Prevalence and characteristics of prisoners requiring end-of-life care: A prospective national survey

Lionel Pazart, Aurélie Godard-Marceau, Aline Chassagne, Aurore Vivot-Pugin, Elodie Cretin, Edouard Amzallag, Regis Aubry, PARME Study Group, Lionel Pazart, Aurélie Godard-Marceau, Aline Chassagne, Aurore Vivot-Pugin, Elodie Cretin, Edouard Amzallag, Regis Aubry, PARME Study Group

Abstract

Background: Ensuring adequate end-of-life care for prisoners is a critical issue. In France, data investigating the impact of laws allowing release of seriously ill prisoners are lacking.

Aim: To assess the number and characteristics of prisoners requiring palliative care in French prisons.

Design: A prospective, national survey collecting data over a 3-month period.

Setting/participants: All healthcare units ( n = 190) providing care for prisoners in France. The prison population was 66,698 during the study period. Data collection concerned prisoners requiring end-of-life care, that is, with serious, advanced, progressive, or terminal illness and life expectancy <1 year.

Results: Estimated annual prevalence of ill prisoners requiring end-of-life care was 15.2 (confidence interval: 12.5-18.3) per 10,000 prisoners. The observed number of prisoners requiring palliative care ( n = 50) was twice as high as the expected age- and sex-standardized number based on the general population and similar to the expected number among persons 10 years older in the free community. In all, 41 of 44 (93%) of identified ill prisoners were eligible for temporary or permanent compassionate release, according to their practitioner. Only 33 of 48 (68%) of ill prisoners requested suspension or reduction in their sentence on medical grounds; half (16/33) received a positive answer.

Conclusion: The proportion of prisoners requiring palliative care is higher than expected in the general population. The general frailty and co-existing conditions of prisoners before incarceration and the acceleration of these phenomena in prison could explain this increase in end-of-life situations among prisoners.

Trial registration: ClinicalTrials.gov NCT02362295.

Keywords: Palliative care; premature aging; prevalence; prisoners; terminally ill.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Geographical distribution of prisoners included in the study by study period.
Figure 2.
Figure 2.
Katz’s scale with two supplementary questions adapted to the correctional context.

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Source: PubMed

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