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Esposito M, Szocik K, Capasso E, Chisari M, Sessa F, Salerno M. Respect for bioethical principles and human rights in prisons: a systematic review on the state of the art. BMC Med Ethics 2024; 25:62. [PMID: 38773588 PMCID: PMC11110298 DOI: 10.1186/s12910-024-01049-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 04/18/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Respect for human rights and bioethical principles in prisons is a crucial aspect of society and is proportional to the well-being of the general population. To date, these ethical principles have been lacking in prisons and prisoners are victims of abuse with strong repercussions on their physical and mental health. METHODS A systematic review was performed, through a MESH of the following words (bioethics) AND (prison), (ethics) AND (prison), (bioethics) AND (jail), (ethics) AND (jail), (bioethics) AND (penitentiary), (ethics) AND (penitentiary), (prison) AND (human rights). Inclusion and exclusion criteria were defined and after PRISMA, 17 articles were included in the systematic review. RESULTS Of the 17 articles, most were prevalence studies (n.5) or surveys (n.4), followed by cross-sectional studies (n.3), qualitative studies (n.1), retrospective (n.1) and an explanatory sequential mixed-methods study design (n.1). In most cases, the studies associated bioethics with prisoners' access to treatment for various pathologies such as vaccinations, tuberculosis, hepatitis, HIV, it was also found that bioethics in prisons was related to the mental health of prisoners, disability, ageing, the condition of women, the risk of suicide or with the request for end-of-life by prisoners. The results showed shortcomings in the system of maintaining bioethical principles and respect for human rights. CONCLUSIONS Prisoners, in fact, find it difficult to access care, and have an increased risk of suicide and disability. Furthermore, they are often used as improper organ donors and have constrained autonomy that also compromises their willingness to have end-of-life treatments. In conclusion, prison staff (doctors, nurses, warders, managers) must undergo continuous refresher courses to ensure compliance with ethical principles and human rights in prisons.
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Affiliation(s)
- Massimiliano Esposito
- Faculty of Medicine and Surgery, Kore" University of Enna, 94100, Enna, Italy.
- , Enna, Italia.
| | - Konrad Szocik
- Interdisciplinary Center for Bioethics, Yale University, New Haven, USA
- Department of Social Sciences, University of Information Technology and Management in Rzeszow, Sucharskiego 2 St., 35-225, Rzeszow, Poland
| | - Emanuele Capasso
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80138, Naples, Italy
| | - Mario Chisari
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121, Catania, Italy
| | - Francesco Sessa
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121, Catania, Italy
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121, Catania, Italy
- , Catania, Italia
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Santoriello C, De Rosa C, Rufo C, Romano F, Termoli G, Fiorillo G, Caprio L, Vitolo M, Pagano AM. Suicide Risk Screening and Assessment before and after the COVID-19 Pandemic in New Inmates. Healthcare (Basel) 2024; 12:100. [PMID: 38201006 PMCID: PMC10779268 DOI: 10.3390/healthcare12010100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/26/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Suicide is the main cause of death in Italian prisons. The largest number of inmates who killed themselves was recorded during three years of the COVID-19 pandemic. This study aimed to explore psychosocial risk factors for suicide among inmates incarcerated before and after the onset of COVID-19. (2) Methods: At prison reception, inmates underwent clinical interviews and were assessed using the Blaauw Scale and Suicide Assessment Scale. Psychological distress, measured by the Symptom Checklist-90-R, was compared between inmates admitted before and after COVID-19. Regression analyses were run to examine psychosocial vulnerabilities associated with suicidal intent in newly incarcerated individuals at risk of suicide. (3) Results: Among the 2098 newly admitted inmates (93.7% male) aged 18 to 87 years (M = 39.93; SD = 12.04), 1347 met the criteria for suicide risk, and 98 exhibited high suicidal intent. Inmates who entered prison after the onset of COVID-19 were older and had fewer social relationships. They had a higher prevalence of recidivism and substance abuse, along with elevated levels of psychological distress. An increase in perceived loss of control, anergia, obsessive-compulsive symptoms, phobic anxiety, and paranoid ideation emerged as the factors most strongly associated with high suicidal intent. (4) Conclusions: These findings support the value of psychosocial screening in promptly identifying inmates at risk of suicide, enabling the implementation of targeted, multi-professional interventions. Future research should replicate these results, with a focus on longitudinal studies that monitor the same inmates throughout their incarceration period.
