|Does it go beyond the door?|
Again – in theory – prisoners’ interactions with professionals working in prisons, including doctors, nurses and psychiatric staff, should be treated in the same way as in the local health centre or clinic in the community. While certain types of information sharing are permissible (particularly to protect the vulnerable or children at risk) I think it is fair to say that most of us would take a very dim view of a local GP or nurse who chose to write a sensational ‘treat and tell’ book exposing our confidential medical information to the wider world, or even in a tabloid newspaper, especially when the patients are identified by their real names.
|HMP Altcourse - a G4S prison|
Reading the article – although not the book (which I am also not naming as I don’t feel I should be giving it the oxygen of further publicity) – I was struck with a sense that this is clinical information that really shouldn’t be in the public domain. This is not only because of the potential impact on the prisoner concerned, but also because of the likelihood that the newspaper coverage will come to the attention of the victim’s family. Details of a particularly grisly crime, including photos of both the prisoner and the victim, are included in the article.
|Healthcare: behind bars|
There would be serious ethical issues involved even if every prisoner mentioned in such a publication had given free consent, yet I very much doubt that this was obtained, let alone permission from the families of victims involved in specific crimes. Perhaps if names had been changed or anonymised, the potential breaches of trust might have been largely avoided, yet it is clear that real names and specific offences are being described in gory detail.
In my view the publication of this book – and others like it – are a serious indictment both of our present prison system and of the professional bodies that are supposed to regulate staff members that provide medical and clinical care to prisoners. I believe strongly that this duty of care and confidentiality should not cease when either a prisoner is released or a healthcare professional retires. Surely this should be reflected in staff employment contracts?
|Asking the right questions|
I recall that when I was in prison I was asked by a healthcare department to sign a document giving my permission for the sharing of my medical data with the prison authorities. I declined, not because I had anything I wished to conceal about my own health but because no one could explain why this access would be of any specific benefit to me. Indeed, I have come across cases where the sharing of prisoners’ medical information - for example a diagnosis of autism - has impacted negatively on indeterminate sentenced inmates’ chances of parole.
|Let's talk about medical ethics|
Surely at a time when we have a well documented mental health crisis across our prison estate, any publication that further undermines the very fragile relationship of trust between prisoners and prison medical staff should be a matter of concern for the Ministry of Justice and for the wider prison service. So, will any action be taken to be prevent unauthorised disclosure of clinical data? I’m afraid I’m not taking a deep breath.