Surgical Treatment of Prisoners

Abstract

Objective : Issues with the medical care of prisoners incarcerated in Nagoya Prison who were referred to our hospital for surgical treatment were investigated. Patients : The study subjects were 67 patients treated during the previous 5 years. Their mean age was 56.6 years, and all were men. Benign conditions were present in 32, with malignant conditions in 35. None of the procedures was performed under health insurance, and since none of the patients was able to pay, all costs were met by the prison. The authority to decide on inpatient treatment was vested in the warden, and decisions on admission, surgery, and transfer were made in consultation between the attending doctor and the warden. Method : Diseases, preoperative investigations, surgery, perioperative complications, and postoperative course were investigated. Results : Preoperative investigations showed many abnormal test values, with many patients being in poor condition for surgery. Most patients with malignant conditions were at an advanced stage, with 54% at stage 3 or 4. Discussion : Legislation relating to the treatment of prisoners includes the right to receive appropriate medical care, but families were not informed of treatment or even the disease itself, and the tenets of medical ethics were not genuinely observed.