А. М. Туленков (A. M. Tulenkov)


The article discusses the bioethical foundations and problems of ensuring the practical implementation of the principle of equivalence of medical care for prisoners. 

The urgency of the problem in question is conditioned by the need to improve the quality of medical care in prisons.Among the key problems can be identified socio-demographic characteristics of prisoners: a large proportion of representatives of the marginalized population, low level of medical literacy, risky behavior, gender specific structure of the prison population. These features determine a significant difference in the structure of morbidity, characterized by a wider prevalence of chronic and socially significant diseases and a higher need for prisoners in medical care.Another aspect under consideration is the prison conditions themselves, in which the implementation of the principle of equivalence is difficult due to the specifics of their activities, dictating the need for strict adherence to regime and restrictive measures, which manifests itself in a significant restriction on the free choice of a doctor or medical institution, the need to disclose the diagnosis of the prison administration and other.An important factor is the negative social factor deprivation of prisoners, which not only hinders the effective rehabilitation of patients suffering from mental illnesses, but also is the cause of their occurrence.Finally, the role of a doctor in the penitentiary health system plays a crucial role in ensuring the equivalence principle. On the one hand, this relationship is a doctor-administration, on the other hand it is a doctor-patient relationship. A departure from the principle of equivalence in these relationships can lead to the phenomenon of "double loyalty" and mutual distrust.

Key words:principles of bioethics, prisoners, equivalence, medical care


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