measures, and may even have a preventive efect. During its prison visits50
the CPT has constantly recommended the systematic recording of all cases
of violence.
1.6 Other ethical issues
Involving prison doctors in security‑related issues
and disciplinary measures
Medical practitioners in prison should act as personal doctors of prisoners
and should establish a positive doctor–patient relationship with them. The
practice of prison doctors certifying whether a prisoner is ft to undergo soli‑
tary confnement as a punishment (or any other type of solitary confnement
imposed against the prisoner’s will) does not promote this relationship. This
issue is emphasised in the EPR. Medical staf should never participate in any
decision‑making process resulting in any type of solitary confnement, unless
the measure is applied for medical reasons.
On the other hand, health‑care staf should be very attentive to the situation
of all prisoners placed in solitary confnement. The health‑care staf should be
informed of every such placement and should visit the prisoner immediately
after placement and thereafter, on a regular basis, at least once a day, and
provide him/her with prompt medical assistance and treatment as required.
They should report to the prison director whenever a prisoner’s health is being
put seriously at risk by being held in solitary confnement.
The prison doctor should not carry out any body searches or examinations
requested by an authority, except in emergency situations when no other
doctor can be called in. In those exceptional cases when the examination of
body cavities cannot be avoided, it should be done by a doctor with appropriate
medical training. However, in the interest of safeguarding the doctor–patient
relationship, this person should not be the doctor who treats the prisoner
with respect to health care. This point is also emphasised by the WMA in its
Statement on Body Searches of Prisoners.51
Special security measures might be called for in specifc cases, but the system‑
atic placing of prisoners in barred areas when injections are administered is
50. CPT/Inf (2009)13; (2010)3; (2010)27; (2010)33; (2011)3; (2011)20; (2012)1; (2012)9.
51. WMA: Statement on body searches of prisoners, Budapest (1993, rev. 2005).
Prison health care and medical ethics Page 24
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