Articoli di riviste sul tema "Women prisoners – Abuse of – Palestine"

Purpose The purpose of this paper is to explore the incidence and impact of exposure to sexual victimisation for women in the criminal justice system. Key ongoing vulnerabilities in respect of mental health and substance abuse, and their contribution to women’s offending, are examined. Treatment responses to address these women’s trauma in custodial settings are then discussed. It is argued that a therapeutic approach is required to provide a holistic response to victimised women offenders. Unfortunately, instead of doing so, many prisons’ ethos and approaches may actually produce a further layer of vulnerability. The paper concludes with commentary on future directions for research and practice. Design/methodology/approach The researchers undertook a desk-based literature review, using search terms such as “women”, “corrections”, “sexual abuse and/or victimisation” and “trauma”. The literature was analysed through a feminist framework, adopting a vulnerability paradigm. Findings The paper analyses the incidence and impact of sexual victimisation on women prisoners and notes that comprehensive trauma-informed care in custodial settings is needed but highly problematic within a prison context. Research limitations/implications The researchers focused primarily on Australia, and the conclusions may therefore be of more limited relevance to imprisoned women in other countries. Practical implications The paper suggests good practice requirements for delivering trauma-informed care to victimised women prisoners. Non-custodial alternatives to imprisonment are likely to be more sensitive to many female offenders’ layers of vulnerability. Originality/value This paper highlights the relationship between women offenders’ sexual victimisation histories, substance abuse, mental illness and offending behaviour, and demonstrates the need for and challenges in delivering trauma-informed care. The originality derives from the examination of the three rules of abuse (and prisons) and how they correlate with multiple vulnerabilities, which leads to the conclusion that prison is not the best place for rehabilitation of most women.

This is the third and final installment of Um Jabr's ““life story,”” earlier segments of which——on village life in pre-1948 Palestine and on the 1948 war and its aftermath——were published in JPS 138 (winter 2006) and JPS 140 (summer 2006). The current excerpts focus on Um Jabr's intense involvement in the prisoner issue that began when two of her sons were in Israeli jails. In particular, her activism took the form of organizing other women to visit prisoners from Arab countries who had no one to visit them on the twice monthly visits allowed. Um Jabr's 36,000-word ““life story”” was one of seven collected as part of an oral history project, as yet unpublished, carried out by Barbara Bill, an Australian who since 1996 has worked with the Women's Empowerment Project of the Gaza Community Mental Health Program, and Ghada Ageel, a refugee from al-Bureij camp now earning her Ph.D. at the University of Exeter in England. The women who participated in the project were interviewed a number of times during the first half of 2001; after the tapes were transcribed, the memories were set down exactly as they were told, the only ““editing”” being the integration of material from the various interviews into one ““life story.”” Um Jabr, who was in her early 70s at the time of the interviews, still lives in al-Bureij camp, where she has since 1950.

Objective: The objective of the study was to investigate the rates of mental disorder among women in prison in Victoria, and to compare with community rates. Design: A midnight census of all women in prison in Victoria was undertaken. Respondents were interviewed with a version of the Composite International Diagnostic Interview (CIDI), an adapted version of the Personality Diagnostic Questionnaire (PDQ-4+) and a demographics questionnaire. Main Outcome Measures: Twelve-month prevalence rates of ICD-10 mental disorders including depressive disorders, anxiety disorders and drug-related disorders were examined. Prevalence of personality disorders was also investigated. Results: Eighty-four per cent of the female prisoners interviewed met the criteria for a mental disorder (including substance harmful use/dependence) in the year prior to interview. This rate was reduced to 66% when drug-related disorders were excluded. Fortythree per cent of subjects were identified as cases on a personality disorder screener. For all disorders, (except obsessive-compulsive disorder and alcohol harmful use) women in prison had a significantly greater likelihood of having met the 12-month diagnostic criteria when compared to women in the community. The most prevalent disorders among the female prisoners were: drug use disorder (57%), major depression (44%), Posttraumatic stress disorder (36%), and personality disorders. Almost a quarter (24%) of respondents were identified as a ‘case’ on the psychosis screen. Conclusions: In the present study female prisoners had significantly higher rates of the mental disorders investigated (with the exceptions of OCD and alcohol harmful use) when compared with women in the community. The pattern of disorder found among female prisoners is consistent with the abuse literature, suggesting that histories of abuse among the prison population may account for part of the discrepancy. These results highlight the need for improved assessment and treatment resources to meet the demands of this population.

