CARE ALTERNATIVES IN PRISON SYSTEMS: Factors Influencing End-of-Life Treatment Selection

The authors examined age at the end of prison sentence, race, and psychosocial factors on end-of-life treatment preferences among 73 male inmates (28 nonlifers, 45 lifers) from the Alabama Aged and Infirmed Correctional Facility. All measures (e.g., Brief Symptom Inventory, Death Anxiety Scale) were administered in an interview format. A significant amount of variance in treatment preferences for cardiopulmonary resuscitation, feeding tube, and palliative care was predicted by race, lifer status, and death anxiety. Inmates who were members of minority groups, nonlifers, and those with high death anxiety expressed greater desire for a feeding tube, whereas inmates who were Caucasian or lifers expressed a greater desire for palliative care. Given the aging of the inmate population and increasing health care costs, further exploration of end-of-life treatment preferences among older inmates is warranted.