recorded by the prison physician and, together with the objective fndings from
the medical examination and the physician’s conclusion regarding consistency,
should be brought immediately to the attention of the relevant prosecutor.31
Screening for transmissible diseases during the medical examination on admis‑
sion is essential to identify patients who need to be isolated and to prevent the
spread of disease, such as the airborne transmission of tuberculosis. Isolation
of prisoners because of the risk of infection should be applied in prison in
exactly the same way as in the community32 – so there is no reason at all to
isolate prisoners because of infection with HIV or hepatitis B and C. However,
education and information about the risks of acquiring these infections in
prison – ofering harm‑reduction measures, invitations to undergo voluntary
confdential counselling and testing, and, if appropriate, early treatment –
should be part of the medical consultation on admission. In several recent
country visits, the CPT criticised the lack or insufciency of screening for
transmissible diseases during entry medical examinations.33
Persons with mental or physical disabilities are particularly vulnerable to
imprisonment. Due to their handicaps they cannot understand and/or cope
with the strict and rigid conditions of a “total institution” like prison and are
at risk of mental or physical abuse by uncaring staf and fellow inmates. It
is the task of the health‑care professionals to identify disabled prisoners on
admission in order to ofer them humanitarian assistance34 and recommend
appropriate measures to protect them. The European Court of Human Rights
found a violation of Article 3 of the ECHR35 in cases of non‑compliance with
this responsibility, considering it as degrading treatment.
Considering all the above responsibilities of health‑care professionals during
medical consultations on admission, it becomes clear that in order to fulfl all
these tasks adequate time must be available for each consultation. Considering
further the demand that the consultation should be performed on the day
of admission, it is inevitable that the health‑care team should be stafed
adequately in accordance with the number of daily admissions to prisons,
31. CPT Standards 2002 (rev. 2011).
32. CPT/Inf (2009)38; (2011)20; (2012)17; (2012)32.
33. CPT/Inf (2011)26; (2012)1; (2012)4; (2012)11; (2012)15; (2012)17; (2012)32.
34. CPT Standards 2002 (rev. 2011).
35. Price v. the United Kingdom 33394/96.
Prison health care and medical ethics Page 18
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