Prison healthcare
Enclosed prison populations are particularly vulnerable to infectious diseases, including arthritis, asthma, hypertension, cervical cancer, hepatitis, tuberculosis, AIDS, and HIV, and mental health issues, such as Depression, mania, anxiety, and post-traumatic stress disorder.
In the United States, inmates infected with HIV have superior access to treatment and care than the general population.
[10]: 12 The work of Villermé and other French hygienists was an inspiration to German, American, and British public health leaders and spurred an overhaul in the conditions in which prisoners were held.
[4]: 310 Prisons are a complicated, stigmatized environment to practice medicine, which makes it difficult to develop specific training programs for them.
[17]: 125 It is also hard for prisoners to receive the best medical care because they are frequently relocated and often serve short sentences.
[18] In one pilot prison-healthcare rotation in the United States, students believed they benefited from exposure to a diverse patient population although the prison's remote location and lack of organized schedule made the experience difficult.
A prime example occurred from 1913 to 1951 when Doctor Leo Stanley[21]—a member of the eugenicist movement—served as the chief surgeon at San Quentin State Prison.
Stanley had an interest in the field of endocrinology, and he believed that the effects of aging consequently lead to a higher propensity for criminality, weak morality, and undesirable physical attributes.
Another example of the unethical experimentation on prisoners is the case of Doctor Albert Kligman, a famous dermatologist at the University of Pennsylvania who is more known for his discovery of Retin-A.
In 1965, Kligman exposed 75 prisoners at Holmesburg Detention Center and House of Correction in Pennsylvania to high doses of dioxin, the main poisonous ingredient in Agent Orange—a military herbicide and defoliant chemical.
Many of these surgeries were considered "cosmetic" operations, and involved facelifts, blepharoplasties, chin augmentation, scar removal, and more, the goal being to reduce recidivism, based on psychological theories surrounding lookism.
They also offered a way to subvert the "ugly laws" that discriminated against people based on their appearance, which intersected with racism and poverty.
Another relevant case of the unethical experimentation on prisoners involves the case of Sloan-Kettering Institute oncologist Doctor Chester Southam, who recruited prisoners during the 1950s and 1960s and injected HeLa cancer cells into them in order to learn about how people's immune systems would react when directly exposed to cancer cells.
[27] The House of Commons Health Select Committee produced a report on prison healthcare in November 2018.
[15] In 2018 the UK Government published standards for the provision of services to improve the health and well-being of women in prison.
[30] The guidelines recognize that interventions must take account of gender as well as circumstances while inside prison and when they are released back into the community particularly with regard to their children.
[32] Before the 1960s, prisons determined what healthcare they would provide with little state or federal oversight, due to the US' "hands-off" doctrine.
[11]: 15–16 In the 1970s, widespread intervention by federal courts improved conditions of confinement, including health care services and public health conditions, and stimulated investment in medical staff, equipment, and facilities to improve the quality of prison and jail medical services.
[11]: 17 Compared to the UK, the US now uses more partnerships with universities and the private sector to provide healthcare to prison populations.
[38] Inmates often receive more medical treatment in prison than they do in the outside world, largely because many ex-prisoners lose federal benefits such as Medicaid after incarceration.
However, upon release, inmates do not continue to receive the treatment they need and oftentimes their condition reverts to pre-incarceration level severity.
