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Ageing Prisoners’ Views on Death and Dying: Contemplating End-of-Life in Prison

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Abstract

Rising numbers of ageing prisoners and goals on implementing equivalent health care in prison raise issues surrounding end-of-life care for prisoners. The paucity of research on this topic in Europe means that the needs of older prisoners contemplating death in prison have not been established. To investigate elderly prisoners’ attitudes towards death and dying, 35 qualitative interviews with inmates aged 51 to 71 years were conducted in 12 Swiss prisons. About half of the prisoners reported having thought about dying in prison, with some mentioning it in relation with suicidal thoughts and others to disease and old age. Themes identified during data analysis included general thoughts about death and dying, accounts of other prisoners’ deaths, availability of end-of-life services, contact with social relations, and wishes to die outside of prison. Study findings are discussed using Allmark’s concept of “death without indignities,” bringing forth two ethical issues: fostering autonomy and removing barriers. Attributing the identified themes to these two ethical actions clarifies the current needs of ageing prisoners in Switzerland and could be a first step towards the implementation of end-of-life services in correctional systems.

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Acknowledgments

The authors highly appreciate the access given by the participating prisons and the time and willingness of the prisoners who shared their life stories and ageing concerns. We also thank our assistants for transcribing the data. We are indebted to the following persons for supporting the overall project: Prof. B. Elger, Prof. C. Büla, Dr. B. Gravier, Prof. N. Biller-Andorno, Prof. M. Aebi, Prof. A. Holly, Dr. J. Page, Dr. A. Stuckelberger, J. Sommer, W. Bretschneider, and Dr. C. Ritter.

Funding Support

This work was supported by the Swiss National Science Foundation (CR13I1_135035/1).

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Correspondence to Violet Handtke.

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Handtke, V., Wangmo, T. Ageing Prisoners’ Views on Death and Dying: Contemplating End-of-Life in Prison. Bioethical Inquiry 11, 373–386 (2014). https://doi.org/10.1007/s11673-014-9548-x

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