ESSEX PAPER 3: INITIAL GUIDANCE ON THE INTERPRETATION AND IMPLEMENTATION OF THE UN NELSON MANDELA RULES A medical file should be compiled for each patient, containing diagnostic information as well as an ongoing record of the patient’s evolution and of any special examinations he has undergone.249 Standard 40 also provides that, A personal and confidential medical file should be opened for each patient. The file should contain diagnostic information (including the results of any special examinations which the patient has undergone) as well as an ongoing record of the patient’s mental and somatic state of health and of his treatment.250 Standard 74 provides that, Recording of the medical examination in cases of traumatic injuries should be made on a special form provided for this purpose, with body charts for marking traumatic injuries that will be kept in the medical file of the prisoner. Further, it would be desirable for photographs to be taken of the injuries, and the photographs should also be placed in the medical file.251 The medical file should be kept separate from other files and in a lockable room that is only accessible by the health-care staff252. The Essex Group also pointed out that the right of the prisoner to access to files provided in Rule 26(1) includes the right to copy the files, not only look at them. The files should be understood as the property of the prisoner not the prison. The experts also noted that systems should be put in place to ensure continuity of access to medical files and care when a prisoner is transferred to another prison or another facility so that records follow the prisoner. The experts recalled that for women prisoners confidentiality of medical information includes information about their sexual and reproductive health history. They noted that women prisoners may have reasons not to want to share such information, ‘especially in countries or societies where out of marriage pregnancies and childbirth may be a cause for stigmatisation, and in some societies may be considered criminal acts. Information about any abortions is particularly sensitive, due to its criminalisation in many countries’.253 They referred to the Bangkok Rules which acknowledge that women prisoners should only be requested to provide information about their reproductive health history on a voluntary basis, and that no woman should be forced to provide such information.254 The experts referred to specific guidance on confidentiality in the case of HIV and AIDS in Principles 32 and 33 of the World Health Organization (WHO) Guidelines on HIV Infection and AIDS in Prisons (1999): 32.Information regarding HIV status may only be disclosed to prison managers if the health personnel consider, with due regard to medical ethics, that this is warranted to ensure the safety and well-being of prisoners and staff, applying to disclosure the same At 40. 249  At 52. 250  At 98. 251  UNOPS Technical Guidance for Prison Planning at 156. 252  Pew Research Center, Worldwide Abortion Policies (October 2015), available at: http://www.pewresearch.org/ interactives/global-abortion/ 253  Penal Reform International and Thailand Institute of Justice Guidance Document on the Bangkok Rules (2013), available at: https://www.penalreform.org/wp-content/uploads/2013/10/PRI-TIJ-Guidance-Document-on-Bangkok-RulesOctober-2013.pdf, pp. 40 and 46. 254  Penal Reform International and the Essex Human Rights Centre | 69