# Medical devices needed by prison inmates **URL:** \ **Category:** Factual Questions\ **Created:** [October 12, 2018, 11:27am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849 "2018-10-12T11:27:15Z")\ **Posts on this page:** 15\ **Page:** 2
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [October 12, 2018, 10:36pm UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/21 "2018-10-12T22:36:35Z")
Yup, inserting you-name it into any available orifice sounds like this guy. I don’t think they made his hospital confinement stark, I think they just declared him “well enough” and shipped him back to prison. But not before giving the hospital staff some good stories. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [October 12, 2018, 10:36pm UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/22 "2018-10-12T22:36:41Z")
> [@brossa](#): > > I may have asked this before, but what if a prisoner just stops eating? No declarations, no defiance, no demands, just doesn’t get in the chow line or whatever. Maybe a couple of weeks pass and he’s noticeably thinner but won’t talk about it. How often would an inmate get a medical check/how soon might this come to the attention of officials? If he just refuses to cooperate with medical evaluation (but through remaining mute rather than physical resistance, or maybe purging after being tube fed) what would be done? As soon as it’s noticed, we start the ‘food refusal’ protocol, and he gets monitored and talked to regularly. If he doesn’t allow examination and we can make a case for him possibly being at immediate risk for severe harm due to his observed refusal behavior, we can generally get a court order that will allow us to take a blood pressure, basic labs, etc. Now, if he still physically refuses to cooperate, we weigh the merits of actual use of force on a case by case basis. I don’t want my staff at risk just to obtain a pulse, nor do I wish to injure the patient. I tend to use a LOT of watchful waiting until the patient either collapses into unconsciousness in which case we ship him to the ER (a lot of guys get more cooperative in that setting) and see what happens there. So we do try to avoid forcing evaluation or treatment, unless it’s a grave situation. I find I’m far less likely to advocate for forced treatment than the court is, honestly. I’ve told judges that I thought the patient’s desire to refuse treatment was not unreasonable even if it did put them at some risk, only to have the judge order treatment. It’s a labyrinthine, contradictory system. ---
**Author:** ![K2500](https://avatars.discourse-cdn.com/v4/letter/k/f6c823/32.png) [@K2500](https://boards.straightdope.com/u/K2500)\ **Post date:** [October 12, 2018, 11:37pm UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/23 "2018-10-12T23:37:21Z")
> [@Qadgop\_the\_Mercotan](#): > > The practitioner does so, in accordance with the standard of care in the community. A guy wants his ACL repaired to he can play basketball better? No, the standard of care is to repair it if the tear prevents normal functioning for the typical patient, and such a repair would get it closer to normal functioning, not sports level functioning. I interpret that to mean, good enough to get 'em through alive and whole , not so good they’re getting better than the local community(or did you mean standards of the medical community). I suppose that’s about what I would have expected. If they happen to have their own money to pay would they be able to buy their way up, so to speak, to a more prefered treatment? For instance, the ACL repair mentioned? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [October 13, 2018, 2:12am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/24 "2018-10-13T02:12:55Z")
> [@K2500](#): > > I interpret that to mean, good enough to get 'em through alive and whole , not so good they’re getting better than the local community(or did you mean standards of the medical community). I suppose that’s about what I would have expected. If they happen to have their own money to pay would they be able to buy their way up, so to speak, to a more prefered treatment? For instance, the ACL repair mentioned? No, that’s **not** how it’s meant. The community standard requires that the patient be told what other physicians in the same community would tell a patient in the same or similar circumstances. Access to the same quality of care across the board. If all US citizens had this sort of de facto care, we’d have a far, far healthier population than we do have. As it is, convicted felons are the only class of US citizens who has government-provided health care mandated for them in the US constitution. The courts have ruled that to not provide medical care consistent with the community standard is the equivalent of cruel and unusual punishment. However, they’ve also ruled that this means _necessary_ medical care. But no, they don’t have a way to get ‘preferred’ treatment. We’ve barely got staff enough (due to a practitioner shortage in general, not just in prisons) to try to get the necessary care to all our inmates, so we’re not going to provide care that’s not medically necessary, nor are we obliged to provide _futile_ care, either. We won’t do a heart transplant on a 90 year old, or do CPR on someone whose ribs are so riddled with bone cancer that the act of pushing on their chest would shatter them. ---
