Is palliative care possible in prison? A national PARME study about inmates with terminal illness in France

We continue our series on the posters that caught our attention at the 9th World Congress of the EAPC Research Network in Dublin last year. Conference posters are an important feature of every European Association for Palliative Care Congress – presenting the key messages of a project in a creative, informative and eye-catching way. 

This series also offers an opportunity for discussion of these interesting and challenging posters and makes them visible beyond the (sometimes rather small) range of readers in front of the poster billboards. Maybe this is an interesting new approach to scientific presentations using social media . . .

Aurélie Godard Marceau

Aurélie Godard Marceau

Aline Chassagne

Aline Chassagne

Aurélie Godard Marceau and Aline Chassagne from the Clinical Investigation Center (CIC1431-INSERM) of the University Hospital of Besançon, France, explain the background to their poster.

 

 

Since 2002, the law in France permits seriously ill or dying inmates to request compassionate release in order to receive health care outside of prison. Nevertheless, every year in France, a hundred inmates die in prison as a result of their illness.

We conducted a mixed-methods research that aimed to describe and understand the situation of inmates with a terminal illness (defined as a patient with a life expectancy of less than a year).

We conducted two studies:

  • A national epidemiology study over three months (177 healthcare units in prison (UCSA) and nine secure inpatient care units in hospitals (UHSI)).
  • A qualitative study with 62 individual semi-structured, in-depth interviews relating to the situations of 14 patients.

parme_poster_eapc_defIn 2013, the prevalence of prisoners requiring palliative care was 15.2 per 10,000 inmates (95% CI: 12.5 – 18.3). Our results highlighted that it isn’t easy to provide inmates who are ill with access to effective end-of-life care.

First, the organisation of healthcare units in prisons (UCSA) is limited to provide only primary health care. Moreover, there is no physician or nurse during the night or the weekend. Also, seriously ill inmates have special needs that are difficult to provide, such as equipment to help to reduce pain and discomfort (medical mattress, special food). This is especially prevalent in older prisons since only recently built prisons have adapted cells for people with disabilities. Lastly, relationships with family members are not easy in prison: families have very little information about their relative’s health and can visit them only once or twice a week.

Then, when the health of a seriously ill inmate deteriorates, he/she may be transferred to a secure inpatient care unit (UHSI) in a university hospital for stays lasting more than 48 hours. But while admission to hospital offers better access to painkillers and improved conditions, for some inmates it may also mean being far from their family, even though visiting conditions are easier in UHSI.

It is also important to note that providing palliative care in UHSI is difficult for health professionals: it’s not always easy to get access to the patient because of security regulations and they haven’t been trained to provide holistic end-of-life care. For health professionals, there is also the issue that dying in prison is a taboo, creating tension between what is possible and what they would like to be able to do for the patients.

For all these reasons, physicians and caregivers consider that prisoners with a terminal illness should be released on compassionate grounds and should not die in prison.

To find out more . . .

Is Palliative Care Possible in Prison? National Study about Inmates with Terminal Illness in France, PARME Study,  Godard-Marceau, Aurélie; Chassagne, Aline; Cretin, Elodie; Pazart, Lionel; Aubry, Régis. Abstract number: P329.  View the abstract for this poster in ‘Abstracts of the 9th World Research Congress of the European Association for Palliative Care (EAPC), Dublin, Ireland, 9-11 June 2016’ published online on the Palliative Medicine website.

Reference
PARME Study: PAlliative situations and compassionate Release for MEdical reasons

View more posts in this series on the EAPC Blog. Next week, Mariona Guerrero, Josep Porta-Sales and Rebecca Latter from the WeCare Chair: End of Life Care research group, Barcelona, Spain, explain the background to their group’s poster . . .

 

new-new-eapc17_header_960x21115th EAPC World Congress. Early Bird offer closes 15 February 2017 – up to 25% saving if you book by Wednesday, 15 February!

Click here to register now before the Early Bird offer closes on 15 February. Please share so that others can take advantage of the Early Bird Offer. After 15 February, registration is still possible via the congress website but at a higher fee. Book your accommodation via the congress website. The 15th EAPC World Congress – Progressing Palliative Care – takes place in Madrid 18 to 20 May 2017. To register and find out more, visit the congress website. Follow us on Twitter @EAPCOnlus – our official congress hashtag is #EAPC2017

 

 

This entry was posted in EAPC Congresses, EAPC World Research Congresses, Minority Communities, PATIENT & FAMILY CARE and tagged . Bookmark the permalink.

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