Witness to dilemma and deformation: Observations on health professional practice inside a women's prison

Dual loyalties often lead to compromised professional standards and practice by health care professionals working in prisons. Medical providers in New York State (NYS) prisons are employed by the New York State Department of Corrections and Community Supervision (DCCS) to provide health care to people who are incarcerated. The DCCS administers the four traditional sentencing goals of deterrence, incapacitation, retribution and rehabilitation, and recently added to New York State law, that of reentry and reintegration. The punishment and security objectives of the institution can create conditions in which the health professional is not able to or does not want to perform health care up to professional standards. Health providers are sometimes placed in stressful situations in which it is extremely difficult, or seeming impossible to perform health duties. At Bedford Hills Correctional Facility, the maximum security prison for women in New York State, examples of these pressures on health professionals demonstrate the objective conditions that create divided loyalties for the health provider between their patients and prison security assessments.