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.
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.
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.
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:
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.
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.
I had a guy that kept swallowing toothbrushes because he enjoyed the trips to the hospital.
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.
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.
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.
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).