Health care in prisons - between health and human rights - viewed with respect to epilepsy

Introduction This paper examines the differentiation of healthcare and human rights in prisons, with reference to epilepsy, in Australia. Management of Healthcare for Prisons in NSW Corrective Services NSW (CSNSW) holds duty of care for prisoners. Justice Health administers their healthcare, expecting medical assessment when entering prison. The Australian Institute of Health and Welfare (AIHW) collects second yearly data, mostly acquired from prisoners, the majority serving less than 2 years, with implications for ongoing care. Researching Epilepsy in Prisons Researching health measures, assessing epilepsy in prisoners, is difficult because prisons are reluctant to co-operate and face-to-face interviews cause potential interference with prison routine, considered counterproductive. Optimal outcomes may necessitate an educative program for both prisoners and officials running the prisons. Managing Epilepsy in Prisons Justice Health delivers services for prisoners with epilepsy, arranging clinic visits, transferring prisoners and organising appointments, tests and follow-up. There is often lack of epilepsy-related history and limited prisoner health-literacy. About half the prisoners have additional medical conditions, including mental health disorders, potentially impacting epilepsy management. Sociological influences impede medical care. Trials of anti-seizure medications (ASMs) require patient compliance, correct choice thereof, adequate seizure and relevant past medical histories. Prisons often purchase generic equivalents ofASMs which may affect epilepsy control. Regimented prison life may improve seizure frequency. More accurate medical records and/or contact details for access thereto would assist care providers. Attention should focus on both 'in-prison' and 'post-prison' care. Conclusions The healthcare of prisoners which respects their human rights, continues to face challenges, as demonstrated when examining a single diagnosis, such as epilepsy.