Drugs abuse is a complex problem facing family and society. Drug abuse cases have long long been recognized. in Indoneisia the cases started to gain public attention in 1969. Today, the similiar cases are increasing in number. There have been more number cases and type of drugs abused (multiple drugs). The Risk factors for drug abuse vary among individuals and involve several factors namely individual, environment and drugs. The interaction of the three factors leads to the drug abuse. To cope with that, a holistic approach is needed. This study was aimed at dinding out the risk factors for drug abuse among women serving in women prison of Semarang due to drug abuse. In this cross-sectional study, chi square test was applied to assess the correlation between the risk factors and the drug abuse. Cooficient contigency was applied to evaluate the degree of correlation among variables. The result showed that out of 273 women prisoners, 176 were drug abusers. The individual factors of enxiety had a normal possitive correlation with drug abuse with a weak correlation (p<0,05, r=0,221.)

SynopsisInformation about contact with psychiatric services before imprisonment was obtained for a stratified random sample of sentenced prisoners, who were not receiving prison psychiatric care, in Melbourne's three metropolitan prisons. The sample of 158 men and 31 women was matched with the longitudinal person-linked records of state psychiatric service use in the Victorian Psychiatric Case Register (VPCR). Records of contact with the state services were found for 54 men (34%) and 19 women (61%), including records of in-patient treatment for 25 men (16%) and 15 women (48%). For 64% of individuals with a positive match, the case-note diagnoses were substance use disorders only. Diagnoses of psychotic disorders were recorded for four prisoners, and mood disorders for another six.In addition, clinicians conducted standardized diagnostic interviews and enquired about treatment and personal history. A further 24 prisoners reported specialist psychiatric treatment outside the state treatment sector.This study links the findings from an interview survey of psychiatric morbidity in prisoners with the records available in the VPCR, and emphasizes a number of matters important to the public health. The high rates of previous treatment for substance abuse disorders, the apparent pool of prisoners with largely untreated major depression, and the service needs of those with chronic psychotic disorders are discussed.

Bethlehem prison was the only women’s prison in Palestine during the British Mandate. It housed over two hundred Jewish women, mainly from the Irgun and Lehi underground movements. This article describes, for the first time, the experience of the women in Bethlehem prison and analyzes it using gender tools. Their experiences were documented and preserved in ego-documents that include personal letters, diaries, and subsequently written memoirs. The analysis of gender content in the writings of the women in Bethlehem prison focuses the discussion on a number of components: their relations with Jewish prisoners accused of criminal offenses and with Arab prisoners; feminine outward markers and concern about external appearance and the women’s physical and medical needs; family and motherhood behind bars; and also, spiritual elements, including ritual practice in female environments. We also discuss elements that do not appear in their writings, including feminist themes or at least those interpreted as feminist in a modern reading. All of this sheds light on the unique perspective of the woman fighter in the Revisionist movement and adds another layer to the history of women and gender in the Jewish Yishuv and the study of the underground movements

This article highlights the need for correctional policy to address health education and self-efficacy training, as well as treatment of chemical dependence, among female prisoners with histories of psychological impairments and high-risk HIV-related behaviors. The authors examine the substance abuse and high-risk behavior histories of a group of 80 newly incarcerated women in Texas prisons with histories of varying degrees of mental impairment. In addition, the authors analyze the risk-taking behavior of a subset of 29 of these women who report histories of prostitution. This study's findings indicate that the majority of these 80 female inmates have histories of sustained use of alcohol and illicit drugs, recognize a current need for substance abuse and/or psychiatric treatment, and have recent histories of numerous high-risk behaviors for the transmission of AIDS. Yet, their self-perception of chances of contracting HIV is low.

