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Human Rights in Hospitals: an End to Routine Shackling.

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Medical students revised policies to end routine shackling of incarcerated patients, promoting individualized care. This human rights victory led to system-wide changes and advocacy for less restrictive alternatives.

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Area of Science:

  • Medical Ethics
  • Public Health Policy
  • Human Rights in Healthcare

Background:

  • Routine physical restraints (shackling) are common for incarcerated patients in US hospitals, irrespective of medical condition.
  • A policy revision at Boston Medical Center (BMC) introduced individualized assessments for shackling.
  • The initiative aimed to humanize inpatient care for incarcerated individuals.

Discussion:

  • The revised policy at BMC allows for unshackling based on defined clinical criteria.
  • A coalition of diverse stakeholders was formed to advocate for policy change.
  • This led to adoption of similar policies within the Mass General Brigham health system.

Key Insights:

  • Medical students initiated a successful campaign against universal shackling of incarcerated patients.
  • The Stop Shackling Patients Coalition (SSP Coalition) achieved significant policy changes at state and national levels.
  • An incarcerated patient was successfully unshackled for medical and human dignity reasons.

Outlook:

  • The Massachusetts Medical Society adopted a resolution advocating for least restrictive alternatives.
  • The SSP Coalition's policy statement was adopted by the American Public Health Association.
  • Further advocacy is planned with the American Medical Association to address universal shackling practices.