[Prison medicine and medical care-experiences from practice]

In Germany, there are approximately 70,000 prison spaces (criminal and pre-trial detention), which are currently over 90% full. Medical care is organized by the judicial administration. Section 63 of the Bremen Prison Act (BremStVollzG) regulates medical care. It stipulates that prisoners are entitled to "necessary, sufficient, and appropriate medical services, observing the principle of cost-effectiveness and taking into account the general standards of statutory health insurance."The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) identifies important principles for prison medicine: unhindered access to a physician, equivalent healthcare to that provided in freedom, patient self-determination and physician confidentiality/discretion, preventive healthcare, humanitarian assistance, professional independence, and sufficient medical competence.This article first outlines the requirements for prison medicine based on these principles. The author then reports on his own professional experiences as a prison physician at the Bremen Correctional Facility, including the challenges posed by the widespread prevalence of mental disorders, substance use, infectious diseases, and physical violence in prisons. Adequate training of medical staff is essential to meeting these unique requirements.