The conditions faced by female delinquents and convicts in the criminal justice system of Pakistan are deeply dismaying. Prisons in Pakistan resonate the helplessness of women, who apart from being in emotional trauma, prior to conviction, are often subjected to coercion and torture after being incarcerated. According to a survey of female prisoners conducted in 1998 in Punjab (both convicts and pre-trials), about 78 percent alleged ill treatment during police custody and about 72 percent alleged that they had been sexually assaulted by police officials1. In 2014, the Justice Project Pakistan initiative revealed compelling evidence of abuse against 134 female prisoners, of which 82 had to endure sexual abuse in Faisalabad prison1. Women, who face domestic violence or sexual abuse prior to conviction, are more susceptible to serious mental health problems like anxiety, depression and low self-esteem during the period of their imprisonment, which oftentimes leads to suicide attempts. Delay in conviction, sexual harassment, poor medical facilities, lack of ante-natal care, and deficiency of proper care facilities for their children, lack of psychological support are amongst the few problems2. A major problem that prevails in the criminal justice system of Pakistan is that most women are detained before they are convicted of any felony or criminal offense. According to the committee, of the 1,121 women in prison as of mid-2020, 66 percent had not been convicted of any offense and were detained while awaiting conclusion of their trial by courts. More than 300 women were detained in facilities outside the districts where they lived, making family visits nearly impossible. These prisoners included 46 women over the age of 60 and 10 girls under the age of 183. Sexual harassment is very common in various prisons of Pakistan; Women are more likely than men to be infected with HIV as well as STIs like chlamydia, gonorrhea, and syphilis when they first enter prison4. One-fifth of respondents claimed to have had a STI within the previous six months, according to a survey of female prisoners in Pakistan, and only 18% reported receiving the necessary treatment for these infections. Slightly more than half of respondents were aware that STIs existed4. The committee constituted by former Prime Minister of Pakistan, Mr. Imran Khan to probe the issues faced by female prisoners in 2020 found that 134 women had children with them in prison, some as old as 9 and 10, despite the legal limit of 5 years. At least 195 children were housed in prisons as of 20202. Pregnancy and care of pregnant women prisoners is a very important issue that is in dire need of attention. Female prisoners in Pakistan are denied their fundamental pre-natal and post-natal rights, which make them prone to contract infections while also putting the health of their newborns in jeopardy. Nursing and expectant females in Pakistani prisons do not have access to adequate nutrition and their predicament is further exacerbated by the fact that only 24 female health workers are available to provide full-time care to women and girls in prisons across the country. Moreover, female prisoners often give birth in the unhygienic jail conditions, which escalate infant mortality rates in the prisons of Pakistan. Due to the dearth of adequate facilities and resources, prisons are not able to fulfill the sanitary and menstrual requirements of women prisoners. During the Covid-19 pandemic, there was no enforcement of stringent measures to ensure that Standard Operating Procedures were being implemented, putting the lives of aged women with suppressed immune systems at stake 4,5. Compared to male prisoners, female prisoners have higher rates of hepatitis and tuberculosis (TB).Women in prison are more likely than men to have hepatitis C (HCV) infection, especially if they have a history of injecting drugs. Inmates who are female are more likely than male inmates to contract HCV. Similar to HIV, HCV is spread through blood-sharing activities like sharing injection supplies or through sexual contact6. Compared to men, women are much more likely to contract hepatitis C from sexual activity. Coughing or sneezing can spread TB, which spreads through the air. The greatest risk of infection exists for people who stay in the same residence as those who have active tuberculosis. People cannot contract tuberculosis by shaking hands, sitting on toilet seats, or sharing dishes and utensils with a patient. Numerous prisons have tuberculosis rates that are 10 to 100 times higher than those in the general population due to overcrowding and subpar nutrition7, 8. Children whose mothers were incarcerated may have suffered the trauma and loss brought on by their mothers' incarceration as well as other issues, and they may also have some attention issues and developmental delays8. In light of these deplorable conditions, the government of Pakistan needs to ensure gender-specific services for female prisoners in order to alleviate their plight and cope with their psychological, emotional and social needs. The prison environment does not always take into account the specific needs of women, such as accessibility to free personal sanitary products for menstruation such as sanitary pads and enabling female prisoners to dispose them of properly to maintain hygiene7,8. Female prisoners, who suffer from psychological issues after incarceration should be given the right to seek counseling for their mental health problems from psychiatrists and psychologists, appointed by the state8.Furthermore, the government of Pakistan needs to make arrangements for keeping women in separate prison cells, based on the type of offense they have been convicted with to resolve the issue of overcrowding in jails. There is an exigent need for the government to make genders sensitive training available in all Pakistani prisons. Like pregnant women, lactating mothers have certain health and nutritional requirements which need to be fulfilled. Meals of high nutritional value should be provided regularly and flexibly to breastfeeding mothers and their newborn babies.

