Prospective National Survey of the Palliative Situation Among Inmates in French Prisons (PARME)

PARME study had 3 objectives:

• To identify the specific number of incarcerated individuals with terminal illness in need of palliative care.
• To describe the health and penal situation of these prisoners.
• To analyse the situation of these ill prisoners especially in the context of suspended sentence for medical ground

In order to answer these questions, the investigators used a mixed method research.

Study Overview

• Status: Completed
• Conditions: Critical Illness; Terminal Illness
• Intervention / Treatment: Other: qualitative interview

Detailed Description

First, in order to establish a baseline, the investigators contacted the medical units in all French prisons, which means 178 care units and 8 secures inpatient care units. The investigators census every patient with terminal illness, which was defined in this study as an evolutive pathology with a life prognosis less than a year.

A questionnaire was completed by these physicians for every situation. The census was conducted for three months across France.

For the qualitative study, the investigators selected 14 specific situations chosen into these which had been identified by the physicians.

The investigators wanted to get 3 types of patients :

1. patient who had obtained a compassionate release
2. patient whose demand has been refused
3. patient who did not demand any release. The four interviews (patients, physisians, judges, probation workers) for each situation has explained the global situation.

Each interviewee spoke about the situation with his/her perspective and sense that they attributed to the actions of others.

This research analyzes the particularity of each of these end of life situations in prison.

• Study Type: Observational
• Enrollment (Actual): 15

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Every prisonners with terminal illness

Description

Inclusion Criteria:

• prisonners
• serious and evolving pathology
• vital prognosis less than a year

Exclusion Criteria:

• less than 18 year
• person under tutelage
• patient who refuse to participate

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
census; qualitative interview	Other: qualitative interview; some patient are interviewed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
census ill prisonners with vital prognosis less than a year and understand how penal and medical professional are coping with these situations	1 year

Secondary Outcome Measures

Outcome Measure	Time Frame
uderstand how professionnels are coping with not condamned prisonners	1 year
Question the meaning of the sentence for ill prisonners	1 year
Compare the way professionnal are coping with these situation around France	1 year

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Besancon
• Collaborators: Assistance Publique - Hôpitaux de Paris; Hospices Civils de Lyon; Central Hospital, Nancy, France; University Hospital, Bordeaux; Rennes University Hospital; University Hospital, Toulouse; University Hospital, Lille; University Hospital, Marseille
• Investigators: Principal Investigator: Edouard Amzallag, Dr, CHU Lyon; Principal Investigator: Sebastien Grignard, Dr, Centre Hospitalier Universitaire de Besançon; Principal Investigator: Blanchet Emmanuelle, Dr, CHU Nancy; Principal Investigator: Grimopont Frederic, Dr, CHU Lille; Principal Investigator: Bartoli Christophe, Dr, CHU Marseille; Principal Investigator: BAYLE Paule, Dr, CHU Toulouse; Principal Investigator: Bedry Regis, Dr, CHU Bordeaux; Principal Investigator: Bernard Benoit, Dr, CHU Rennes; Principal Investigator: Auger Yvain, Dr, APHP

