Does this make sense:Prisons to reduce hepatitis treatment?? - page 2

posted on thu, jul. 24, 2003 prisons to reduce hepatitis treatment fewer pa. inmates will be eligible, due to budget issues. officials say the candidates will be better targeted. by mark... Read More

  1. by   SmilingBluEyes
    what sjoe said.
  2. by   BBFRN
    Originally posted by geekgolightly
    That policy is murder, IMHO.

    Non-compliance should be dealt with on an individual basis for those using that as an excuse for this policy.

    Our "captive audience" is dependent upon the state to take care of bodily needs. Doing time for a crime does not mean they should be dealt a death sentence. leave that for capital crimes, if that.
    Do you think these inmates ectively sought treatment when they were out on the street? Unfortunately, in my experience with them, they were not. Do you think they will get released and continue their course of treatment? Nope- they usually don't, unless they are Veterans and have VA benefits, and even then, it's a big maybe. They are not being denied treatment- they are being told that if they want it, then they will have to pay for it (therefore, they'll have to work while they're incarcerated)- it's called responsibility.

    A good majority of inmates that have Hepatitis are IV drug abusers- what do you think their priority is when they get out?

    And if we release them back into the public, where Hep. Tx may be too expensive for them, are we still responsible for them, and continuing to give them a death sentence?

    The "excuses" for this policy have been listed above by Sjoe, and if you have any experience with healthcare in the prison system, you know why this policy is in place.

    Hep+ inmates are monitored closely. Their enzymes are checked regularly, and great care is given not to prescribe meds for them that are hard on their livers. And, I have yet to see someone die in prison of liver failure related to Hep.
  3. by   geekgolightly
    Originally posted by sjoe
    "Our "captive audience" is dependent upon the state to take care of bodily needs."

    Which does NOT include elective surgeries, experimental treatments, unconventional treatments, and procedures that are outside accepted "standards of care."

    And might I add that these people are "captive" because they willingly chose to thumb their noses at the rules and laws which the rest of us in society accept (or at least are not caught breaking). They were not forced to make those choices.
    I love the empathy shared at this board. It's so refreshing.
  4. by   geekgolightly
    Originally posted by lgflamini
    Do you think these inmates ectively sought treatment when they were out on the street?


    not only is that none of my business, but it is none of the state's business.

    Unfortunately, in my experience with them, they were not. Do you think they will get released and continue their course of treatment?
    again, not only is it none of my business (unless they WANT help) it is not the state's business (again, unless the patient/parolee wants the help)

    They are not being denied treatment- they are being told that if they want it, then they will have to pay for it (therefore, they'll have to work while they're incarcerated)- it's called responsibility.
    i must have missed this part. it is perfectly reasonable to expect an inmate to spend a portion of his earnings in prison on things other than contraband. i like the responsibility aspect of this. putting some of the burden on them teaches them that you have to earn things. good plan. i hope its availible to anyone who wishes to spend their money in that way.

    A good majority of inmates that have Hepatitis are IV drug abusers- what do you think their priority is when they get out?
    again with the assumptions and the busybody notions. it is none of my business and none of the states what their "priorpities" are when they get out. if they fail to act in a lawful manner they should be thrown in again, but i certainly would never hold someone accountable and guilty for crimes they have not yet committed, NO MATTER WHAT THE STATS.


    And if we release them back into the public, where Hep. Tx may be too expensive for them, are we still responsible for them, and continuing to give them a death sentence?
    this is a differnt issue entirely. we are responsible for those whom we hold captive for fair treatment, offering them access to medical care rahter than shortening or ending the lives of those who are held against their will. when they are of their own free will it then becomes the old debate of randian objectivism vs. socialism. i obviously, as i am a bleeding heart on my sleeve type of gal, choose for more social programs.

    The "excuses" for this policy have been listed above by Sjoe, and if you have any experience with healthcare in the prison system, you know why this policy is in place.
    ive studied the prison system formally and classically. ive read foucault, ive read davis, ive read law enforcement manuals and studied philsophy and the sociology of deviance. im so woefully inadequate at assessing the ethical and moral responsibilities of those who are holding our captive audience because i "haven't done the time?" please. try and come up with something more plausible.

