Facing the challenges of an increasingly ageing prison population in Switzerland: In search of ethically acceptable solutions

Abstract

German and French abstracts see p. 139 Prisons in Switzerland are facing challenges associated with growing numbers of ageing prisoners. This paper explores two health care related concerns linked to this changing demographic pattern and eval- uates them using the principle of equivalence of care. The principle stip- ulates that health care received by prisoners and non prisoners should be equivalent. Its implication for prison health care is analysed focusing on the declining abilities of older prisoners within the unsuitable physi- cal environment of the prison. The equivalence principle is also used to address questions about adequate access to health care for older pris- oners at the end of life. Health care services such as palliative or hos- pice care are explored along with other alternative solutions such as compassionate release. Finally, ethically acceptable solutions to prison medicine that adequately respond to the needs of ageing and dying pris- oners are discussed with an emphasis on duties of health care provid- ers and other stakeholders.