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Scientific article
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English

Prisoners' insomnia: to treat or not to treat? Medical decision-making in places of detention

Contributors

Elger, Bernice Simone

Published in

Medicine, Science and the Law, vol. 48, no. 4, p. 307-316

Publication date

2008

Abstract

Insomnia is a frequent reason for medical and psychiatric consultation in prisons. Medical decision-making in correctional health care should be based on the same principles as outside correctional institutions. In places of detention, principles should be balanced according to the same criteria as outside correctional institutions, while taking into account the unique harm-benefit ratios related to the specific context. The aim of this paper was to examine the existing attitudes and ethical issues related to decision-making about insomnia evaluation and treatment in places of detention. An analysis of the ethical issues and an evidence-based review of the consequences of different attitudes and treatments with regard to prison medicine were carried out. Insomnia is a public health problem and requires adequate evaluation and treatment to avoid more serious health consequences both within and outside correctional institutions. Insomnia treatment in places of detention is an ethical dilemma, but there is no evidence-based reason to avoid benzodiazepines in prison completely and to use only neuroleptics and antidepressants, which might represent more dangerous and less efficient treatment. In prison medicine, should we even treat insomnia? Widely accepted ethical strategies of decision-making indicate that we should. Institutional guidelines on insomnia should be based on ethically sound decision-making that takes into account the available evidence.

Keywords

  • Decision Making
  • Ethics, Medical
  • Humans
  • Prisoners
  • Sleep Initiation and Maintenance Disorders/therapy

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

ELGER, Bernice Simone. Prisoners” insomnia: to treat or not to treat? Medical decision-making in places of detention. In: Medicine, Science and the Law, 2008, vol. 48, n° 4, p. 307–316. doi: 10.1258/rsmmsl.48.4.307

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Article (Accepted version)

Identifiers

Journal ISSN

0025-8024
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Technical informations

Creation

20/04/2009 08:55:00

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20/04/2009 08:55:00

Update

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