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Abstract: 

Housing and treatment of inmates with serious, life-threatening conditions is a growing challenge for prisons and jails. “Traditionally, there has been great discomfort and reluctance in allowing death to occur on-site for fear that the death would be equated with neglect. Often to avoid potential legal, ethical, and medical complications facilities have found it easier to send all dying patients out of the facility.” (May, 1998) In addition to being costly, both in terms of hospital and additional security costs, transferring dying patients to the hospital may not always be the most humane approach. At the hospital, the initial effort is often one of aggressive treatment, and not palliation. But palliation may be indicated based on inmate wishes, and futility in treating an end stage, irreversible disease process. Sending dying inmates out of the facility may also exacerbate inmate mistrust of health services and leave both health care staff and other inmates with unresolved feelings of loss. And, for the inmates, especially long-term inmates, it may mean that he or she dies among strangers.

Keywords: AIDS, Hospice, Robert Wood Johnson, GRACE Project, palliative care, NHO Standards

Affiliations:  1: Volunteers of America.