Shackling in the Hospital
Lawrence A Haber1, Lisa A Pratt2, Hans P Erickson3
1Division of Hospital Medicine, Department of Medicine, Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center, University of California, 1001 Potrero Ave, Building 5, San Francisco, CA, 6A1094110, USA. lawrence.haber@ucsf.edu.
Journal of General Internal Medicine
|January 29, 2022
Summary
Hospitalized incarcerated patients are often shackled during medical treatment due to lack of policy. This practice can cause harm, and evidence supporting its necessity is limited, suggesting a need for better security measures.
Area of Science:
- Medical ethics
- Public health policy
- Forensic medicine
Background:
- Incarcerated patients frequently receive medical care in community hospitals.
- Shackling is a common practice for these patients to prevent escape or harm.
- Lack of clear policies leads to consistent shackling during routine care.
Purpose of the Study:
- Examine the practice of inpatient shackling of incarcerated patients.
- Review the existing evidence supporting medical-legal justifications for shackling.
- Identify the potential harms associated with hospital shackling.
Main Methods:
- Medical-legal review of inpatient shackling practices.
- Analysis of limited evidence supporting shackling.
- Discussion of harms incurred by shackled patients.
Main Results:
- Evidence supporting routine inpatient shackling is minimal.
- Clinicians often do not unshackle patients due to policy gaps.
- Shackling can lead to physical harm and prejudice.
Conclusions:
- Current inpatient shackling practices lack strong evidence.
- There is a need for evidence-based guidelines for shackling.
- Alternative security measures should be prioritized over routine shackling.
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