**Author:** ![pool](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pool/32/4152_2.png) [@pool](https://boards.straightdope.com/u/pool)\ **Post date:** [October 13, 2018, 2:35am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/25 "2018-10-13T02:35:55Z")
I’ve never really thought about people with Parkinson’s trying to harm themselves is that really a widespread phenomena or mainly the people with it that are in prison? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [October 13, 2018, 2:37am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/26 "2018-10-13T02:37:42Z")
> [@pool](#): > > I’ve never really thought about people with Parkinson’s trying to harm themselves is that really a widespread phenomena or mainly the people with it that are in prison? Sorry, that was a brain fart on my part. I was thinking **Huntington’s** disease but typed Parkinson’s. Thanks for catching that one. :smack: ---
**Author:** ![Peter\_Morris](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/peter_morris/32/359_2.png) [@Peter\_Morris](https://boards.straightdope.com/u/Peter_Morris)\ **Post date:** [October 13, 2018, 3:13am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/27 "2018-10-13T03:13:37Z")
I’ve seen a couple of TV shows where someone tried to get sent to prison so they could get free medical care. Is this a real thing? Does it ever actually happen? What would happen if someone tried it? In one show it was a recently released ex-prisoner, he had been getting free care while in prison, but it stopped as soon as he was released. He punched his parole officer to get sent back. ---
**Author:** ![K2500](https://avatars.discourse-cdn.com/v4/letter/k/f6c823/32.png) [@K2500](https://boards.straightdope.com/u/K2500)\ **Post date:** [October 13, 2018, 3:17am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/28 "2018-10-13T03:17:37Z")
> [@Qadgop\_the\_Mercotan](#): > > No, that’s **not** how it’s meant. The community standard requires that the patient be told what other physicians in the same community would tell a patient in the same or similar circumstances. Access to the same quality of care across the board. If all US citizens had this sort of de facto care, we’d have a far, far healthier population than we do have. > > As it is, convicted felons are the only class of US citizens who has government-provided health care mandated for them in the US constitution. The courts have ruled that to not provide medical care consistent with the community standard is the equivalent of cruel and unusual punishment. However, they’ve also ruled that this means _necessary_ medical care. > > But no, they don’t have a way to get ‘preferred’ treatment. We’ve barely got staff enough (due to a practitioner shortage in general, not just in prisons) to try to get the necessary care to all our inmates, so we’re not going to provide care that’s not medically necessary, nor are we obliged to provide _futile_ care, either. We won’t do a heart transplant on a 90 year old, or do CPR on someone whose ribs are so riddled with bone cancer that the act of pushing on their chest would shatter them. Forgive me but, I’m trying to shake the thought that if I were both poor and sick that I might need to commit a crime to get affordable care. I’m not sure what to make of that. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [October 13, 2018, 3:43am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/29 "2018-10-13T03:43:54Z")
> [@Qadgop\_the\_Mercotan](#): > > that type of patient is not uncommon, sadly. eventually we make their hospital confinement more stark, reducing entertainment and food choices. > > Even so, many of these folks will continue to self mutilate, inserting you name it into any available orifice, or even make their own orifices. They know they’ll usually get at least some sedation during removal procedures, and maybe some opioid pain killers for a bit, afterwards. I had a guy that kept swallowing toothbrushes because he enjoyed the trips to the hospital. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [October 13, 2018, 3:45am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/30 "2018-10-13T03:45:29Z")
