[NYAPRS Enews] AP: Jail Healthcare Workers Compromised by Use of Solitary Confinement, Force

[Harvey Rosenthal]

Change In Jail Health Care Advised
Study Recommends Workers Not Be Asked To Approve Stints In Solitary Confinement
By Jake Pearson, Associated Press  April 3, 2015
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New York City jail health workers say their medical ethics are often compromised by the demands of treating patients who are also prisoners, such as when they witness guards' use of force or are asked to approve stints in solitary confinement, according to a first-of-its-kind city study.



The two-year study at New York's sprawling Rikers Island jail complex concluded with a bold recommendation to remove health workers entirely from the most contentious issue they face - whether to put an inmate in solitary. That's because many doctors believe the confinement, which involves 23-hour stretches of isolation, could harm inmates.



"Whatever the security reasoning for placement in such units, the participation of health staff in this process is cumbersome, time intensive, of questionable value and does not reflect a patient-health provider interaction that is in the patient's best interest," city health officials write in the study, set to be published in the June issue of the Health and Human Rights Journal<http://www.timesunion.com/search/?action=search&channel=news&inlineLink=1&searchindex=gsa&query=%22Human+Rights+Journal%22>.



Corrections officials didn't comment on the study's recommendation, but a spokeswoman for jails Commissioner Joseph Ponte<http://www.timesunion.com/search/?action=search&channel=news&inlineLink=1&searchindex=gsa&query=%22Joseph+Ponte%22> said in a statement in the past year, corrections and health officials have worked to improve conditions and reduce the use of solitary, including creating therapeutic housing units for seriously mentally ill inmates who have trouble following jailhouse rules.



Tension between jail guards, who focus on enforcing order, and health workers, who have taken an oath to protect patient health, exists in lockups across the country.



But experts have specifically cited such competing priorities as a problem that has played a role in neglect and poor treatment at Rikers Island. The 10-jail complex employs more than 9,000 guards and 1,400 health workers; 40 percent of the roughly 11,000 inmates have a mental health diagnosis, and many come in with long-untreated health problems.



The Associated Press<http://www.timesunion.com/search/?action=search&channel=news&inlineLink=1&searchindex=gsa&query=%22The+Associated+Press%22> reported last year that breakdowns in procedures and protocols may have contributed to nine of 11 suicides at Rikers over the past five years. And the AP also uncovered documents over the same period that questioned the quality and timeliness of care in 15 inmate deaths that had been considered purely medical.



Correctional health experts say the Rikers health worker study - based on a review of thousands of health records, survey responses, focus groups and interviews with 19 patients who hurt themselves while locked away - is perhaps the most comprehensive documentation in a U.S. correctional setting of the "dual loyalties" phenomenon.



"A bedrock principle is that the physician's primary ethic is to act in the interests of the patients," said Dr. Scott Allen<http://www.timesunion.com/search/?action=search&channel=news&inlineLink=1&searchindex=gsa&query=%22Scott+Allen%22>, a professor at University of California Riverside School of Medicine<http://www.timesunion.com/search/?action=search&channel=news&inlineLink=1&searchindex=gsa&query=%22University+of+California+Riverside+School+of+Medicine%22> who formerly served as the top medical official in Rhode Island's prisons.



http://www.timesunion.com/news/article/Change-in-jail-health-care-advised-6178582.php
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