Chapter 2

Punish and Care. The difficult apprehension by European law of a paradoxical injunction

“Prisoners are entitled to medical treatment in conditions comparable to those enjoyed by patients in the outside community and should have access to the health services available in the country without discrimination on grounds of their legal situation” (Wenner v. Germany, no. 62303/13, 1 September 2016, § 66).

Over the last 30 years, the UN and Council of Europe have consecrated that States have a duty of care for the health of prisoners and that prison health care services should be provided in conditions equivalent to the ones enjoyed by the general population.

Still, prisons remain overrepresented by people with poor health status and prevalence rates of infectious and mental health disease in prison are several times higher than in the general population.

Not only do prison health care systems generally show they are incapable of coping with a high and increasing burden of diseases in an ageing prison population, but the enshrinement of prison health care in the security paradigm of the prison institution also creates structural conditions for violations of Article 3 of the European Convention of Human Rights and other violations of fundamental rights of people in prison.

Without an independent prison medicine committed to public health and deontological principles and prioritizing the health needs of the patient over institutional security and investigative interests, prisoners are condemned to see their state of health deteriorating in detention.

At a time when Covid-19 pandemic risks have shown the urgency of considering prison health as public health, formerly incarcerated people who use drugs and who live with HIV, medical doctors, human rights defenders and international experts joined in this Chapter to draw analysis on the efficiency of right to health of prisoners and the structural issue of the independence of prison medicine as a condition for States to implement the principle of equivalence of care.

Leave No One Behind: WHO approach to the principle of equivalence of care

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Video

All countries

Leave No One Behind: WHO approach to the principle of equivalence of care

In this video-interview, Dr. Carina Ferreira-Borges, Head of WHO European Office for Prevention and Control of Noncommunicable Diseases and Dr. Filipa Alves da Costa expert in the WHO Alcohol, Illicit Drugs & Prison Health Programme come back for us on the duty of states to ensure equivalence of care for people in detention. The WHO […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Article

All countries

UNODC, WHO, UNAIDS and OHCHR joint statement on COVID-19 in prisons and other closed settings

Interview with David Chipanta, Senior Advisor at UNAIDS: “Decarceration still a priority in the response to COVID-19 in prisons” In an interview given to the European Prison Litigation Network in April 2021, David Chipanta, Senior Advisor, Social Protection, Community Support, Social Justice and Inclusion Department at UNAIDS, Geneva, looks back at a year of coordinated […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Video

All countries

France

On the deontology of healthcare personnel working in prison

Dr. Fadi Meroueh, head of the health unit at the prison of Villeneuve-lès-Maguelone, France and President of Health without Barriers, the European Federation for Prison Health, questions in this interview the paradoxical injunctions to prison doctors to both treat incarcerated patients and provide medical expertise on the health status of the prisoners to the prison […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Article

All countries

Dangers of the psychiatrization of the repressive apparatus

Since the start of this century, penal law, in Europe and beyond, has become more severe in the name of the increasing security risks for the State and the safety of people. In some approaches, security has become the ‘foremost freedom’ and the precautionary principle has moved from hazardous products to dangerous people, whilst security measures […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Article

All countries

The Pompidou Group’s human rights approach to developing comprehensive drug treatment systems in prisons

Interview with Robert Teltzrow, Principal Project Consultant at the Council of Europe Pompidou Group In this interview filmed on 26 March 2021, Robert Teltzrow presents the Council of Europe Pompidou Group’s approach to further human rights and public health in the highly stigmatized and vulnerable key population of incarcerated people who use drugs. From the […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Article

Bulgaria

The (Sick) Hospital Care in the Penitentiary System

“This is not a hospital, this is a morgue.” (quote of a prisoner treated in Sofia prison hospital) In 2019, the National Preventive Mechanism with the Office of the Ombudsman made a number of concerning findings about the state of medical services in the prison system. It raised the alarm that the Ministry of Justice […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Article

All countries

Human Rights Charter of Health without Barriers, the European Federation for Prison Health

Prisons can be detrimental to health and wellbeing. There is a higher prevalence of complex chronic health conditions, and behavioural health risk factors (such as substance use disorders and insufficient social supports) among prisoners, than in the non-incarcerated population. The nature of incarceration makes prisoners fully depend on the correctional authorities for timely access to […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Article

All countries

Covid-19 in European prisons

Text by Alessio Scandurra, Senior Researcher at the NGO Antigone, coordinator of the European Prison Observatory, February 2021 At the beginning of 2020, the Covid-19 pandemic began to threaten penitentiary systems around the world, bringing another aspect of the challenge posed by this global emergency under the spotlight. Prisons suddenly became a problem and many […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Video

Georgia

Moldova

Russia

Ukraine

Mobilisation of the community of people who use drugs for the defense of rights of detainees

In Europe, 10 to 25% of incarcerated persons are defined as drug dependent on admission and 3 to 26% started using drugs while incarcerated. Whereas harsh drug policies in Eastern Europe have resulted in the mass incarceration of people who use drugs and while the region is the only in the world with rising HIV […]

Chapter 2 — Punish and Care. The difficult apprehension by European law of a paradoxical injunction

Article

Ukraine

The role of NGOs in the defense of the rights of people with infectious diseases in prison in Ukraine

The following text is a transcripted version of the intervention of Aleksandr Pavlichenko, Executive director of the Ukrainian Helsinki Human Rights Union at the conference “Prisons of Russia, Ukraine, France, Germany : Questioning Prison Violence” held by the European Prison Litigation Network and the Dortmund University of Applied Sciences and Arts on 25 and 26 […]