…BEHIND THE WALLS.
Confidentiality is the right of an individual to have personal, identifiable medical information kept private. Patient confidentiality means that personal and medical information given to a health care or insurance provider will not be disclosed to others unless the individual has given specific permission for such release.
Prison health care workers are subject to this obligation of course, but congregate living environments present unusual challenges. How much privacy can be expected when an inmate patient needs to be segregated or made available for frequent treatment or placed in an infirmary? Who has access to mental/emotional health assessments? How are disclosure decisions made and whose input matters? These are and should be dilemmas calling for assessments that include the best interests of the inmate.
Of note however, is one unacceptable and intolerable practice that management seems unwilling to address. When an inmate submits a form for health care attention it includes the reason for the application. Unfortunately, this form is or can be subject to scrutiny by non-health care staff. The major concern though arises when inmates are escorted to medical appointments by guards who may then refuse to give the inmate and health care worker privacy for “security reasons.” This can lead to a sensitive medical complaint becoming fodder for gossip among guards who overhear privileged conversations. When spread throughout an institution, an inmate in treatment for a very personal condition will be the butt of jokes and ridicule.
This must stop. It only serves to further damage trust in society.
We don’t hear about sexual assaults in Canadian prisons. For anyone who pays no attention to our prison industry, the subject doesn’t register. Odd though, that in the American penal systems sexual violence and harassment is a common darker facet of life behind the walls. Are we then to believe that incarcerated Canadians are ladies and gentlemen when it comes to matters of intimacy, that sex is not used as a weapon?
Correctional Investigator Ivan Zinger’s latest published Annual Report (2019-2020) devotes over 35 pages to a chapter he has titled, “A Culture of Silence: National Investigation into Sexual Coercion and Violence in Federal Corrections.” He notes that sexual coercion and violence in the community is one of the most under-reported of crimes and estimates suggest that perhaps only 5% of sexual assaults come to the attention of police.
“Prisons are largely closed to public view…..sexual violence in custodial settings….is even more susceptible to under-reporting…..incarcerated individuals face a myriad of disincentives for reporting experiences of sexual violence. Many are afraid to report, fearing retaliation, retribution, or re-victimization by the perpetrators, be it other inmates or staff. Furthermore, they face the risk of not being believed, being ridiculed, or even punished for reporting coerced sex.”
Sexual coercion and violence (SCV) have a public profile in the United States. It’s not hidden away. Canada does not have an equivalent to the U.S. Prison Rape Elimination Act, and we do not have any mandatory public reporting requirements. Further, Correctional Service of Canada does not have a distinct Commissioner’s Directive instructing staff on how to respond to a reported or suspected sexual assault. What information on the subject is referenced in CSC documentation makes Health Services primarily responsible for handling SCV incidents.
Could CSC Commissioner Kelly be persuaded to video a reading of their Mission Statement for posting on the agency’s web site?
If you don’t know what’s going on, you have a perfect excuse to do nothing.
Toronto Star reader, September, 2013