Clinical Ethics Consultation for Patients Impacted by Incarceration: A Single Center Retrospective Review

Area of Science:

• Medical Ethics
• Health Law
• Public Health

Background:

• Patients impacted by incarceration face distinct medical, legal, and ethical challenges.
• Ethics consultations for this population are not well-understood.
• Understanding these consultations is crucial for equitable care.

Purpose of the Study:

• To characterize the primary ethical issues in ethics consultations for patients impacted by incarceration.
• To identify contextual features of these consultations.
• To compare demographics of these patients with the general incarcerated population.

Main Methods:

• Qualitative concept content analysis of ethics consultations.
• Descriptive statistics of patient demographics (Jan 2015-June 2022).
• Comparison with institutional data on patients impacted by incarceration.

Main Results:

• Patients impacted by incarceration comprised 3% of ethics consults (n=38).
• Primary ethical issues: surrogate decision-making (34%) and fiduciary duties (16%).
• Key contextual feature: intra-family communication challenges (37%).

Conclusions:

• Incarceration status affects access to decision-makers and care.
• Ethics consultation may be underutilized for women and in outpatient/emergency settings.
• Enhanced education and coordination with correctional facilities are needed.