Community standard may not be enough for prison health: Recent human rights issues in prison health care

For some time in Europe, the measure used to determine adequate health care in prisons was that of equivalence; in 1993, WHO guidelines on prevention and control of HIV in prisons stated: ‘all prisoners have the right to receive health care …equivalent to that available in the community without discrimination..' Since then, continued developments in therapies and the fact of higher health care expectations in people based on much better information has raised questions about what is meant by equivalence of care in prisons. Two recent events in Europe will be outlined. The first is a decision of the European Court of Human Rights in which France was held to have breached Article 3 of the Convention on Human Rights 1950 , which concerns the prohibition of inhuman or degrading treatment in failing to provide appropriate medical care to a prisoner who had several health conditions. The second event concerns the alleged failure to provide cancer treatment drugs to a terminally ill prisoner, drugs which at best would have prolonged life by a few months. The trend in Europe seems therefore to steadily widen the requirements for health care of prisoners even if beyond what would normally be provided in the community. It is proposed that prison health services generally will need to reconsider the definition of equivalence and will need further guidance on an acceptable way forward as regards human rights is concerned.