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73.
A prison doctor acts as a patient's personal doctor. Consequently, in the interests of
safeguarding the doctor/patient relationship, he should not be asked to certify that a prisoner is fit
to undergo punishment. Nor should he carry out any body searches or examinations requested by
an authority, except in an emergency when no other doctor can be called in.
74.
It should also be noted that a prison doctor's professional freedom is limited by the
prison situation itself: he cannot freely choose his patients, as the prisoners have no other
medical option at their disposal. His professional duty still exists even if the patient breaks the
medical rules or resorts to threats or violence.
g.
Professional competence
75.
Prison doctors and nurses should possess specialist knowledge enabling them to
deal with the particular forms of prison pathology and adapt their treatment methods to the
conditions imposed by detention.
In particular, professional attitudes designed to prevent violence - and, where
appropriate, control it - should be developed.
76.
To ensure the presence of an adequate number of staff, nurses are frequently
assisted by medical orderlies, some of whom are recruited from among the prison officers. At
the various levels, the necessary experience should be passed on by the qualified staff and
periodically updated.
Sometimes prisoners themselves are allowed to act as medical orderlies. No doubt,
such an approach can have the advantage of providing a certain number of prisoners with a
useful job. Nevertheless, it should be seen as a last resort. Further, prisoners should never be
involved in the distribution of medicines.
77.
Finally, the CPT would suggest that the specific features of the provision of health
care in a prison environment may justify the introduction of a recognised professional
speciality, both for doctors and for nurses, on the basis of postgraduate training and regular inservice training.
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