Quality of Care in Prisons

Infirmary beds for prison healthcare

The Need for Independent Healthcare Staff in Prisons  

Marquette Cummings died an egregious death—not because of how he died, but rather who killed him. After being stabbed in the eye by another incarcerated person, Cummings was taken from St. Clair Correctional Facility in Springville, Alabama to the University of Alabama at Birmingham Hospital in critical condition. Even though Cummings’s mother said he was …

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Metal Sculpture at the Nelson Mandela Capture Site in Howick, Kwazulu Natal, South Africa

We Already Know What to Do: The Nelson Mandela Rules

Our correctional medicine experts are often asked to opine on cases involving injury and death at the hands of negligent (and sometimes deliberately harmful) medical providers; in those cases, the adverse health outcome can indicate the need for reform. But minimum standards regarding how to protect prisoners’ rights have already been spelled out. In 1955, …

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Lower half of a person's face, covered in orange and yellow swirls to depict heat.

“Hotter than Three Hells”: Heat-Related Deaths in Prison

On December 7, 2020, 44-year-old Thomas Rutledge was found unresponsive in the mental health ward of William E. Donaldson Correctional Facility in Bessemer, Alabama. His body temperature was 109°F, ten degrees above normal body temperature. He died soon afterward from severe hyperthermia. So how does someone die from hyperthermia in December? According to an investigation, …

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Woman holding magnifying glass up to her left eye

Correctional Oversight Systems: Who’s Watching the Watchers?

“The simple presence of an outside observer changes what happens inside a prison environment. It also can show us who we really are.” Michele Dietch From 2001 to 2019, the U.S. Department of Justice compiled the records of every inmate death in federal and state prisons (Carson, 2021a, 2021b). The results painted a grim picture of what …

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The Responsible Health Authority in Correctional Healthcare

Correctional healthcare, like care in the community, involves a patient and a doctor who meet in an examination room.  The patient voices his or her complaints, the doctor takes a history and then performs a physical examination.  Perhaps some testing is needed.   There is then a diagnosis and a recommended treatment.  Straightforward, right? Not quite. …

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person taking a pill and holding glass

Improving Chronic Pain Management in Prisons and Jails (Part 2 of 2)

Even though chronic pain management in a correctional environment is challenging, standard of care in correctional practice is that chronic pain must be responsibly managed and treated.  To do so requires the following components: The physician has to take an appropriate history, perform an examination, order indicated diagnostic testing, and involve specialist consultation as needed …

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improving chronic pain management

Improving Chronic Pain Management in Prisons and Jails (Part 1 of 2)

Whether the location is a state prison or a local county jail, complaints of pain are extraordinarily common for physicians to encounter in clinical practice at a correctional facility. Pain is not like blood pressure or weight which can be easily measured.  Pain is subjective and there is no test a physician can order to …

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