This study describes the prevalence of childhood adverse events (CAEs) among men and women prisoners and assesses the relationship of CAEs to adult symptoms of traumatic distress. Interview data for 427 men and 315 women were analyzed assessing childhood abuse and household dysfunction, drug and criminal histories, and symptoms of traumatic distress. Women offenders had much greater exposure to CAEs than did men and more often reported continued sexual abuse in adolescence and as an adult. Linear regression results showed that the impact of CAEs on traumatic distress was strong and cumulative for both men and women (greater exposure to CAEs increased the likelihood of 6 out of 7 mental health outcomes, although women had higher levels of traumatic distress overall). The findings indicate the need for early prevention and intervention as well as trauma-based treatment within the correctional setting.

The study aims to determine the rate of dual diagnosis (DD), examine the most common mental disorders, and determine whether a history of childhood sexual/physical abuse (CSA/CPA) is associated with this phenomenon. One-hundred and eighty inmates from a Spanish prison were assessed using the Mini International Neuropsychiatric Interview and the Addiction Severity Index–6. The data showed that 46.8% of the males and 65.1% of the females had a substance use disorder. With regard to CPA, similar percentages were found in both genders. Nevertheless, rates of CSA were highest in females. Logistic regression analysis was performed by gender. CPA was predictor of DD for males, and CSA was predictor of DD for females, showing the greatest weight. In addition, in both cases, the number of drugs of abuse was an adequate predictor. We can state that these forms of maltreatment are risk factors for the development of a broad range of psychopathological problems.

Abstract Most divorces in Palestine come about through a private unregulated agreement between the spouses referred to as “ṭalāq bit-taradi” (consensual ṭalāq), often called mukhalaʿa or mubāraʾa. Over the last century, women’s economic rights in the unilateral ṭalāq have increased. At the same time, the number of consensual ṭalāq has risen. While the consensual ṭalāq provides a way out of an unwanted marriage for women, it hardly represents a form of ‘gender equality’. Rather, it is a field where kin-patriarchy is asserting itself through women’s dependence on agnates to reach an agreement and to bear the cost of such divorces. Furthermore, the consensual ṭalāq invites abuse and economic extortion from husbands. As the Islamic shariʿa court condemns such behaviour, our study nevertheless finds that the court facilitates the consensual ṭalāq by setting the bar for litigated divorce too high and by letting time pass.

In Victoria, Australia, the rate of female incarceration has continued to rise in the last decade. The majority of women prisoners are primary caregivers of their children. This article examines issues mothers face in mothering, both inside and outside prison, as seen by professionals and stakeholders who support them. Reunification of mothers and children is hampered by factors such as poverty, homelessness, abuse, and lack of access to services. Research and government interventions to address incarcerated mothers’ situations have had little positive impact for over 50 years.

