Palliative care & the injustice of mass incarceration

critical reflections on a harm reduction response to end of life behind bars

Authors

DOI:

https://doi.org/10.25071/2291-5796.32

Keywords:

palliative care, harm reduction, prisoner health, health equity, social justice

Abstract

Due to the criminalization of marginalized people, many markers of social disadvantage are overrepresented among prisoners. With an aging population, end of life in prison thus becomes a social justice issue that nurses must contend with, engaging with the dual suffering of dying and of incarceration. However, prison palliative care is constrained by the punitive mandate of the institution and has been critiqued for normalizing death behind bars and appealing to discourses of individual redemption. This paper argues that prison palliative has much to learn from harm reduction. Critical reflections from harm reduction scholars and practitioners hold important insights for prison palliative care: decoupled from its historical efforts to reshape the social terrain inhabited by people who use drugs, harm reduction can become institutionalized and depoliticized. Efforts to address the harms of substandard palliative care must therefore be interwoven with the necessarily political work of addressing the injustice of incarceration.

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Author Biographies

Helen Hudson, University of Ottawa

Helen Hudson, RN, BScN is a PhD candidate at the University of Ottawa School of Nursing. Her doctoral research will examine dying and palliative care within the Canadian federal prison system.

Amélie Perron, University of Ottawa School of Nursing

Amélie Perron, RN, PhD, is an Associate professor at the School of Nursing at the University of Ottawa and Co-President of the Nursing Observatory. Her clinical practice is grounded in community psychiatry and crisis intervention. As a researcher, she has worked on many research projects in psychiatric nursing and forensic psychiatry in Canada, France and Australia. Her work is grounded in Critical Theory. Her research interests include nursing care to captive and marginalised populations; power relationships between health care professionals, patients and care settings; issues of discourse, risk, gender and ethics; and nursing epistemology. Through her work with the Nursing Observatory, she is more specifically interested in the sociopolitical aspects of care and nurses' political consciousness and action. She is co-author of "On the politics of ignorance in nursing and health care: Knowing ignorance" (2015, Routledge) and co-edited "Power and the Psychiatric Apparatus: Assistance, Repression and Transformation" (2014, Ashgate) and "(Re)Thinking Violence in Health Care Settings: A Critical Approach" (2012, Ashgate). She has published 80 peer-reviewed papers and book chapters, and has presented at numerous international peer-reviewed conferences in a range of disciplines. She is also Editor of Aporia - The Nursing Journal.

David Kenneth Wright

David Kenneth Wright RN, PhD is assistant professor and co-director of the Nursing Palliative Care Research and Education Unit, University of Ottawa. He has methodological expertise in qualitative health research, and employs a variety of designs to deepen understanding about health, care, and the contexts in which these occur. His PhD was an ethnographic analysis of how the ‘good death’, as a caregiving ethic, orients nurses and their colleagues in care of patients and families who experience end-of-life delirium. After completing postdoctoral work on a national study about the ethics of medical assistance in dying using discourse analysis (PIs: Jennifer Fishman and Mary Ellen Macdonald, McGill), David has led a number of studies that seek to analyze and articulate the ethics of assisted death from a nursing perspective. Currently, David’s research and teaching activities are organized around two main themes: palliative / end-of-life care and nursing ethics. His program is underpinned by the basic belief that in everyday practice, nurses enact complex processes of moral reasoning and action. His work seeks to make these processes visible so that they can be analyzed, debated, and recognized. He currently mentors a number of graduate students, many of whom are drawing on theoretical lenses of moral experience, identity, and agency in nursing, to better understand various issues in contemporary end-of-life care.  Most recently, David was a visiting scholar at the KU Leuven in Belgium, where he led a project about the nursing ethics of palliative sedation. David is the inaugural director-at-large for research with the Canadian Hospice Palliative Care Nurses Group (2016-2018). He holds specialty certification in hospice palliative nursing from the Canadian Nurses Association, and maintains an active clinical practice as a direct-care registered nurse at a residential palliative care facility in Montreal. 

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Published

2019-12-09

How to Cite

Hudson, H., Perron, A., & Wright, D. K. (2019). Palliative care & the injustice of mass incarceration: critical reflections on a harm reduction response to end of life behind bars. Witness: The Canadian Journal of Critical Nursing Discourse, 1(2), 4–16. https://doi.org/10.25071/2291-5796.32

Issue

Vol. 1 No. 2 (2019): Social Justice Nursing

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Articles

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