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1.
Obstet Gynecol ; 136(5): 1036-1039, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030860

RESUMO

The population of women within carceral systems is growing rapidly. A portion of these individuals are pregnant and will deliver while incarcerated. Although shackling laws for pregnant persons have improved, incarcerated patients are forced to labor without the support of anyone but a carceral officer and their medical staff. We believe access to continuous labor support is critical for all pregnant persons. Carceral systems and their affiliated hospitals have the opportunity to change policies to reflect that continuous labor support is a basic human right and should be permitted for incarcerated pregnant persons in labor, either through a doula program or a selected person of choice.


Assuntos
Parto Obstétrico/ética , Trabalho de Parto/psicologia , Direitos do Paciente/legislação & jurisprudência , Assistência Perinatal/ética , Prisioneiros/psicologia , Entorno do Parto , Parto Obstétrico/legislação & jurisprudência , Feminino , Humanos , Assistência Perinatal/legislação & jurisprudência , Gravidez , Prisioneiros/legislação & jurisprudência
5.
Cad Saude Publica ; 35(7): e00242618, 2019 07 29.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31365702

RESUMO

The current status of policies on illicit drugs has implications for Collective Health that need to be discussed in depth. This essay aims to explore, in light of the best evidence, the public health impact of drug policies focused on the criminalization of growing, selling, and consuming psychoactive substances. Brazil provides the context for the main analysis. The principal points addressed in this work include drugs as a social issue and the definition of the prohibitionist paradigm, evidence of the unhealthy relationship between this paradigm and the population's health, the issue of a model of care for users of psychoactive substances focused on therapeutic communities, and future paths to be explored to overcome the prohibition of illicit drugs as the principal approach to the issue. Among the main problematic elements in the repressive approach in the Brazilian context, the study highlights violence and homicides, the health impacts of incarceration and blocked access to the health system, and potential new therapies derived from currently banned psychoactive substances. As proposals for future policy changes, the study highlights decriminalization of the use, possession, and small-scale sale of drugs; the reduction of the violence and discrimination associated with policing; focus on harm reduction policies; approach to gender-related specificities; and inclusion of social variables as metrics for successful treatment of problematic drug use. In conclusion, it is relevant that the social issue and drug policy have become the object of more studies in the field of Collective Health.


Assuntos
Controle de Medicamentos e Entorpecentes/organização & administração , Drogas Ilícitas/legislação & jurisprudência , Administração em Saúde Pública , Política Pública/legislação & jurisprudência , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Brasil , Usuários de Drogas/legislação & jurisprudência , Controle de Medicamentos e Entorpecentes/história , Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Acesso aos Serviços de Saúde , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Prisioneiros/legislação & jurisprudência , Prisioneiros/estatística & dados numéricos , Política Pública/tendências
6.
Psychiatr Serv ; 70(7): 622-624, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31258031

RESUMO

As death row prisoners age, a new set of issues arises regarding their competence to be executed. Can a prisoner with dementia who no longer remembers the crime be put to death? What if the dementia has progressed to the point that the prisoner no longer understands that he or she faces execution, or why? These issues were considered by the U.S. Supreme Court in its recent decision in Madison v. Alabama. Implicitly rejecting the cruelty of executing a highly impaired prisoner, the court clarified the conditions that could preclude execution and the degree of impairment that must be present.


Assuntos
Pena de Morte/legislação & jurisprudência , Demência , Psiquiatria Legal/legislação & jurisprudência , Competência Mental/legislação & jurisprudência , Prisioneiros/legislação & jurisprudência , Decisões da Suprema Corte , Idoso , Humanos , Masculino , Estados Unidos
7.
Arch Dermatol Res ; 311(10): 837-840, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31321507

RESUMO

While prison medicine is a heavily researched area for quality improvement, little is known regarding prisoner access to dermatologists. The goal of this study was to characterize the claims related to a lack of dermatologist access in prison malpractice cases. We searched the LexisNexis Academic database of legal records from 1970 to 2018 using the terms "medical malpractice and dermatologist" to yield federal malpractice cases involving dermatologists. Ultimately, 89 distinct cases in which a prisoner was not able to see a dermatologist were included in the final analysis. Data relating to year, location, anatomical site, symptoms, dermatologist related claim, specialty of treating physician, and final diagnosis were extracted for each case. The 89 cases involving prisoners who were not able to see a dermatologist for their skin condition ranged from 1982 to 2018, with California (n = 12) and Pennsylvania (n = 11) containing the largest number of cases. 76% of the prisoners were only treated by primary care prison physicians for their dermatologic concerns. Several issues regarding dermatologist access were categorized in this study. This study reveals limited access to dermatologists for prisoners in need of dermatologic care. Improved collaboration between prison officials, prison medical staff, and dermatologists could help improve prisoner care and limit malpractice risk.