Objective: The aim of the paper is to describe some of the psychiatric, social and criminological features of female prisoners in Tasmania between 1981 and 1990 inclusive. Method: Data were collated from prison records for all 210 women prisoners incarcerated between the above dates. Using the Mental Health Services database it was determined which prisoners had prior contact with State Psychiatric Services, their clinical state, various demographic data and ICD-9 diagnoses. Forensic data obtained from prison records were compared for those with and those without a psychiatric history of attendance at Mental Health Services; appropriate privacy safeguards were used in handling the material. Results: Thirty-five per cent of prisoners had prior contact with the Mental Health Services before imprisonment. They were predominantly persons with an abnormal personality. Non-addictive drug abuse was the next most common psychiatric category (19%). Only 3% suffered from schizophrenia or affective disorder. Those with prior psychiatric presentation had greater social maladjustment, longer sentences for similar offences and a higher recidivism rate. There was an increase in the number of prisoners with and without a psychiatric diagnosis during the decade. Conclusions: Thirty-five per cent of the female prison population had previously attended psychiatric services in the State. This is fewer than reported in Britain and the US, probably because of the different social structure of this community. These persons differ from other prisoners by showing greater impairment in social adjustments and relationships. They appear to be treated differently with respect to sentencing. There was no evidence of a simple reciprocal relationship between deinstitutionalisation and imprisonment.

Between June and September 1987 926 prisoners received into Perth metropolitan prisons were screened for alcohol and drug problems. A comprehensive interviewer administered questionnaire and other measures such as content analysis of medical and criminal records provided the data base. To enable a thorough analysis, and a comparison across record types, an eight point classification system was used. This system incorporated dimensions of “consumption”, “dependency”, “association with crime” and “self perception” for alcohol and drug use. The results suggest that a third of the sample consume “hazardous” amounts of alcohol. Only 6% of the sample were classified as current drug dependents. The results support previous research which indicates that alcohol abuse amongst offenders is a major problem. The groups that emerge as the main concerns are: Aboriginal alcohol abusers, alcohol abusers not concerned with their alcohol use, drunk drivers and women drug and alcohol abusers. The validity of the screening insruments is examined, a strategy for screening for drug and alcohol problems is susggested and the implications of the results for prevention and treatment interventions is discussed.

Little is known about the health needs of detained juvenile females, yet there is emerging concern regarding substance misuse, mental health problems, poor sexual health and poorer general physical health on a range of indicators. This study sought to identify health needs from the perspective of imprisoned young women themselves and key professionals working with them to inform healthcare provision. We conducted semi‐structured interviews and focus groups with detained juvenile women and adult professionals in four specialist female young offender institutions. The study presents new qualitative findings on the profound impact of social exclusion and multiple forms of abuse and victimisation on the health of juvenile women prisoners. Concerns regarding substance misuse, mental health problems, self‐harm and poor sexual health are reinforced by this study. Young women tended to focus on their immediate health needs in contrast to the professionals who emphasised longer‐term issues. The study identified the need for priority interventions in relation to mental health, substance misuse, self‐harm and sexual health and tentatively suggests that ‘compensatory care’may offer some scope to redress health inequalities experienced by these young women.

Abstract In November 2021, in an act of despair, Adelina Sejdini, an Albanian woman who had bravely denounced her pimps and captors, put an end to her life by throwing herself into the Tiber River in Rome. Adelina was one of the numerous Albanian women kidnapped at a very young age in her own country and destined to the sex trafficking market in Italy. She endured the unspeakable violence of her tormentors, but she could not survive the systemic failures and rigid migration laws that left her hopeless and isolated. This article will address the issue of sex trafficking in Italy from the perspective of the young Albanian women who were forced into it, as described in Elvira Dones's Sole bruciato. More specifically, I will examine how prejudice spread through the Italian media played a significant role in facilitating the institutional mechanisms that kept Albanian women prisoners despite the clear evidence of their abuse.

