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Abstract: 

Based on the author’s more than 35 years as a consulting psychiatrist for the Ohio prison system, this article examines some of the most difficult and important ethical issues that typically confront clinicians working in correctional settings, including inmate requests for controlled medications; treating sleep problems and distinguishing between poor sleep caused by underlying physical conditions and the normal sleep disruption caused by the prison environment; dealing with inmates who request special privileges; when and how rules of doctor-patient confidentiality may depart from practices in the outside world, including the so-called Tarasoff duty; and dual agent conflicts that arise frequently when medical needs clash with prison order, safety, or security.

Keywords: Controlled Medications; Sleep Complaints; “Special Privileges”; Confidentiality; Multiple-Agent Conflicts

Affiliations:  1: The Ohio State University (Retired).