Skip to main content

Advertisement

Log in

Contextualising Professional Ethics: The Impact of the Prison Context on the Practices and Norms of Health Care Practitioners

  • Original Research
  • Published:
Journal of Bioethical Inquiry Aims and scope Submit manuscript

Abstract

Health care is provided in many contexts—not just hospitals, clinics, and community health settings. Different institutional settings may significantly influence the design and delivery of health care and the ethical obligations and practices of health care practitioners working within them. This is particularly true in institutions that are established to constrain freedom, ensure security and authority, and restrict movement and choice. We describe the results of a qualitative study of the experiences of doctors and nurses working within two women’s prisons in the state of New South Wales (NSW), Australia. Their accounts make clear how the provision and ethics of health care may be compromised by the physical design of the prison, the institutional policies and practices restricting movement of prisoners and practitioners, the focus on maintaining control and security, and the very purpose of the prison and prison system itself. The results of this study make clear the impact that context has on professional practice and illustrate the importance of sociology and anthropology to bioethics and to the development of a more nuanced account of professional ethics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Anno, B.J., and S.S. Spencer. 1998. Medical ethics and correctional health care. In Clinical practice in correctional medicine, edited by M. Puisis, 22–53. St. Louis: Mosby.

    Google Scholar 

  • Arboleda-Flórez, J. 1991. Ethical issues regarding research on prisoners. International Journal of Offender Therapy and Comparative Criminology 35(1): 1–5.

    Article  PubMed  Google Scholar 

  • Attride-Stirling, J. 2001. Thematic networks: An analytic tool for qualitative research. Qualitative Research 1(3): 385–405.

    Article  Google Scholar 

  • Australian Medical Association. 2013. Medical ethics in custodial settings. https://ama.com.au/position-statement/medical-ethics-custodial-settings-2013. Accessed November 13, 2013.

  • Birmingham, L., S. Wilson, and G. Adshead. 2006. Prison medicine: Ethics and equivalence. British Journal of Psychiatry 188(1): 4–6.

    Article  PubMed  Google Scholar 

  • British Medical Association. 2001. The medical profession and human rights: Handbook for a changing agenda. London: Zed Book.

    Google Scholar 

  • Butler, T., and L. Milner. 2003. 2001 New South Wales inmate health survey. Sydney: NSW Corrections Health Service, (CHS) 030148.

  • Butler, T.G., K.A. Dolan, M.J. Ferson, L.M. McGuinness, P.R. Brown, and P.W. Robertson. 1997. Hepatitis B and C in New South Wales prisons: Prevalence and risk factors. The Medical Journal of Australia 166(3): 127–130.

    CAS  PubMed  Google Scholar 

  • Clark, P. 2006. Medical ethics at Guantanamo Bay and Abu Ghraib: The problem of dual loyalty. The Journal of Law, Medicine and Ethics 34(3): 570–580.

    Article  PubMed  Google Scholar 

  • Crampton, R. 2007. How do nurses care for prisoner patients? Negative attitudes towards prisoner patients, and a range of moral and ethical conflicts, can make the caring role difficult for some nurses. Kai Tiaki: Nursing New Zealand 13(3): 32–33.

    PubMed  Google Scholar 

  • Doyle, J. 1998. Prisoners as patients: The experience of delivering mental health nursing care in an Australian prison. Journal of Psychosocial Nursing and Mental Health Services 36(12): 25–29.

    CAS  PubMed  Google Scholar 

  • Doyle, J. 2003. Custody and caring: Innovations in Australian correctional mental health nursing practice. Contemporary Nurse 14(3): 305–311.

    Article  PubMed  Google Scholar 

  • Flanagan, N.A. 2006. Testing the relationship between job stress and satisfaction in correctional nurses. Nursing Research 55(5): 316–327.

    Article  PubMed  Google Scholar 

  • Fletcher, J., P.N. Reams, M.N. Smith, and E. Spencer. 1998. Making the case for bioethics in corrections: Formal programs or policies can alleviate pressure on correctional health care workers. Corrections Today 60(2): 112–7.

    Google Scholar 

  • Goffman, E. 1961. Asylums: Essays on the social situation of mental patients and other inmates. New York: Anchor Books.

    Google Scholar 

  • Hanks, P., ed. 1979. Collins dictionary of the English language. Sydney: Collins.

    Google Scholar 

  • Happell, B., J. Pinikahana, and T. Martin. 2003. Stress and burnout in forensic psychiatric nursing. Stress and Health 19(2): 63–68.

    Article  Google Scholar 

  • Hayes, M.O. 2006. Prisoner and autonomy: Implications for the informed consent process with vulnerable populations. Journal of Forensic Nursing 2(2): 84–89.

    Article  PubMed  Google Scholar 

  • Holmes, D., and C. Federman. 2003. Killing for the state: The darkest side of American nursing. Nursing Inquiry 10(1): 2–10.

    Article  PubMed  Google Scholar 

  • Holmes, D., A. Perron, and G. Michaud. 2007. Nursing in corrections: Lessons from France. Global Forensic Nursing 3(3–4): 126–131.

    Article  Google Scholar 

  • Holmwood, C., and D. Rae. 2003. Prison health: A different place for GPs. Australian Family Physician 32(10): 854–856.

