Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality

Respecting the consent and confidentiality of a patient is an underlying element in establishing the patient's trust in the physician and, implicitly, obtaining the patient's compliance. In particular, cases of inmate patients require increased attention in order to fulfill this goal against a background of institutional interferences, which, in certain situations, may endanger the autonomy of the physician and their respect for the inmate's dignity. The purpose of this article is to depict the characteristics of consent and confidentiality in a prison environment, in special cases, such as hunger strikes, violent acts, HIV testing, COVID-19 measures, and drug use, bringing into focus the physician and the inmate in the context of the particular situation where the target is disciplining someone in order for them to conform to social and juridical norms. Respecting the dignity of the inmate patient requires an adequate approach of informed consent and confidentiality, depending on each case, considering the potential unspoken aspects of the inmate's account, which can be key elements in obtaining their compliance and avoiding malpractice claims.