NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2017 86 Annex The role of medical personnel in places of detention – ethical dilemmas, dual loyalty and the importance of international standards Presented as the Keynote Address at the Norwegian Parliamentary Ombudsman’s Human Rights Seminar in Oslo, 26 October 2017 By Dr. Jörg Pont, Vienna, Austria The normative basis for providing healthcare in prisons and any other places of detention can be outlined as: ››The right of everyone, including detained individu- als, to the highest attainable standard of physical and mental health according to the International Covenant on Economic, Social and Cultural Rights from 19661 ; ››The stipulation that persons deprived of their liberty retain all rights that are not lawfully taken away from them according to the European Prison Rules2 ; and ››Based on WHO statements that Prison Health is an important part of Public Health. 3,4 Considering these clear basic norms, one might wonder why there is any need for additional considerations, rules and documents on healthcare ethics in prison in addition to the general healthcare ethics. However, providing healthcare in prison and other places of detention has some peculiarities that are typical for this setting and that pose particular challenges, as described below. The role of medical personnel in providing healthcare in prison Firstly, as a rule, the detained individual cannot choose his/her healthcare providers and the health of inmates is therefore the responsibility of the state, which, legally and/or de facto, took away their liberty of movement. Secondly, in prisons and other places of detention, two completely different tasks have to be performed by two different professional groups under the same roof: 1 United Nations: International Covenant on Economic, Social and Cultural Rights. http://www.ohchr.org/EN/ProfessionalInterest/ Pages/CESCR.aspx 2 European Prison Rules 2006, Council of Europe Publishing. http://www.coe.int/t/dgi/criminallawcoop/Presentation/Documents/ European-Prison-Rules_978-92-871-5982-3.pdf 3 WHO, Moscow Declaration on Prison Health as Part of Public Health, 2003. http://www.euro.who.int/en/health-topics/healthdeterminants/prisons-and-health/publications/pre-2005/moscow-declaration-on-prison-health-as-part-of-public-health 4 WHO, The Madrid Recommendation, 2010 http://www.euro.who.int/__data/assets/pdf_file/0012/111360/E93574.pdf?ua=1