Assuntos
Dermatologistas/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Imperícia/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Dermatopatias/terapia , Bases de Dados Factuais/estatística & dados numéricos , Dermatologistas/história , Dermatologistas/legislação & jurisprudência , Feminino , Acesso aos Serviços de Saúde/história , Acesso aos Serviços de Saúde/legislação & jurisprudência , História do Século XX , História do Século XXI , Humanos , Colaboração Intersetorial , Masculino , Imperícia/história , Imperícia/legislação & jurisprudência , Prisioneiros/história , Prisioneiros/legislação & jurisprudência , Estados Unidos
9.
Health Secur ; 17(3): 240-247, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31206320

RESUMO

Legal Perspectives is aimed at informing healthcare providers, emergency planners, public health practitioners, and other decision makers about important legal issues related to public health and healthcare preparedness and response. The articles describe these potentially challenging topics and conclude with the authors' suggestions for further action. The articles do not provide legal advice. Therefore, those affected by the issues discussed in this column should seek further guidance from legal counsel. Readers may submit topics of interest to the column's editor, Lainie Rutkow, JD, PhD, MPH, at lrutkow@jhu.edu. This article describes and analyzes the body of emergency preparedness, response, and recovery litigation that has arisen since the September 11, 2001, terrorist attacks. Search terms were developed to identify judicial opinions related to emergency preparedness, response, and recovery activities. Using the Thomson Reuters Westlaw legal database, searches were conducted to collect judicial opinions related to disasters that occurred in the United States between September 11, 2001, and December 31, 2015. An electronic form was used for data abstraction. Cases that did not directly involve emergency response, preparedness, or recovery activities were excluded. Data were summarized with descriptive statistics. We identified 215 cases for data abstraction. Many of the cases stemmed from preparedness, response, and recovery activities related to hurricanes (57.7%) and terrorist attacks (16.7%). The most prevalent emergency response activities at issue were disaster mitigation (29.3%), disaster clean-up (21.9%), a defendant's duty to plan (14.4%), evacuation (12.6%), and conditions of incarceration (12.1%). Although it can be anticipated that litigation will arise out of all phases of disaster preparedness, response, and recovery, policymakers can anticipate that the most litigation will result from pre-event mitigation and post-event recovery activities, and allocate resources accordingly.


Assuntos
Defesa Civil/legislação & jurisprudência , Planejamento em Desastres/legislação & jurisprudência , Recuperação e Remediação Ambiental/legislação & jurisprudência , Desastres/prevenção & controle , Humanos , Prisioneiros/legislação & jurisprudência
12.
J Am Acad Psychiatry Law ; 47(2): 233-239, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31048366

RESUMO

In 2003, Arizona began a jail-based restoration to competency program for detainees in its largest jail system in Phoenix. Today, jail-based competency programs have become the rule statewide to the degree that very few incompetent detainees are now referred to the Arizona State Hospital for restoration services. This article focuses on the topic of treatment refusal and the use of forced medications for detainees who are in these jail-based restoration programs. We describe Arizona's novel statewide jail-based programs, Arizona's statutory and case law approach to treatment refusal, and the restoration to competency programs in one large county jail that has no legal mechanism outside of civil commitment for the determination of whether forced treatment will be permitted. We conclude with a discussion of specific override procedures that might apply directly to incompetent detainees in a jail-based competency restoration program and whether the use of these procedures is prudent in a jail environment.


Assuntos
Competência Mental/legislação & jurisprudência , Transtornos Mentais/terapia , Prisioneiros/legislação & jurisprudência , Recusa do Paciente ao Tratamento/legislação & jurisprudência , Arizona , Humanos , Prisioneiros/psicologia
13.
Behav Sci Law ; 37(3): 281-303, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31099078

RESUMO

Custodial suicide is a foundational concern for correctional systems. The incarcerated population is at an increased risk for suicide as compared with people living in the community. Sufficient suicide prevention is a critical component of a constitutionally adequate system of correctional mental health care. The remedial phases of class action litigations have animated improvement in suicide prevention in many correctional systems across the United States. In the current climate, many legal obstacles make it more difficult for plaintiffs to prevail in such cases, but it is expected that advocates will find novel approaches in response to these legal hurdles, such as greater reliance on state law remedies, and will seek to expand the scope of potential actions in emerging areas such as immigration detention. Defendants and courts will, in turn, need to respond to these changes. This article explores the history of relevant litigations, and the legal obstacles currently faced by plaintiffs, as well as future directions the authors consider will likely be taken. Practical issues such as appropriate measurement of improvement in the area of suicide prevention are also explored.


