Hastings Cent Rep. 2023 Nov;53(6):25-35. doi: 10.1002/hast.1541.
A growing body of literature has engaged with mass incarceration as a public health problem. This article reviews some of that literature, illustrating why and how bioethicists can and should engage with the problem of mass incarceration as a remediable cause of health inequities. "Mass incarceration" refers to a phenomenon that emerged in the United States fifty years ago: imprisoning a vastly larger proportion of the population than peer countries do, with a greatly disproportionate number of incarcerated people being members of marginalized racial and ethnic groups. Bioethicists have long engaged with questions of health justice for incarcerated people, including consent issues for those participating in research and access to health care. This article provides an overview of the individual and public health impacts of mass incarceration. The article argues that mass incarceration is a bioethics issue that should be addressed in medical education, identifies opportunities for bioethicists to guide hospitals' interactions with law enforcement officials, and calls on bioethicists to be in conversation with medical and nursing students and health care professionals about these groups' advocacy efforts concerning structural racism, police violence, and mass incarceration.
越来越多的文献探讨了监禁人数众多这一现象,将其视为公共卫生问题。本文回顾了其中的一些文献,阐明了为什么以及如何让生物伦理学家能够并应该将大规模监禁作为造成健康不平等的可纠正原因来加以应对。“大规模监禁”指的是 50 年前在美国出现的一种现象:监禁的人口比例远远高于其他国家,而被监禁的人中有很大一部分属于边缘化的种族和族裔群体。生物伦理学家长期以来一直关注被监禁者的健康公正问题,包括参与研究的人的同意问题和获得医疗保健的问题。本文概述了大规模监禁对个人和公共健康的影响。文章认为,大规模监禁是一个生物伦理学问题,应该在医学教育中加以解决,确定了生物伦理学家为指导医院与执法官员互动的机会,并呼吁生物伦理学家与医学生、护理学生和医疗保健专业人员就这些群体在结构性种族主义、警察暴力和大规模监禁方面的宣传工作进行对话。