Bernheim J
Bull Schweiz Akad Med Wiss. 1980 Nov;36(4-6):411-8.
A series of situations and decisions involving medical ethics in a prison medical service are discussed. The doctor's independence is considered in relation to his contract with administrative authorities. In contrast with most private doctor-patient relationships, there is usually no possibility for prisoners to choose their doctor and vice-versa. Freedom of consent on the part of the patient may also imply a right to no-treatment. Medical care in prison is not easy to delineate, also because patients often try to involve the doctor in non-medical demands. A prison doctor should avoid taking part in decisions which ought to be made by the judiciary or by administrative authorities. Programmes involving preventive medicine and sociotherapy imply collaboration between therapeutic and security staff. The continuous interplay and readjustment between powers based on public authority, on the rights of each individual prisoner and on the medical programmes makes it possible for some sort of therapeutic freedom to exist in the prison.
本文讨论了监狱医疗服务中一系列涉及医学伦理的情况和决策。医生的独立性是相对于其与行政当局的合同而言的。与大多数私人医患关系不同，囚犯通常没有选择医生的可能性，反之亦然。患者的同意自由也可能意味着拒绝治疗的权利。监狱医疗护理不易界定，还因为患者常常试图让医生参与非医疗需求。监狱医生应避免参与应由司法部门或行政当局做出的决策。涉及预防医学和社会疗法的项目意味着治疗人员和安保人员之间的协作。基于公共权力、每个囚犯的权利以及医疗项目的各种权力之间持续的相互作用和调整，使得监狱中某种程度的治疗自由得以存在。
