{"title":"The Ethical and Psychosocial Dimensions of Palliative Care in Prison : A Scoping Review.","authors":"Ana Gehl-Costa, P Reis-Pina","doi":"10.1007/s11673-026-10562-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>With prison populations expanding and aging, palliative care (PC) is an urgent concern. People in prison (PIP) face chronic illness, mental health conditions, and social vulnerabilities, creating ethical and psychosocial challenges to dignified end-of-life (EOL) care.</p><p><strong>Objective: </strong>This scoping review mapped key ethical and psychosocial domains in the provision of PC in prisons.</p><p><strong>Methods: </strong>PubMed, Web of Science, and ScienceDirect were searched using the strategy: Population-individuals in prison; Concept-ethical and/or psychosocial issues in PC; Context-PC provision in prisons across regions and healthcare models. Data were coded inductively, organized into ethical and psychosocial domains, and synthesized narratively.</p><p><strong>Results: </strong>Sixteen studies were included, mainly conceptual analyses (n=10), most from North America (n=11). Ethical domains included structural neglect of PIP with life-limiting illness, barriers to compassionate release, compromised autonomy, denial of death in prison culture, and inadequacies in care quality and access. Psychosocial domains encompassed stigma, mistrust, isolation, existential suffering, and fractured social bonds. PIP-led hospice models offered companionship but raised tensions around labour, confidentiality, and the normalization of death in custody.</p><p><strong>Conclusion: </strong>Prison-based PC requires systemic reforms, staff training, family and advocacy involvement, and legal safeguards to ensure equitable, compassionate, and dignified EOL care.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Bioethical Inquiry","FirstCategoryId":"98","ListUrlMain":"https://doi.org/10.1007/s11673-026-10562-8","RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: With prison populations expanding and aging, palliative care (PC) is an urgent concern. People in prison (PIP) face chronic illness, mental health conditions, and social vulnerabilities, creating ethical and psychosocial challenges to dignified end-of-life (EOL) care.
Objective: This scoping review mapped key ethical and psychosocial domains in the provision of PC in prisons.
Methods: PubMed, Web of Science, and ScienceDirect were searched using the strategy: Population-individuals in prison; Concept-ethical and/or psychosocial issues in PC; Context-PC provision in prisons across regions and healthcare models. Data were coded inductively, organized into ethical and psychosocial domains, and synthesized narratively.
Results: Sixteen studies were included, mainly conceptual analyses (n=10), most from North America (n=11). Ethical domains included structural neglect of PIP with life-limiting illness, barriers to compassionate release, compromised autonomy, denial of death in prison culture, and inadequacies in care quality and access. Psychosocial domains encompassed stigma, mistrust, isolation, existential suffering, and fractured social bonds. PIP-led hospice models offered companionship but raised tensions around labour, confidentiality, and the normalization of death in custody.
Conclusion: Prison-based PC requires systemic reforms, staff training, family and advocacy involvement, and legal safeguards to ensure equitable, compassionate, and dignified EOL care.
背景：随着监狱人口的扩大和老龄化，姑息治疗（PC）是一个迫切关注的问题。监狱在押人员面临慢性疾病、精神健康状况和社会脆弱性，给有尊严的临终关怀带来伦理和社会心理挑战。目的：这一范围审查绘制了关键的伦理和社会心理领域，在监狱提供PC。方法：PubMed、Web of Science和ScienceDirect采用以下策略进行检索：人口-监狱中的个人；概念-个人电脑的伦理和/或社会心理问题；背景-各地区监狱的个人电脑供应和医疗模式。数据被归纳编码，组织成伦理和社会心理领域，并以叙事方式合成。结果：纳入16项研究，主要是概念分析（n=10），大部分来自北美（n=11）。伦理领域包括对患有限制生命的疾病的PIP的结构性忽视，同情释放的障碍，受到损害的自主权，监狱文化中否认死亡，以及护理质量和机会不足。社会心理领域包括耻辱、不信任、孤立、存在的痛苦和断裂的社会纽带。pip领导的临终关怀模式提供了陪伴，但在劳动、保密和羁押中死亡的常态化方面引发了紧张。结论：基于监狱的个人护理需要系统改革、员工培训、家庭和倡导参与以及法律保障，以确保公平、富有同情心和有尊严的EOL护理。
期刊介绍：
The JBI welcomes both reports of empirical research and articles that increase theoretical understanding of medicine and health care, the health professions and the biological sciences. The JBI is also open to critical reflections on medicine and conventional bioethics, the nature of health, illness and disability, the sources of ethics, the nature of ethical communities, and possible implications of new developments in science and technology for social and cultural life and human identity. We welcome contributions from perspectives that are less commonly published in existing journals in the field and reports of empirical research studies using both qualitative and quantitative methodologies.
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