    PubMed  Google Scholar 

  • Hooten, J., and D. Shipman. 2013. Comment: The ethical dilemmas of nurses’ participation prisoner executions. Nursing Ethics 20(4): 491–492.

    Article  PubMed  Google Scholar 

  • Iacopino, V., and S.N. Xenakis. 2011. Neglect of medical evidence of torture in Guantánamo Bay: A case series. PLoS Medicine 8(4). doi:10.1371/journal.pmed.1001027.

  • International Council of Nurses. 2011. Nurses’ role in the care of detainees and prisoners. http://www.icn.ch/images/stories/documents/publications/position_statements/A13_Nurses_Role_Detainees_Prisoners.pdf. Accessed November 13, 2013.

  • Katz, J. 1996. The Nuremberg code and the Nuremberg trial: A reappraisal. The Journal of the American Medical Association 276(20): 1662–1666.

    CAS  Google Scholar 

  • Lefor, A.T. 2005. Scientific misconduct and unethical human experimentation: Historic parallels and moral implications. Nutrition 21(7–8): 878–882.

    Article  PubMed  Google Scholar 

  • Lewis, C. 2006. Treating incarcerated women: Gender matters. Psychiatric Clinics of North America 29(3): 773–789.

    Article  PubMed  Google Scholar 

  • Lin, S.S., L. Rich, J.D. Pal, and R.M. Sade. 2012. Prisoners on death row should be accepted as organ donors. The Annals of Thoracic Surgery 93(6): 1773–1779.

    Article  PubMed Central  PubMed  Google Scholar 

  • Maeve, M.K. 1997. Nursing practice with incarcerated women: Caring with mandated allenation [sic]. Issues in Mental Health Nursing 18(5): 495–510.

    Article  CAS  PubMed  Google Scholar 

  • Marks, J.H. 2005. Doctors of interrogation. The Hastings Center Report 35(4): 17–22.

    Article  PubMed  Google Scholar 

  • O’Brien, K.P. 1998. Pivotal issues in forensic psychiatry. The Australian and New Zealand Journal of Psychiatry 32(1): 1–5.

    Article  PubMed  Google Scholar 

  • Pope, C., and N. Mays. 2006. Qualitative research in health care, 3rd ed. London: Wiley.

    Book  Google Scholar 

  • Rice, P.L., and D. Ezzy. 1999. Qualitative research methods: A health focus. South Melbourne: Oxford University Press.

    Google Scholar 

  • Roberts, L.W. 2002. Informed consent and capacity for voluntarism. The American Journal of Psychiatry 159(5): 705–712.

    Article  PubMed  Google Scholar 

  • Sered, S., and M. Norton-Hawk. 2008. Disrupted lives, fragmented care: Illness experience of criminalized women. Women and Health 48(1): 43–61.

    Article  PubMed  Google Scholar 

  • Shuster, E. 1998. The Nuremberg code: Hippocratic ethics and human rights. The Lancet 351(9107): 974–977.

    Article  CAS  Google Scholar 

  • Taborda, J.G.V., and J. Arboleda-Flórez. 1999. Forensic medicine in the next century: Some ethical challenges. International Journal of Offender Therapy and Comparative Criminology 43(2): 188–201.

    Article  PubMed  Google Scholar 

  • Taylor, R.W.M., and A. Buchanan. 1998. Ethical problems in forensic psychiatry. Current Opinion in Psychiatry 11(6): 695–702.

    Article  PubMed  Google Scholar 

  • Tye, C.S., and P.E. Mullen. 2006. Mental disorders in female prisoners. The Australian and New Zealand Journal of Psychiatry 40(3): 266–271.

    Article  PubMed  Google Scholar 

  • United Nations. 1955. Standard minimum rules for the treatment of prisoners. http://www.ohchr.org/EN/ProfessionalInterest/Pages/TreatmentOfPrisoners.aspx. Accessed November 13, 2013.

  • Veal, C. 2001. Clinical challenges that face nurses working in a correctional setting. Contemporary Nurse 10(3–4): 228–233.

    Article  CAS  PubMed  Google Scholar 

  • Vollmann, J., and R. Winau. 1996. Informed consent in human experimentation before the Nuremberg code. British Medical Journal 313(7070): 1445–1449.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Weinstein, H.C. 2002. Ethics issues in security hospitals. Behavioural Sciences and the Law 20(5): 443–461.

    Article  Google Scholar 

  • Weiskopf, C.S. 2005. Nurses’ experience of caring for inmate patients. Journal of Advanced Nursing 49(4): 336–343.

    Article  PubMed  Google Scholar 

  • Woodham, R. 2005. Security in correctional systems. In Corrections criminology, edited by S. O’Toole and S. Eyland, 53–59. Annandale: Hawkins Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karolyn L. A. White.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

White, K.L.A., Jordens, C.F.C. & Kerridge, I. Contextualising Professional Ethics: The Impact of the Prison Context on the Practices and Norms of Health Care Practitioners. Bioethical Inquiry 11, 333–345 (2014). https://doi.org/10.1007/s11673-014-9558-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11673-014-9558-8

Keywords

Navigation