Heidari Raheleh, Wangmo Tenzin, Galli Serena, Shaw David M, Elger Bernice S
Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, CH-4056 Basel, Switzerland.
Faculty of Medicine, University of Basel, Klingelbergstrasse 61, CH-4056 Basel, Switzerland.
J Forensic Leg Med. 2017 Nov;52:223-228. doi: 10.1016/j.jflm.2017.10.001. Epub 2017 Oct 4.
Aging in custody and the rising population of elderly prisoners are creating compelling challenges for criminal justice, prison and public healthcare systems. Geriatric syndrome and higher prevalence of co-morbidities amongst older inmates result in heightened vulnerability in prison environments. Empirical research addressing older adults' access to medical care in detention is scarce; therefore, this study assessed access to medical care in prison from the perspective of older prisoners in Switzerland. We interviewed a sample of 35 older inmates (average age 61 years) on their experience of healthcare accessibility in prison; data were qualitatively analysed and major themes regarding evaluation of their access to medical services were extracted. Our findings identified three barriers to accessing health services in prison including psychological obstacles, negative consequences of healthcare utilization, and environmental hurdles. We advocate facilitating older inmates' access to medical care in order to relieve the psychological burden of seeking health services in detention and adequately informing them of their right to demand these services, thereby lessening the negative consequences of their requests. We suggest further training of prison and medical staff for better management of age-related issues in prison can ease the environmental obstacles.
在押人员老龄化以及老年囚犯数量的不断增加，给刑事司法、监狱和公共医疗系统带来了严峻挑战。老年综合征以及老年囚犯中合并症的高患病率导致他们在监狱环境中更加脆弱。针对老年人在拘留期间获得医疗服务的实证研究很少；因此，本研究从瑞士老年囚犯的角度评估了监狱中的医疗服务获取情况。我们采访了35名老年囚犯（平均年龄61岁），了解他们在监狱中获得医疗服务的经历；对数据进行了定性分析，并提取了关于评估他们获得医疗服务情况的主要主题。我们的研究结果确定了在监狱中获得医疗服务的三个障碍，包括心理障碍、医疗服务利用的负面后果和环境障碍。我们主张为老年囚犯提供便利，使其能够获得医疗服务，以减轻他们在拘留期间寻求医疗服务的心理负担，并充分告知他们要求获得这些服务的权利，从而减少他们提出请求的负面后果。我们建议对监狱和医务人员进行进一步培训，以便更好地管理监狱中与年龄相关的问题，从而缓解环境障碍。