    Hep+ inmates are monitored closely. Their enzymes are checked regularly, and great care is given not to prescribe meds for them that are hard on their livers. And, I have yet to see someone die in prison of liver failure related to Hep.
    that is AWESOME. im glad to hear it.
  5. by   caroladybelle
    For my own personal opinion:

    As I suspect that the treatment involves antivirals, and viruses tend to develop resistance rapidly when antivirals are not used in a compliant manner, it is of national and of international concern when prescribing such drugs to a non-compliant client. By doing so, we may hasten the development of a resistant/more virulent strain. And many HIV specialists have limited the use of some antivirals in some patients d/t non-compliance issues. We are also seeing MDs being required to provide "proof" that their patients need a newer form of ABX before it may be used, as these newer drugs are more expensive and to prevent over prescribing/development of resistance. So there is precedent for limitation of services.

    Also, money for meds is not infinite. In many places, healthcare is rationed, so unfortunately it is "our business" that those dollars are spent well and most effectively. And unfortunately, many of those with HepC that are incarcerated have already proven that they do not make very good life choices.

    And where did the author of the article come up with the word "cure" in reference to a virus? While we can control viruses, and limit their effects on the body and ability to spread, do we now have an "official" cure for a virus? Or is this a regimen that controls or puts the disease into remission. When it comes out of remission, are we obligated to retreat them? So we have an endless cycle of money out. If this indeed cures them, it makes a better financial deal than if it is a "remission" situation.

    Also, if this is not a accepted treatment, will inmates be able to sue over problems and are they clearly aware of the longterm issues involved.
  6. by   BBFRN
    Originally posted by caroladybelle
    For my own personal opinion:

    As I suspect that the treatment involves antivirals, and viruses tend to develop resistance rapidly when antivirals are not used in a compliant manner, it is of national and of international concern when prescribing such drugs to a non-compliant client. By doing so, we may hasten the development of a resistant/more virulent strain. And many HIV specialists have limited the use of some antivirals in some patients d/t non-compliance issues. We are also seeing MDs being required to provide "proof" that their patients need a newer form of ABX before it may be used, as these newer drugs are more expensive and to prevent over prescribing/development of resistance. So there is precedent for limitation of services.

    Thank you Caroladybelle- that was what I was so ineptly trying to convey. That the noncompliance, and non-continuity of care after release actually makes the problem worse.
  7. by   BBFRN
    [QUOTE]Originally posted by geekgolightly




    [i]again, not only is it none of my business (unless they WANT help) it is not the state's business (again, unless the patient/parolee wants the help)
    I totally agree with this. I'm not saying it's a moral judgement issue, but an issue of scruples when treating (not curing) a virus such as this.



    [i]i must have missed this part. it is perfectly reasonable to expect an inmate to spend a portion of his earnings in prison on things other than contraband. i like the responsibility aspect of this. putting some of the burden on them teaches them that you have to earn things. good plan. i hope its availible to anyone who wishes to spend their money in that way.[/B]
    Where I worked, inmates were never denied treatment of any kind. The fact is, if the State's Board of Prisons won't approve coverage of the treatment, the inmate is given an option of paying for it themselves.

    [i]again with the assumptions and the busybody notions. it is none of my business and none of the states what their "priorpities" are when they get out. if they fail to act in a lawful manner they should be thrown in again, but i certainly would never hold someone accountable and guilty for crimes they have not yet committed, NO MATTER WHAT THE STATS. [/B]
    OK, I didn't convey what I was trying to get across very well at all. See Caroladybelle's post- she did a much better job at it.

    [i]ive studied the prison system formally and classically. ive read foucault, ive read davis, ive read law enforcement manuals and studied philsophy and the sociology of deviance. im so woefully inadequate at assessing the ethical and moral responsibilities of those who are holding our captive audience because i "haven't done the time?" please. try and come up with something more plausible. [/B]
    I wasn't pointing my comment at you, or saying you had no idea what you were talking about...lol. It was more directed at the article, which left out some very important facts. The most important one being that inmates are not denied treatment, but are told they will have to pay for some of them (which were listed by Sjoe), and for good reason.
  8. by   geekgolightly
    oh ok. when you quoted me, i thought you were directing your comments at me.

    i think getting inmates to participate in their own health care and being financially responsible for their own health care is an EXCELLENT idea. i love it. i think that many of our captive audience are unaware of the cause and effect of being responsible. it works if you work it kind of thing. some people think it only works, if you cheat it. know what i mean?
  9. by   geekgolightly
    p.s. your sig is fantastic!

    Remember, if you ever need a helping hand, you will find one at the end of each of your arms...Audrey Hepburn
  10. by   BBFRN
    Hey, Geek: I PM'd you.

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