Assuntos
Prisioneiros/legislação & jurisprudência , Prisioneiros/estatística & dados numéricos , Prisões/legislação & jurisprudência , Suicídio/legislação & jurisprudência , Suicídio/prevenção & controle , Previsões , Humanos , Medição de Risco/legislação & jurisprudência , Medição de Risco/estatística & dados numéricos , Suicídio/tendências , Estados Unidos
14.
Arq. ciências saúde UNIPAR ; 23(2): 71-80, maio-ago. 2019.
Artigo em Português | LILACS | ID: biblio-996654

RESUMO

O Brasil apresenta a terceira maior população carcerária do mundo com 726.712 pessoas encarceradas. Verifica-se um déficit de 358.663 vagas no sistema prisional. A Constituição Brasileira de 1988 garante o direito à saúde as pessoas privadas de liberdade. Como estratégia para efetivar ações de saúde no âmbito prisional, em 2003, foi instituído o Plano Nacional de Saúde do Sistema Penitenciário no SUS. Durante 10 anos a sua execução buscou garantir cuidado de saúde à população carcerária. Trata-se de uma pesquisa qualitativa, do tipo descritiva e exploratória. O objetivo principal foi compreender a assistência à saúde das pessoas residentes no CDP, na cidade de Pau dos Ferros/RN/Brasil. Participaram da pesquisa profissionais de saúde (n=4) e da justiça (n=9). Como instrumento de coleta de dados utilizou-se a entrevista semiestruturada, que após transcrição foram analisadas e interpretadas pelo método da Análise Temática. Ao final, quatro categorias emergiram: Conhecimento dos Trabalhadores da Saúde e da Justiça sobre a garantia da Saúde no Sistema Prisional. As ações de saúde realizadas para atender as necessidades e problemas das pessoas privadas de liberdade. O diálogo entre as instituições de saúde e da justiça no sentido de garantir o direito à saúde. A efetivação do direito à saúde no sistema prisional: limites e possibilidades. O estudo demonstrou o quanto é carente a assistência em saúde aos homens em situação de detenção provisória e, como é cogente a aplicação na prática dos princípios do SUS, somente assim, há de se conquistar a quimera que é o diálogo entre a saúde e a justiça para a real operacionalização da Política Nacional de Atenção Integral da Saúde Prisional, resultando assim numa melhoria da situação de saúde vivenciada no sistema prisional.


Brazil has the third largest prison population in the world with 726,712 people incarcerated. There is a deficit of 358,663 places in the prison system. The Brazilian 1988 Federal Constitution guarantees the right to health to persons deprived of their freedom. As a strategy to implement health actions in prison, in 2003, the National Health Plan of the Penitentiary System in the Single Health System was established. For 10 years, its execution sought to guarantee health care to the imprisoned population. This study presents a descriptive, exploratory qualitative research, where the main objective was to understand the health care provided to people living in CDP, in the city of Pau dos Ferros in the state of Rio Grande do Norte, Brazil. Health professionals (n = 4) and justice professionals (n = 9) participated in the research. A semi-structured interview was used as a data collection instrument, which, after transcription, was analyzed and interpreted by the Thematic Analysis method. In the end, four categories emerged: Knowledge of Health and Justice Professionals about Health Care in the Prison System. Health actions taken to address the needs and problems of persons deprived of their freedom. Dialogue between health and justice institutions in order to guarantee the right to health. The right to health accomplishment in the prison system: limits and possibilities. The study demonstrated the lack of health care for men in custody and, as the practical application of the SUS principles is required, it is the only way to conquer the chimera that is the dialogue between health and justice for the real operationalization of the National Policy of Integral Prison Health Care resulting in an improvement of the health situation experienced within the prison system.


Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde/legislação & jurisprudência , Prisioneiros/legislação & jurisprudência , Efetividade , Direitos dos Prisioneiros , Prisões/legislação & jurisprudência , Sistema Único de Saúde , Assistência à Saúde , Populações Vulneráveis/legislação & jurisprudência , Direito à Saúde/legislação & jurisprudência , Direitos Humanos/legislação & jurisprudência
15.
Encephale ; 45(4): 297-303, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-30961972

RESUMO

INTRODUCTION: The injunction to care (IC) is a new compulsory treatment created by the Act of June 17, 1998. Initially, this judicial tool concerned mainly sex offenders, but then the number of overall crimes requiring an IC began to dramatically rise. The judge can order this measure only if a psychiatric expertise has concluded to its potential opportunity. Then the convict must undergo a psychiatric follow-up after having served the sentence. The creation of a court-ordered treatment is based on the premise that many offenders are affected by psychiatric disorders. For the lawmaker, the aim is to lower the risk of recidivism. PURPOSES: The main purpose of this study is to assess the convicts concerned by the IC describing their sociodemographic characteristics, psychiatric diagnostics and criminal characteristics. The second purpose is to assess the efficiency of this measure regarding re-offending and specifically legal recidivism. METHODS: This is a retrospective and descriptive study concerning 119 subjects followed-up by two "coordinating doctors" in the department of Sarthe who could assess their psychiatric diagnostics and sociodemographic characteristics. They could also compare medical data with the judicial data for 78 of the subjects. RESULTS: The population was composed of 117 men (98.3%) aged 45 years old on average. They had a job in 37% of cases (n=44) and were single in 56.3% of cases (n=67). According to the DSM-IV-TR, only 29 subjects (24.4%) had an axis I disorder and 37.8% of the population had a pathological personality trait (non DSM-IV-TR categorized disorder). Furthermore, 51.3% (n=61) of the subjects were addicted (mainly alcohol). The medical follow-up was carried out by a psychiatrist in 83.2% of cases (n=99). The average duration of follow-up was five years. Among the 78 subjects for whom there was access to juridical data, 13 (16.7%) had committed a new offense during follow-up. Among them, seven had recidivated six of whom were initially sentenced for sexual offense. CONCLUSIONS: Most of the subjects in injunction to care had no axis I disorder but addictions and/or pathological personality traits. Nevertheless, the expert concluded the need of an IC. Personality and behavior disorders do not always require psychiatric care, and the management must be multidisciplinary. In France, the psychiatrist remains at the center of injunction to care measure. The addictology care is not developed whereas it is a population at risk and there is a lack of interactions between professionals (medical, social and judicial professionals). The IC is a measure that needs to be improved by means of better communication among the different professionals and a better global assessment of the subjects. Medical care must be a possible option but not a systematic treatment.


Assuntos
Transtornos Mentais , Padrões de Prática Médica , Prisioneiros/psicologia , Psiquiatria/estatística & dados numéricos , Psicoterapia , Delitos Sexuais , Adolescente , Adulto , Internação Compulsória de Doente Mental/legislação & jurisprudência , Internação Compulsória de Doente Mental/estatística & dados numéricos , Criminosos/legislação & jurisprudência , Criminosos/psicologia , Criminosos/estatística & dados numéricos , Feminino , Medicina Legal/normas , Psiquiatria Legal , Humanos , Legislação Médica , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Padrões de Prática Médica/legislação & jurisprudência , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Prisioneiros/legislação & jurisprudência , Prisioneiros/estatística & dados numéricos , Psicoterapia/legislação & jurisprudência , Psicoterapia/normas , Psicoterapia/estatística & dados numéricos , Estudos Retrospectivos , Prevenção Secundária/métodos , Delitos Sexuais/prevenção & controle , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Adulto Jovem
17.
N Z Med J ; 132(1493): 60-68, 2019 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-30973861

RESUMO

We draw upon two recent reports from the Chief Ombudsman that describe the prison management of people assessed at risk of self-harm or suicide, as cruel, inhuman or degrading treatment or punishment. People were mechanically restrained on 'tie-down' beds by their legs, arms and chest or placed in waist restraints with their hands cuffed behind their backs over prolonged periods. These practices occurred at the direction of, or were approved by, health professionals. We highlight ethical issues for health professionals party to 'tie down' and examine the current guidance and regulatory framework for health professionals working in coercive environments. This article is timely in the context of current Government Inquiries into the criminal justice system and mental health and addictions, the review of the health and disability system, the Correction's Amendment Bill before parliament, and Government plans to expand Waikeria prison to include a 100-bed mental health facility. We call for the use of 'tie down' to be abolished in New Zealand prisons, and for all health professionals to refuse to participate in this practice. Government must make provision for sufficient forensic mental health capacity and capability in the health sector, and ensure timely, equitable access to high-quality, trauma-informed and culturally safe services.


