Ethics of Prison Palliative Care

The current ANS featured article is titled “Towards a Guiding Framework for Prison Palliative Care Nursing Ethics” by Helen Hudson, MSc(A); David Kenneth Wright, PhD.  In this article the authors interweave four strands of analysis—contextual, relational, social, and political—to produce a framework to guide ethical action in prison palliative care nursing.  This article is available to download at no cost while it is featured, and we welcome your comments here!  Here is a message about this work from the author Helen Hudson:

Helen Hudson

Most nurses have little cause to think about prisons or prisoners on a day-to-day basis, yet prisoners’ health needs are extensive. Markers of social disadvantage, including racialization, poverty, mental health issues and illiteracy, are overrepresented among prisoners throughout the Western world, reflecting a lack of access to the determinants of health prior to incarceration. As the global prison population ages, more and more people are dying behind bars of illness or age-related causes.

This paper came about as I examined the literature on palliative care for prisoners in anticipation of starting a doctorate on the topic, only to find that most scholarship engaged with the how questions, without considering the why. That is, end-of-life conditions and palliative care practices – where they exist – are described without much interrogation of why so many people are ending their lives in prison, or what that means, ethically, for the nursing discipline. Though the ethical challenges in this field of nursing are well described, to our knowledge no overarching framework has been put forward for understanding and addressing them. Together with my doctoral supervisor David K Wright, RN, PhD, CHPCN(C), I wrote this paper to address that gap. In it, we articulate an ethical analysis of palliative care nursing for prisoners throughout the illness and grieving trajectory (that is, not solely at end of life), both within and outside of prison facilities. Drawing on literature from various health disciplines – nursing, bioethics, medicine, social work, and public health – as well as prison studies and critical criminology, we synthesize perspectives that illuminate moral questions for practice, research, policy, education, and political action.

I’m excited to share this paper with the ANS readership and look forward to engaging with your comments.