Comparatively little is known about how Canadian prisoners experience and make sense of their lives inside Canadian correctional facilities. Based on 39 qualitative in-depth interviews conducted with remanded women in a Western Canadian remand prison as part of the University of Alberta Prison Project (UAPP), this article serves to describe the five main issues that women in our sample highlighted about their incarceration and how those were shaped by their own backgrounds and life histories: 1) Victimization; 2) Distrust of the police, 3) Parenting while incarcerated; 4) Addictions and mental health; 5) Contextual benefits of prison. The implications of this work for criminal justice practitioners, policymakers, and scholars are discussed. Our findings serve to detail the commonalities between the women in an effort to provide criminal justice and social service actors with contextual background information about their clients. They show that the women lack access to the myriad social and institutional supports that so many people take for granted, including protection from physical and sexual abuse, access to stable housing, addiction support, medical and dental treatment, mental health supports, trauma counselling, and the like.

Protests and resistance from those locked away in jails, prisons and detention centers occur but receive limited, if any, mainstream attention. In the United States and Canada, 61 instances of prisoner unrest occurred in 2018 alone. In August of the same year, incarcerated men and women in the United States planned nineteen days of peaceful protest to improve prison conditions. Complex links of institutionalized power, white supremacy and Black resistance is receiving renewed attention; however, state-condoned violence against women in correctional institutions (e.g., physical, sexual and emotional abuse, and medical neglect by prison staff) is understudied. This qualitative case study examines 10 top-tier Criminology journals from 2008-2018 for the presence of prisoner unrest/protest. Findings reveal a paucity of attention devoted to prisoner unrest or state-sanctioned violence. This paper argues that the invisibility of prisoner unrest conceals the breadth and depth of state-inflicted violence against prisoners, especially marginalized peoples. This paper concludes with a discussion of the historical legacy and contemporary invisibility of Black women’s resistance against state-inflicted violence. This paper argues that in order to make sense of and tackle state-condoned violence we must turn to incarcerated individuals, activists, and Black and Indigenous thinkers and grassroots actors.

Descriptive approach via a questionnaire to evaluate the Palestinian woman's image in media at different levels in Gaza strip, Palestine. 530 female university students were drawn from three universities in Gaza strip involving the Islamic university, Al-Azhar university, and university of Palestine. The outcomes of this study show that women have two prominent traits in that media that is self-made and patient, and sacrificing. The other traits include weak and needy. In addition, at the political level, the media has demonstrated interests in the Palestinian media ladies, and shown their roles in covering the Palestinian political news. At the social level, the outcomes have proved that social media networks have contributed in shaping the mainstream supporting the Palestinian woman's social issues. Besides, at the cultural level, they have stated that customs and traditions hinder media from adopting courageous issues treating the Palestinian woman's political and social status quo. Furthermore, at the economic level, media has given an image about the working Palestinian woman's materialistic abuse. In conclusion, the media should not exaggerate in portraying the woman's image in the issues of violence. It is necessary to present a positive image about her and defend her freedom and rights. Moreover, it recommended to support her to be designated in governmental, ministerial and leadership positions, as well as, to cast light on exemplars for successful women in the field of reasoning and knowledge, and set a media plan based on justice and equality.

The nefarious nexus of patriarchy and nationalism that characterized Francoist Spain (1939‐75) made sexualized violence inflicted on the state’s female prisoners an immanently political act. Focusing on En el infierno: Ser mujer en las cárceles de España (1977), the prison memoir of the communist and feminist activist Lidia Falcón, this article draws on theories of trauma, victimhood and memory to interrogate how Falcón navigates questions of (self-)representation and agency through the portrayal of rape and sexualized violence in Franco’s women’s prisons. Rape, for Falcón, is a multifaceted act that violates both the female body and the collective body politic, while the various manifestations of abuse ‐ ‘las modalidades de violación’ ‐ reify sexual and political dominance. By speaking on behalf of the female prison population, Falcón utilizes the collective voice so as to presuppose a collective victimhood that fosters solidarity amongst women and resists subjugation by the masculinist state.

