Health care in custody: Ethical fundamentals

that the risk of death among former inmates was 12.7 times higher than that of non incarcerated residents during the first two weeks after release, with a markedly elevated relative risk of death from drug overdose [10]. The detention setting has been identified as a significant opportunity to address the health needs of vulnerable groups. Modern prison health services should aim to reduce inequalities by providing a range and quality of health care equivalent to that available in the community, according to the principles outlined by the Council of Europe [11] This article will highlight the ethical aspects of medical management in custody with special attention to the doctor-patient relationship (one important aspect of provision of health care in prison), which is at the centre of this issue.