violent, suicidal or characterised by unacceptable sexual behaviour, and for most of the time they are incapable of controlling or caring for themselves. The needs of these prisoners are not truly medical, but the prison doctor can promote the development of socio‑therapeutic programmes for them in prison units which are similar to those in the community and are carefully supervised. Such units can reduce these prisoners’ humiliation, contempt and hatred, give them a sense of responsibility and prepare them for reintegration. Another direct advantage of programmes of this type is that they involve the active participation and commitment of the prison staf. There are also prisoners who are unsuited to continued detention because of a serious disease which cannot be properly treated in prison conditions, a short‑term fatal prognosis, a severe disability or advanced age. In such cases, it lies with the prison doctor to draw up a report for the responsible authority with a view to making suitable alternative arrangements. Medical ethics in prison Page 27