Purpose – This participatory health research project of researchers and women prisoners examined housing and homelessness as perceived by incarcerated women to understand this public health concern and help guide policy. The paper aims to discuss these issues. Design/methodology/approach – A participatory research team designed and conducted a survey of 83 incarcerated women in BC, Canada. Using descriptive statistics, the authors examined socio-demographic factors related to social support networks and family housing and women’s housing preference upon release. Findings – In total, 44 percent of participants reported no family home upon release while 31 percent reported lost family ties due to their incarceration. Most vulnerable subpopulations were women aged 25-34, aboriginal women and those with multiple incarcerations. Housing preferences differed between participants suggesting needs for varied options. Further implementation, evaluation and appraisal of social programs are required. Research limitations/implications – This study surveyed one correctional facility: future research could utilize multiple centers. Practical implications – Addressing housing instability among released incarcerated individuals is important fiscally and from a public health lens. Improved discharge planning and housing stability is needed through policy changes and social programs. A social support network, “Women in2 Healing,” has developed from the research group to address these issues. Social implications – Housing stability and recidivism are closely linked: providing stable housing options will lessen the social, fiscal and medical burden of individuals returning to crime, substance abuse, illness and poverty. Originality/value – Housing instability addresses an important social determinant of health and focussing on incarcerated women builds upon a small body of literature.

Female offenders are distinctly different from male offenders, and present with their own gender-specific needs and issues both in and out of the correctional setting. Most approaches to Coping Mechanisms for female offenders are currently based on research involving males and approaches designed for males. Inquiry regarding the gender-specific needs of female inmates as they pertain to treatment, reentry programs, and Coping Mechanisms is necessary so professionals can better understand how to serve this population. This study investigated the Coping Mechanisms Adopted by Women ex-offenders in Nyeri County, Kenya. The study specifically investigated the effects of not addressing the challenges identified for women returning from prison in Nyeri County especially challenges connected to housing, employment, relationships, drug, and substance abuse as well as mental health after incarceration. This was a qualitative study adopting a phenomenological design. The site and respondents were purposively selected with snowballing being used to select the respondents to the point of saturation. This study made use of 41 women ex-convicts, 3 FGDs, and 9 key informants. Data were collected by the use of semi-structured interview schedules. Results indicated that currently, prison is negatively viewed by the community; this is primarily because of the isolation of prisoners and whatever happens behind the bars. The government should involve other sectors such as the churches, the media, schools, and Non- Governmental Organizations in educating the masses in order to ease the re-entry of ex-convicts

The present study describes a much understudied group—namely, female prisoners under forensic-psychiatric care in the German-speaking part of Switzerland—to improve understanding of their risks and their needs. Data were derived from internal databases of a Forensic-Psychiatric Service. Data were collected in the form of their sociodemographic characteristics, prevalence of aversive and traumatic events, type of offence committed, and mental health conditions. Based on a full-sample approach, a total of 1,571 files were analysed. Results reveal that two thirds of the participants were not in a stable relationship, more than half did not complete a school degree, and three quarters were without stable employment prior to their incarceration. Two thirds were mothers and about one third did not grow up with their parents. Almost half grew up with an alcohol abusing parent, about half experienced violence and/or neglect in childhood, and about a quarter of the cases sexual abuse. About 95% had a mental health diagnosis according to International Classification of Diseases–Version 10 (ICD-10), and the most prevalent mental and behavioural disorder was due to psychoactive substance abuse. The most frequent offence type was drug-related crimes. Women convicted for drug-related crimes were more likely to have an ICD-10 F1 disorder compared with those convicted for other crimes. Conversely, women with violent offences were less likely to suffer from ICD-10 F1 disorder than those who had committed nonviolent offences. Findings have implications for practitioners and policy makers, and contribute to the cycle of violence theory discussion. In conclusion, future research areas are suggested.

