Katie Stone, Research Assistant at the Cicely Saunders Institute, King’s College London, introduces a research study that has been selected as this month’s ‘Editor’s choice’ in ‘Palliative Medicine’.
End of life care for those serving prolonged sentences in prisons is a subject sometimes overloaded by a polemic separating the deserving from the undeserving. For the research team who came to write an integrative review assessing prisoners access to palliative care services1 the point was mute: death with dignity was a basic human right for all including those incarcerated and international policies echoed this. Whether policy translated into practice, however, was another issue.
Prison hospices and palliative care services have been spoken of since the 1980s with some well-established services now available. The problem is that the sum of the ‘some’ is small in research terms and appears limited to North America. Through systematically reviewing the body of published evidence it became clear that there were notable disparities between the United Kingdom and the United States in terms of palliative care provision. This included the US establishing international standards (ie GRACE – Guiding Responsive Action in Corrections at End of Life) within a growing prison hospice movement, while in the UK the response was less obvious. Although one highly regarded prison hospice exists in HMP Norwich, the care of those with life-limiting conditions in prisons in the UK is worryingly under-represented. This is important given the rising prison population and increasing age of those serving longer sentences.
We chose to focus the work on these two countries primarily because the literature guided us in this direction and in doing so highlighted a topic, which, although occasionally thrown into mainstream media, remains eerily quiet. Palliative care for the prison population deserves a space in the evidence base and a stronger voice. This international review suggests there is still much work to be done before we hear it speak.
Previously I had been working across three different research areas: palliative care, drugs and alcohol, and nursing. But since writing the article for ‘Palliative Medicine’1 I was lucky enough to secure a position at the Cicely Saunders Institute, King’s College London, where I am now focusing purely on palliative care research. I am grateful to Professor Daniel Kelly (Cardiff University) and Professor Irena Papadopoulos (Middlesex University) for introducing me to such an interesting area and hope in the future to do further work into palliative care and the prison population.
1. K Stone, I Papadopoulos and D Kelly, Establishing hospice care for prison populations: an integrative review assessing UK and USA perspectives. Palliative Medicine, December 2012, 26(8) 969-978; first published online on 12 October 2011, doi: 10.11 77/0269216311424219. (To download a copy of this paper, please see below).
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