• Lionel Pazart, Aurélie Godard-Marceau, Aline Chassagne, Aurore Vivot-Pugin, Elodie Cretin, Edouard Amzallag, Regis Aubry, and PARME Study Group.
• 1 Inserm CIC 1431, University Hospital Besançon, CHRU de Besançon, Besançon, France.
• Palliat Med. 2018 Jan 1; 32 (1): 6166-16.

BackgroundEnsuring adequate end-of-life care for prisoners is a critical issue. In France, data investigating the impact of laws allowing release of seriously ill prisoners are lacking.AimTo assess the number and characteristics of prisoners requiring palliative care in French prisons.DesignA prospective, national survey collecting data over a 3-month period.Setting/ParticipantsAll healthcare units ( n = 190) providing care for prisoners in France. The prison population was 66,698 during the study period. Data collection concerned prisoners requiring end-of-life care, that is, with serious, advanced, progressive, or terminal illness and life expectancy <1 year.ResultsEstimated annual prevalence of ill prisoners requiring end-of-life care was 15.2 (confidence interval: 12.5-18.3) per 10,000 prisoners. The observed number of prisoners requiring palliative care ( n = 50) was twice as high as the expected age- and sex-standardized number based on the general population and similar to the expected number among persons 10 years older in the free community. In all, 41 of 44 (93%) of identified ill prisoners were eligible for temporary or permanent compassionate release, according to their practitioner. Only 33 of 48 (68%) of ill prisoners requested suspension or reduction in their sentence on medical grounds; half (16/33) received a positive answer.ConclusionThe proportion of prisoners requiring palliative care is higher than expected in the general population. The general frailty and co-existing conditions of prisoners before incarceration and the acceleration of these phenomena in prison could explain this increase in end-of-life situations among prisoners.

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