Nguyen Nicholas V, Nguyen Tyler A, Akgün Kathleen M, Sergew Amen, Griffith Matthew F, DeMartino Erin S
Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, United States of America.
Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, United States of America.
PLoS One. 2025 Sep 3;20(9):e0330361. doi: 10.1371/journal.pone.0330361. eCollection 2025.
The United States has one of the highest incarceration rates in the world. Carceral status can complicate clinical encounters in community and academic settings for an already medically vulnerable population. While it is likely physicians will encounter patients experiencing incarceration in their practice, there are few educational opportunities dedicated to ensuring delivery of healthcare that protects patient dignity, autonomy, and privacy. Professional medical associations can play a role in filling this physician knowledge gap. The goal of this analysis is to catalogue and analyze the current landscape of official medical association documents addressing healthcare of people experiencing incarceration. A systematic Internet search was conducted of American Medical Association House of Delegates associations and their existing documents. Out of 116 associations included in the systematic search, 16 groups published materials on incarceration. From these 16 associations, 44 documents were identified and coded thematically. Documents served four main purposes: education on incarceration (28/44), clinical guidance (25/44), logistical guidance (27/44), and policy advocacy (30/44). Common topics included medical conditions of people experiencing incarceration, patient factors antecedent to incarceration, and specialty or population-specific information. Few medical associations have published material on incarceration and the paucity of pragmatic clinical guidance was particularly pronounced. A lack of resources from medical associations can lead to variability and lapses in best healthcare practices when treating patients experiencing incarceration. Medical associations should consider developing guidance for clinicians to maximize this patient population's autonomy and dignity.
美国是世界上监禁率最高的国家之一。对于本就医疗脆弱的人群而言,监禁状况会使社区和学术环境中的临床诊疗变得复杂。虽然医生在执业过程中很可能会遇到有监禁经历的患者,但专门致力于确保提供能保护患者尊严、自主权和隐私的医疗服务的教育机会却很少。专业医学协会可以在填补医生这方面知识空白上发挥作用。本分析的目的是梳理和分析官方医学协会文件中有关被监禁者医疗保健的现状。对美国医学协会代表大会协会及其现有文件进行了系统的互联网搜索。在系统搜索纳入的116个协会中,有16个团体发表了关于监禁问题的材料。从这16个协会中,识别出44份文件并进行了主题编码。这些文件有四个主要目的:关于监禁问题的教育(28/44)、临床指导(25/44)、后勤指导(27/44)和政策倡导(30/44)。常见主题包括被监禁者的医疗状况、监禁前的患者因素以及特定专科或人群的信息。很少有医学协会发表关于监禁问题的材料,而且实用临床指导的匮乏尤为明显。医学协会缺乏资源可能导致在治疗有监禁经历的患者时,最佳医疗实践出现差异和失误。医学协会应考虑为临床医生制定指导方针,以最大限度地保障这一患者群体的自主权和尊严。