Assuntos
Serviços de Saúde Mental/legislação & jurisprudência , Prisioneiros/legislação & jurisprudência , Prisões/legislação & jurisprudência , Restrição Física/legislação & jurisprudência , Internação Compulsória de Doente Mental/legislação & jurisprudência , Humanos , Determinação de Necessidades de Cuidados de Saúde/legislação & jurisprudência , Nova Zelândia , Punição
18.
Am J Public Health ; 109(3): 419-422, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30676805

RESUMO

Expanding access to treatment of opioid use disorder (OUD) is central to addressing the US overdose mortality crisis. Numerous barriers to OUD treatment are encountered in criminal justice institutions and processes, with which people with OUD are disproportionately involved. OUD treatment access is severely limited in US corrections facilities, with few exceptions. Drug treatment courts, which in principle provide court-supervised treatment as an alternative to prison, have also unduly limited treatment options, particularly medication-assisted treatment. The voice and expertise of health professionals are urgently needed to remove these barriers and ensure that criminally accused persons are systematically linked to the care they need.


Assuntos
Defesa do Consumidor/legislação & jurisprudência , Overdose de Drogas/tratamento farmacológico , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Prisioneiros/legislação & jurisprudência , Prisões/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Adulto , Idoso , Idoso de 80 Anos ou mais , Buprenorfina/uso terapêutico , Direito Penal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Entorpecentes/uso terapêutico , Estados Unidos
19.
Int J Legal Med ; 133(4): 1251-1258, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30324326

RESUMO

OBJECTIVE: Custody conditions in police cells are often demeaning and considered inappropriate for human beings. The detention of young adolescents in police custody has received little attention. Our study aimed to describe the characteristics of adolescents under 18 detained in custody. METHODS: We studied all arrestees aged 13-17 examined in 1 year (January 01-December 31, 2014) in a suburban district near Paris. We evaluated the proportion of adolescents under 18 among all arrestees detained in custody and their medical history, addictive behaviors, perceived health status, and opinion on custody. RESULTS: Arrestees aged 13-17 accounted for 1859 individuals. They were predominantly males (94%) and accounted for 19% of all examinations in custody. Nearly half of the arrestees aged 13-15 (42%), and two thirds of those aged 16-17 (65%) had been previously detained in police cells. Somatic and psychiatric disorders were reported by 7% and 4%, respectively, of arrestees aged 13-17. Alcohol, tobacco, and cannabis consumption were reported by 5%, 24%, and 12%, respectively, of arrestees aged 13-15. These proportions were lower than the 16%, 50%, and 35%, respectively, reported by arrestees aged 16-17 (p < 0.0001). Assaults were reported by 18% of arrestees aged 13-17. They had a fair, bad, or very bad opinion on custody in 43% of cases. CONCLUSION: The detention of adolescents in police stations is commonly associated with assaults at the time of arrest. High proportions of adolescent arrestees smoke tobacco or cannabis. We suggest that the medical examination in custody could be an opportunity for adolescents to initiate access to health care.


Assuntos
Delinquência Juvenil/estatística & dados numéricos , Prisioneiros/legislação & jurisprudência , Adolescente , Feminino , Humanos , Delinquência Juvenil/legislação & jurisprudência , Aplicação da Lei/métodos , Masculino , Paris , Exame Físico/normas , Prisioneiros/estatística & dados numéricos , Prisões/legislação & jurisprudência
20.
HEC Forum ; 31(1): 29-48, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30284658

RESUMO

Roughly 80,000 U.S. prisoners are held in solitary confinement at any given time. A significant body of research shows that solitary confinement has severe, long-term effects, and the United Nations has condemned the practice of solitary confinement as torture. For years, prisoners have been organizing hunger strikes in order to protest solitary confinement. But such action is not without consequences, and some inmates have suffered serious injury or death. The question I raise in this paper is whether we ought to force-feed hunger striking prisoners when serious harm is imminent. Both the World Medical Association and the American Medical Association have denounced the practice of force-feeding prisoners on hunger strike, and yet, the practice is common. Such prevalence is likely a result of the tension between the person-as-patient and person-as-prisoner and cannot easily be resolved. Instead, we must take seriously the complaint that solitary confinement is inhumane and avoid placing health professionals in the position where they must choose to force-feed the prisoner against his will or not. I argue that a conventional bioethics debate centering on polarizing principles of prisoner autonomy and a duty-to-protect the prisoner from harm is an inadequate framework for this complex issue. Instead, we must examine the prisoner's intent and his right to freedom of speech. I argue that when the prisoner's intent is to raise awareness and communicate with others, his hunger strike is a form of speech. Protest-as-speech is constitutionally protected-even for prisoners-and remains a minimum ethical obligation for society to uphold.


Assuntos
Nutrição Enteral/ética , Jejum , Prisioneiros/legislação & jurisprudência , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Humanos , Obrigações Morais , Autonomia Pessoal , Prisioneiros/psicologia , Estados Unidos
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