The End of Life of Inmate Patients. Uncertain Timelines in a Controlled Environment

The French Law of 4 March 2002 permits seriously ill or dying inmates to obtain suspended sentences. This kind of ``compassionate release'' entitles French prisoners to request release if they are very ill while incarcerated. Inmates are not always able to obtain release on compassionate grounds. Most dying inmates are hospitalized in secure inpatient care units called ``UHSI'', often for several weeks, sometimes until death. The purpose of this article is to highlight the realities regarding inmates at the end of life putting in perspective the points of views of the sick prisoners with those of the health and correctional professionals accompanying them. On the basis of a qualitative research, the challenge is to highlight several difficulties in providing adequate palliative care in UHSI for inmates. First, the spatial constraints of this unit limit relationships between caregivers, inmates and families. Second, the end of life trajectory of those inmates is characterized by complex decision making, with an uncertain temporality of death and an uncertain possibility of obtaining compassionate release.