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Letter From the Editors

By D. Thomas, M.D., J.D., and Annie De Groot, M.D.

August 2005

Dear Correctional Colleagues:

Correctional health care is back in the news this month. Last month, the California prison system went into receivership over concerns about HIV care. This month, the Limestone prison in Alabama was on the front page of The New York Times, due to alleged malfeasance by a well-known managed care company.

The lesson? An old one. The only acceptable standard of care in correctional health is the same standard that exists outside of prison and jail walls, per the 8th amendment, which prohibits actions that are incompatible with "the evolving standards of decency that mark the progress of a maturing society." Under these principles the Supreme Court has interpreted the 8th Amendment to include medical treatment, based on the fact that denying medical care would result in unnecessary suffering that could serve no penological purpose. The current test for an 8th Amendment violation is whether correctional staff members have shown deliberate indifference to an inmate's serious medical needs.

IDCR has stood by that standard for eight years of publication. Our mission has always been to provide the tools and resources that correctional health providers need to improve the standard of medical care in correctional settings. Furthermore, we do not believe that poor health care is inextricably linked with incarceration. Instead, we can point to a number of examples of medical care excellence within prison and jail walls, and a host of excellent correctional care providers. Poor care in prison is not "inevitable", by any means.

The California and Alabama cases recall two almost rhetorical questions that are repeated every time a correctional facility hits the news: (1) When will states recognize the importance of proper levels of funding for the programs that provide medical services to the inmates under their care, and (2) when will the government establish a set of standards below which no correctional facility would be allowed to fall?

And so we continue our important mission of providing you what you want -- and more importantly -- what you need, in the area of infectious diseases within corrections. To that end, this month, Dr. Joseph Bick presents the second of a two-part series on infection control in corrections.

The editors are committed to continually supplying the essentials of correctional infectious disease care and we challenge each of you to personally adopt the material laid out in this issue and have the entire staff (medical, correctional, administrative and inmate) of your facility practice it.

This article was provided by Brown Medical School. It is a part of the publication Infectious Diseases in Corrections Report. You can find this article online by typing this address into your Web browser:

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