> [@Qadgop\_the\_Mercotan](#): > > Sorry, that was a brain fart on my part. I was thinking **Huntington’s** disease but typed Parkinson’s. Thanks for catching that one. :smack: Wouldn’t a person with Huntington’s go to some kind of long-term care facility? I know they do that with some prisoners who are too ill to be in an infirmary; IIRC they usually go to a state-run home. (I used to work with a woman who got Huntington’s. She was not properly diagnosed until her father, who was believed to have Alzheimer’s, died, and the autopsy revealed this, and in turn she, who was exhibiting strange behaviors, was evaluated and properly diagnosed. Horrible, horrible disease.) I do know that prisoners in the county jail had to see a jail nurse to get injectable drugs, like insulin, but other meds, like inhalers, could usually be handled by a trustee. Inmates who needed controlled substances were admitted to the hospital. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [October 13, 2018, 3:46am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/31 "2018-10-13T03:46:56Z")
> [@Lemur866](#): > > So if a prisoner has a CPAP, then there has to be an electrical outlet in the cell, right? How is that handled? Like, every cell has standard outlets? Seems like an easy way to harm yourself or others. Are they all GFCI? Cells have electrical outlets as standard equipment. If a prisoner specifically uses it to harm himself or cause some other serious problem, we can seal off the outlets with child-proof coverings. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [October 13, 2018, 2:30pm UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/32 "2018-10-13T14:30:08Z")
> [@K2500](#): > > Forgive me but, I’m trying to shake the thought that if I were both poor and sick that I might need to commit a crime to get affordable care. I’m not sure what to make of that. Me either. I have not had any patients tell me directly that they committed a crime to get health care, but I’ve been told by many after they came back in for another stint in prison that they were glad because at least they’d get proper treatment. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [October 13, 2018, 11:30pm UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/33 "2018-10-13T23:30:21Z")
> [@Qadgop\_the\_Mercotan](#): > > Me either. I have not had any patients tell me directly that they committed a crime to get health care, but I’ve been told by many after they came back in for another stint in prison that they were glad because at least they’d get proper treatment. How incredibly tragic that anyone would feel the need to do this. Back when I was practicing, I occasionally worked at pharmacies that took care of the meds for the county jail. Filling for the female unit was always depressing, because it seemed like half of them were pregnant. ☹ Which reminds me: I thought Joe Arpaio had the right idea until I found out how he treated pregnant inmates. No matter what she may have done, the baby is completely innocent and probably already had two strikes against it due to malnutrition and substance abuse, and she does not deserve to be given spoiled food and denied even basic medical care, which he did. I Googled the lady I knew who had Huntington’s, but I was not able to find any information on her. That she has an extremely common name (think something like Jane Green, although that’s not exactly it) was probably why. ---
**Author:** ![K2500](https://avatars.discourse-cdn.com/v4/letter/k/f6c823/32.png) [@K2500](https://boards.straightdope.com/u/K2500)\ **Post date:** [October 14, 2018, 2:54am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/34 "2018-10-14T02:54:05Z")
> [@Qadgop\_the\_Mercotan](#): > > Me either. I have not had any patients tell me directly that they committed a crime to get health care, but I’ve been told by many after they came back in for another stint in prison that they were glad because at least they’d get proper treatment. Wouldn’t it be interesting, if the crime itself were the result of lacking medical care and the punishment included the necessary healthcare that would have prevented the crime. If this isn’t a commonly recognized cycle for the physically ill I’d bet it’s fairly common cycle for the mentally ill. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [October 14, 2018, 3:08am UTC](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849/35 "2018-10-14T03:08:23Z")
> [@K2500](#): > > Wouldn’t it be interesting, if the crime itself were the result of lacking medical care and the punishment included the necessary healthcare that would have prevented the crime. > > If this isn’t a commonly recognized cycle for the physically ill I’d bet it’s fairly common cycle for the mentally ill. Don’t get me started on the terrible tragedy of how we now treat folks with mental illness. It’s ugly. Prisons were not designed to address their needs, but they’ve become the dumping grounds for countless numbers of them. De-institutionalization of these unfortunates has just moved far too many from mental institutions into criminal institutions. As for your first point, I can look at my previously mentioned Huntington’s disease patients for examples of people whose bona fide neurological disease is directly responsible for the behavior that got them sent to prison (sudden aggression and hostile, assaultive behavior due to the loss of the parts of the brain which are supposed to keep that in check). [Previous page](https://boards.straightdope.com/t/medical-devices-needed-by-prison-inmates/822849.md?page=1)