Skip to content

Caring for Prisoners

Prisoner Patients: At a Clinical Ethics Grand Rounds we discussed the ethical and practical dimensions of caring for prisoners. The entire presentation can be found at http://bioethics.unc.edu/talk/ethical-care-of-the-prisoner-patient/:

Can the prisoner-patient decide on the kind of treatment he or she will receive?

  • Yes, a prisoner may be presented with treatment options

Can a prisoner-patient refuse treatment?

Can a prisoner-patient choose code status?

Can a prisoner-patient patient choose a proxy?

Can a prisoner-patient be an organ donator?

  • Yes, Yes, Yes, and Yes -- unless the patient lacks capacity.

Can I offer a prisoner-patient the same treatment options I offer other patients with the same condition? - Yes. Under the 8th Amendment, prisoners have the right to: access to care, care that is ordered, professional medical judgment

Can I discuss sensitive matters or offer bad news in confidence?

  • Prisoners are entitled to confidentiality like all other patients, but the correctional officers cannot be (and should not be dismissed). They are bound under HIPAA and professional standards, but news ought to be delivered to the patient and not the officers.
  • If a non-prisoner patient asks about correctional officer presence on a unit, inform the patient that they are here as part of our normal operations.

Can I support my patient’s loved ones?

  • Staff should not communicate directly with prisoners’ family or friends without first obtaining clearance from the custodial agency

Can a prisoner-patient order whatever he or she wishes from the menu?

  • A specific meal without utensils is ordered for prisoner-patients; however, if a medically necessary diet is needed, an MD must place a medical order. Communicating this need with the officers is helpful.

Can I discuss discharge plans with a prisoner-patient?

  • Treatment options and need for follow-up may be discussed, but specific places and times ought not be discussed with the patient for security reasons.

What do I do, if I do not know the rules or have an issue with one of the correctional officers? Contact the UNC Hospital Police and ask for the Correctional Facility Liaison 984-974-3686.