Department of Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA.
Psychology Department, University of California, Santa Cruz, Santa Cruz, CA, USA.
J Gen Intern Med. 2018 May;33(5):764-768. doi: 10.1007/s11606-018-4318-9. Epub 2018 Feb 5.
Incarcerated individuals, over 95% of whom are eventually released, experience high burdens of chronic disease and behavioral health and social risk factors. Understanding the health needs of this population is critical to ensuring that general medicine physicians in prisons and in the community are adequately prepared to meet those needs. However, people in prison are significantly underrepresented in health research. In response to historical exploitation of prisoners in medical experimentation, federal guidelines appropriately require additional oversight for, and limit the scope of, research in prisons. Yet, according to a 2006 Institute of Medicine report, these requirements have produced inconsistent local regulations that often limit opportunities for incarcerated individuals to participate in research, and can slow the development of innovative medical interventions to improve their health. In this article, we describe the historical context surrounding regulations on research involving individuals in prison, the harms that can arise from excessive limitations to research in such settings, and the benefits of greater access to ethically conducted research in prison. We conclude with recommended actions that can be taken by general medicine researchers, correctional leaders, and policymakers to achieve consistent access to health research for incarcerated populations.
被监禁者中，超过 95%的人最终会被释放，他们承受着严重的慢性疾病和行为健康以及社会风险因素的负担。了解这一人群的健康需求对于确保监狱和社区中的普通内科医生能够充分满足这些需求至关重要。然而，监狱中的人在健康研究中代表性严重不足。为了回应历史上对囚犯在医学实验中的剥削，联邦指南适当要求对监狱中的研究进行额外的监督，并限制研究的范围。然而，根据 2006 年美国医学研究所的一份报告，这些要求产生了不一致的地方规定，这些规定常常限制了囚犯参与研究的机会，并可能减缓创新医疗干预措施的发展，以改善他们的健康状况。在本文中，我们描述了涉及监狱中个人的研究监管的历史背景，过度限制此类环境中的研究可能带来的危害，以及在监狱中进行更多符合伦理的研究的好处。我们最后提出了普通内科医生研究人员、惩教领导人和政策制定者可以采取的建议性行动，以确保被监禁人群能够获得一致的健康研究机会。
