acceptancebythepublicand legal adaptation Incorporation of principles of professional independence of health care workers in penitentiary laws Advocacyof „PrisonHealthis Public Health“ Bucharest 27.02.2013

  18. Geneva Declaration 2012 on Health Care in Prison http://ump.hug-ge.ch/ Geneva.Declaration@hcuge.ch Bucharest 27.02.2013

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