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Affiliation(s)
- Carmen Santoriello
- Unità Operativa Semplice Dipartimentale U.O.S.D. Department of Adults and Minors Healthcare, Criminal Area, Local Health Authority of Salerno, 84132 Salerno, Italy
| | | | | | | | | | | | | | | | - Antonio Maria Pagano
- Unità Operativa Semplice Dipartimentale U.O.S.D. Department of Adults and Minors Healthcare, Criminal Area, Local Health Authority of Salerno, 84132 Salerno, Italy
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Baccon WC, Salci MA, Carreira L, Gallo AM, Marques FRDM, Laranjeira C. "Feeling Trapped in Prison" Due to the COVID-19 Pandemic: Perceptions and Practices among Healthcare Workers and Prison Staff from a Brazilian Maximum Security Unit. Healthcare (Basel) 2023; 11:2451. [PMID: 37685485 PMCID: PMC10487085 DOI: 10.3390/healthcare11172451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
The COVID-19 pandemic had several repercussions on prison staff, but the currently available evidence has mainly ignored these effects. This qualitative study aimed to understand the impact of COVID-19 on the prison system through the narratives of health and security professionals, using the methodological framework of the constructivist grounded theory proposed by Charmaz. The sample included 10 healthcare workers and 10 security professionals. Data collection took place between October and November 2022 through individual in-depth interviews. The data were analyzed using the MaxQDA software. Three categories of interrelated data emerged: (1) "Confrontation and disruption" caused by the COVID-19 pandemic in the prison system; (2) "Between disinfodemic and solicitude" referring to the tension between information management and the practice of care centered on the needs of inmates; and, finally, (3) "Reorganization and mitigation strategies during the fight against COVID-19". Continuous education and the development of specific skills are essential to enable professionals to face the challenges and complex demands that arise in prison contexts. The daily routines professionals had previously taken for granted were disrupted by COVID-19. Thus, investing in adequate training and emotional support programs is crucial to promote the resilience and well-being of these professionals, ensuring an efficient and quality response to critical events.
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Affiliation(s)
- Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Francielle Renata Danielli Martins Marques
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Campus 5, Polytechnic University of Leiria, Rua de Santo André-66-68, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Baccon WC, Salci MA, Carreira L, Gallo AM, Marques FRDM, Paiano M, Baldissera VDA, Laranjeira C. Meanings and Experiences of Prisoners and Family Members Affected by the COVID-19 Pandemic in a Brazilian Prison Unit: A Grounded Theory Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6488. [PMID: 37569028 PMCID: PMC10419247 DOI: 10.3390/ijerph20156488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023]
Abstract
Worldwide, the COVID-19 pandemic represented a health emergency for prisons. This study sought to understand the meanings and experiences through the narratives of prisoners and family members affected by the COVID-19 pandemic in the context of a maximum-security state penitentiary complex in southern Brazil. For this purpose, a qualitative study was developed based on the methodological framework of constructivist grounded theory. Data were collected between February and August 2022 through individual in-depth interviews and field notes. The sample consisted of 41 participants: 28 male prisoners, and 13 family members. Guided by the Charmaz method of grounded theory analysis, the study afforded the core category "Feeling trapped in prison during the COVID-19 pandemic" with three interrelated phases: "Triggering", "Escalating", and "Readjustment". The "Triggering" phase refers to COVID-19-related elements or events that triggered certain reactions, processes, or changes in prison. During the "Escalating" phase, participants became overwhelmed by the suffering caused by incarceration and the pandemic crisis. The "Readjustment" phase involved adapting, reorienting, or reformulating previous approaches or strategies for dealing with a specific situation. Prisons faced complex challenges during the pandemic and were forced to prioritize protecting public health. However, the measures adopted must be carefully evaluated, ensuring their needs and that they are based on scientific evidence. The punitive approach can undermine inmate trust in prison authorities, making it difficult to report symptoms and adhere to preventive measures.
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Affiliation(s)
- Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Francielle Renata Danielli Martins Marques
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Marcelle Paiano
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Vanessa Denardi Antoniassi Baldissera
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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