Publications and helpful links

General Publications

• AUBRY R., 2011, Etat des lieux du développement des soins palliatifs en France en 2010, Rapport à M. Le Président de la République, M. Le Premier Ministre, Comité national de suivi du développement des soins palliatifs.
• BERTRAND D, NIVEAU G, 2006, Santé et Prison. Chêne-Bourg : Editions Médecine & Hygiène, 2006
• Bolger M. Dying in prison: providing palliative care in challenging environments. Int J Palliat Nurs. 2005 Dec;11(12):619-20; discussion 621. doi: 10.12968/ijpn.2005.11.12.20227.
• Byock I. Dying well in corrections: why should we care? Correctcare. 2002 Fall;16(4):18. No abstract available.
• Chow RK. Initiating a long-term care nursing service for aging inmates. Geriatr Nurs. 2002 Jan-Feb;23(1):24-7. doi: 10.1067/mgn.2002.122562.
• Cohn F. The ethics of end-of-life care for prison inmates. J Law Med Ethics. 1999 Fall;27(3):252-9, 210. doi: 10.1111/j.1748-720x.1999.tb01459.x.
• DARBEDA P., mars-juin 1999, " Médecine et détenus ", Journal international de bioéthique, n°1-2, pp 35-45.
• Drescher GP. Prisoner's right to refuse treatment outweighs physician's duty to treat. J Law Med Ethics. 1993 Fall-Winter;21(3-4):400-1. No abstract available.
• Dubler NN. The collision of confinement and care: end-of-life care in prisons and jails. J Law Med Ethics. 1998 Summer;26(2):149-56. doi: 10.1111/j.1748-720x.1998.tb01670.x. No abstract available.
• Finlay IG. Managing terminally ill prisoners: reflection and action. Palliat Med. 1998 Nov;12(6):457-61. doi: 10.1191/026921698674823377.
• Gallagher EM. Elders in prison. Health and well-being of older inmates. Int J Law Psychiatry. 2001 Mar-Jun;24(2-3):325-33. doi: 10.1016/s0160-2527(00)00080-7. No abstract available.
• Kiel RA. Caring for terminally ill inmates: on-site hospice care or compassionate release? Correctcare. 1995 Jun-Jul;9(2):5, 13-14. No abstract available.
• Lin J, Mathew P. Prison inmates and palliative care. JAMA. 2007 Dec 5;298(21):2481; author reply 2481. doi: 10.1001/jama.298.21.2481-a. No abstract available.
• Lincoln A. Improving the conditions of confinement. End-of-life care in prison. Pharos Alpha Omega Alpha Honor Med Soc. 2008 Autumn;71(4):18-25. No abstract available.
• Linder JF, Meyers FJ. Palliative care for prison inmates: "don't let me die in prison". JAMA. 2007 Aug 22;298(8):894-901. doi: 10.1001/jama.298.8.894.
• Lum KL. Palliative care behind bars: the New Zealand prison hospice experience. J Pain Palliat Care Pharmacother. 2003;17(3-4):131-8; discussion 139-40.
• Mahon NB. Introduction: death and dying behind bars--cross-cutting themes and policy imperatives. J Law Med Ethics. 1999 Fall;27(3):213-5. doi: 10.1111/j.1748-720x.1999.tb01454.x. No abstract available.
• Mara CM. Expansion of long-term care in the prison system: an aging inmate population poses policy and programmatic questions. J Aging Soc Policy. 2002;14(2):43-61. doi: 10.1300/J031v14n02_03.
• MOUQUET M-C, 2005 (mars), " La santé des personnes entrées en prison en 2003 ",Études et résultats, n°386, DREES.
• MOUQUET M-C, DUMONT M., BONNEVIE M-C, 1999 (janvier)" La santé à l'entrée en prison, un cumul des facteurs de risques ", Études et résultats, n°4, DREES.
• O'Connor MF. Finding boundaries inside prison walls: case study of a terminally ill inmate. Death Stud. 2004 Jan;28(1):63-76. doi: 10.1080/07481180490249274.
• Ratcliff M, Craig E. The GRACE Project: Guiding End-of-Life Care in Corrections 1998-2001. J Palliat Med. 2004 Apr;7(2):373-9. doi: 10.1089/109662104773709549.
• SANDO ROY (de) B., 2004 (mars), " La suspension de peine pour raison médicale : Une parenthèse de la peine contre une parenthèse de la santé. ", Droit Déontologie & Soin.; 4(1), pp 4-15.
• Reeder D, Meldman L. Conceptualizing psychosocial nursing in the jail setting. J Psychosoc Nurs Ment Health Serv. 1991 Aug;29(8):40-4. doi: 10.3928/0279-3695-19910801-10.
• SANNIER O, MANALOUIL C., 2008, " Est-ce que le secret médical est la clé de voûte du respect de l'éthique médicale en prison ? ", Éthique & Santé; 5(4), pp201-207.
• Snow T. Should dying prisoners be given their freedom for a more dignified end? Nurs Stand. 2009 Aug 26-Sep 1;23(51):12-3. No abstract available.
• TRAULLE É, WERBROUCK A, MANAOUIL C., 2006 (sept) " La suspension de peine pour raison médicale. " Médecine & Droit., 79-80, pp 142-146.
• Turner M, Barbarachild Z, Kidd H, Payne S. How notorious do dying prisoners need to be to receive high quality end-of-life care? Int J Palliat Nurs. 2009 Oct;15(10):472-3. doi: 10.12968/ijpn.2009.15.10.44884. No abstract available.
• Vesely R. Another aging population. More states considering early-release programs for older, infirm inmates. Mod Healthc. 2010 Mar 29;40(13):32-3. No abstract available.
• Zelaya E. The challenges of caring for an incarcerated patient. Am J Hosp Palliat Care. 2009 Jun-Jul;26(3):230-1. doi: 10.1177/1049909109333931. No abstract available.
• Wilford T. Developing effective palliative care within a prison setting. Int J Palliat Nurs. 2001 Nov;7(11):528-30. doi: 10.12968/ijpn.2001.7.11.9292.
• Wood FJ. The challenge of providing palliative care to terminally ill prison inmates in the UK. Int J Palliat Nurs. 2007 Mar;13(3):131-5. doi: 10.12968/ijpn.2007.13.3.23275.
• ZIMMERAMANN N., WALD F.S., THOMPSON A.S., 2002 (juillet), " The needs and ressources for hospice care in the connecticut prison system : a feasibility study. ", Illness, Crisis and Cross, vol 10, n°3, pp204-232.
• Rothman A, McConville S, Hsia R, Metzger L, Ahalt C, Williams BA. Differences between incarcerated and non-incarcerated patients who die in community hospitals highlight the need for palliative care services for seriously ill prisoners in correctional facilities and in community hospitals: A cross-sectional study. Palliat Med. 2018 Jan;32(1):17-22. doi: 10.1177/0269216317731547. Epub 2017 Sep 27.
• Pazart L, Godard-Marceau A, Chassagne A, Vivot-Pugin A, Cretin E, Amzallag E, Aubry R; PARME Study Group. Prevalence and characteristics of prisoners requiring end-of-life care: A prospective national survey. Palliat Med. 2018 Jan;32(1):6-16. doi: 10.1177/0269216317721816. Epub 2017 Aug 8.

Study record dates

Study Major Dates

• Study Start: May 1, 2011
• Primary Completion (Actual): October 1, 2013
• Study Completion (Actual): December 1, 2013

Study Registration Dates

• First Submitted: February 9, 2015
• First Submitted That Met QC Criteria: February 9, 2015
• First Posted (Estimate): February 12, 2015

Study Record Updates

• Last Update Posted (Estimate): February 24, 2015
• Last Update Submitted That Met QC Criteria: February 23, 2015
• Last Verified: February 1, 2015

More Information

Terms related to this study

• Keywords: palliative care; vulnerable population; qualitative research
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Critical Illness
• Other Study ID Numbers: 2011-A00791-40