This article explores the need for compassionate end-of-life care in prisons, highlighting the practice of shackling dying prisoners to their beds during palliative care. It features the perspective of Dr. Mark Boughey, who provides palliative care in a prison ward, and Professor Jennifer Philip, who advocates for the end of shackling in end-of-life care.
Before Mark Boughey can see his patients, he has to pass through several security measures: locked gates, metal detectors, an eye scan. But once he's inside the 40-bed hospital ward at Victoria's Port Phillip Prison, Dr Boughey's focus is on those preparing to die. 'As a person going there for the first time, you might find it a little bit stark, and you've just got to accept that is the space, but that's the space for many people that's become very familiar,' he says.
'They've got their relationships with other prisoners and guards, and so it is their home and their environment, and so you treat it as such.' In his experience, most prisoners in palliative care would prefer to be here, inside the walls of the jail, rather than being transferred to a hospital — largely because of that familiarity. As the Australian prison population ages, the demand for end-of-life care and treatment for chronic illness is set to increase. Prisoners who are transferred to a hospital for palliative care can be shackled to their beds during their final days, attached with leg or hand cuffs.St Vincent's Hospital Melbourne's palliative medicine chair, Jennifer Philip, is among those calling for an end to shackle use on patients in the final stages of end-of-life care. 'I can't imagine what it would be like to be spending my last hours chained to the bed,' Professor Philip says. Her research has shown there are potential physical impacts, along with emotional ones, for both the prisoner and their family. 'They will see the person that they love in that situation, perhaps their last memory is of that person with a chain on, and they will presumably carry that memory for the rest of their lives,' Professor Philip says.She says it can also cause 'distress' to the clinicians, given palliative care seeks 'to try to free people up from their symptoms and their other burdens'
Palliative Care Prisons End-Of-Life Shackling Human Rights
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