Handtke Violet, Wangmo Tenzin
Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland,
J Bioeth Inq. 2014 Sep;11(3):373-86. doi: 10.1007/s11673-014-9548-x. Epub 2014 Jun 26.
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.
老年囚犯人数不断增加，以及在监狱中实施同等医疗保健的目标，引发了围绕囚犯临终关怀的问题。欧洲对这一主题的研究匮乏，这意味着在监狱中考虑死亡的老年囚犯的需求尚未明确。为了调查老年囚犯对死亡和临终的态度，在瑞士的12所监狱对35名年龄在51至71岁之间的囚犯进行了定性访谈。约一半的囚犯表示曾考虑过在监狱中死亡，一些人提到这与自杀念头有关，另一些人则与疾病和年老有关。数据分析过程中确定的主题包括对死亡和临终的总体想法、其他囚犯死亡的描述、临终服务的可获得性、与社会关系的联系以及希望在监狱外死亡。研究结果使用奥尔马克的“尊严地死亡”概念进行讨论，提出了两个伦理问题：促进自主性和消除障碍。将确定的主题归因于这两个伦理行为，明确了瑞士老年囚犯目前的需求，可能是朝着在惩教系统中实施临终服务迈出的第一步。
