Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Gen Intern Med. 2021 Jul;36(7):2094-2099. doi: 10.1007/s11606-021-06861-y. Epub 2021 May 5.
The COVID-19 pandemic has reshaped health care delivery for all patients but has distinctly affected the most marginalized people in society. Incarcerated patients are both more likely to be infected and more likely to die from COVID-19. There is a paucity of guidance for the care of incarcerated patients hospitalized with COVID-19. This article will discuss how patient privacy, adequate communication, and advance care planning are rights that incarcerated patients may not experience during this pandemic. We highlight the role of compassionate release and note how COVID-19 may affect this prospect. A number of pragmatic recommendations are made to attenuate the discrepancy in hospital care experienced by those admitted from prisons and jails. Physicians must be familiar with the relevant hospital policies, be prepared to adapt their practices in order to overcome barriers to care, such as continuous shackling, and advocate to change these policies when they conflict with patient care. Stigma, isolation, and concerns over staff safety are shared experiences for COVID-19 and incarcerated patients, but incarcerated patients have been experiencing this treatment long before the current pandemic. It is crucial that the internist demand the equitable care that we seek for all our patients.
新冠疫情大流行改变了所有患者的医疗服务模式，但对社会中最边缘化的人群产生了明显影响。被监禁的患者更有可能感染新冠病毒，且死于新冠病毒的风险更高。对于因感染新冠病毒而住院的被监禁患者，目前针对其护理的指导意见十分匮乏。本文将讨论在这场大流行期间，被监禁患者可能无法享有的患者隐私、充分沟通和预先护理计划等权利。我们强调了宽大释放的作用，并指出新冠疫情可能会对这一前景产生影响。本文还提出了一些切实可行的建议，以减轻囚犯和看守所转至医院后所经历的医疗服务差异。医生必须熟悉相关医院政策，准备好调整自己的医疗实践，以克服护理障碍，如持续戴手铐，并在这些政策与患者护理发生冲突时，倡导进行政策改革。新冠疫情和被监禁患者都有污名化、隔离和对工作人员安全的担忧，但被监禁患者在当前疫情之前就已经长期面临这种待遇。内科医生必须要求提供我们为所有患者寻求的公平护理，这一点至关重要。