This is the text of the 2009 Shirley Smith Address delivered by Sian Elias on Thursday 9 July 2009, organised by the Wellington Women in Law Committee. The Chief Justice comments on the status of criminal law in New Zealand, arguing that wider social engagement and buy-in is needed to find answers to the issues in our criminal justice system. The author notes the social element of criminal law as well as the growing emphasis of law and order in the sphere of politics and society. The Chief Justice raises concerns about New Zealand's apparent failure to rehabilitate prisoners as well as the country's prison population. The article suggests several solutions: community education (that imprisonment alone does not reduce crime), promoting intervention (so as to avert risk before crimes occur) and probation, addressing mental health and substance abuse (both within the prison population and within the community), and generally reducing the prison population (so as to avoid significant safety and human rights issues). The author concludes by emphasising the societal nature of criminal law and links back to Shirley Smith's own words.

Objectives: Positive social support is critically important to postprison well-being outcomes. However, researchers and program developers are still trying to understand how to best promote stable and sustainable social support for formerly incarcerated individuals during reentry to the community. We sought to add to the body of knowledge on social support and prisoner reentry by comparing men and women releasing from prison on the quality (e.g., positive or negative) and amount of informal social support. Methods: A random sample of 395 male ( n = 165) and female ( n = 230) releasing prisoners participated in the study. After unadjusted bivariate comparisons, multivariate regression was conducted to identify gender differences in preincarceration social support quality of influence and anticipated number of postrelease support persons while controlling for important covariates such as substance abuse and mental illnesses. Results: Males reported higher rates of negative social support overall, and females reported higher rates of both mixed and positive social support compared to their male counterparts. Older participants reported higher levels of positive support compared to younger participants. Men of color reported significantly higher levels of positive support than their White male counterparts. Overall, women had higher prevalence of behavioral health factors that complicate quality of support. However, there were no differences in gender found for the amount of perceived social support available postrelease in the unadjusted models. Implications: Study findings suggest the need for gender-specific and culturally tailored targets for prisoner reentry programs addressing social support. Possible adaptations for interventions are explored.

This study aimed to reveal the extent to which the social and economic security of Palestinian families have been achieved whether this loss was partial (wound or captivity) or total (martyrdom) from the wife’s point of view. It included (140) missing women in the governorates of Hebron and Bethlehem. The data were collected using two scales authored by the researcher after ensuring their validity and reliability, where the reliability coefficient was (0.819). The results of the study showed the need of the sample members for social and economic security in general. The differences appeared in the social dimension in favor of the younger wives. As for the educational level, the differences were in the economic dimension for those who hold bachelor’s and diploma degrees compared with those who hold a high school diploma or less. With regard to the variable nature of the husband’s absence, the statistical significance in the social and economic dimensions came in favor of the wives of the martyrs first, then in favor of the wives of the prisoners secondly, compared to the wives of the wounded. As for the variable of the presence of children, the differences in the economic dimension were in favor of the wives who had children. The researcher recommended the necessity of conducting survey studies on the subject for all regions of Palestine and also recommended the necessity of facilitating the task of institutions to provide social support to all families individually and collectively.

This study aimed to reveal the extent to which the social and economic security of Palestinian families have been achieved whether this loss was partial (wound or captivity) or total (martyrdom) from the wife’s point of view. It included (140) missing women in the governorates of Hebron and Bethlehem. The data were collected using two scales authored by the researcher after ensuring their validity and reliability, where the reliability coefficient was (0.819). The results of the study showed the need of the sample members for social and economic security in general. The differences appeared in the social dimension in favor of the younger wives. As for the educational level, the differences were in the economic dimension for those who hold bachelor’s and diploma degrees compared with those who hold a high school diploma or less. With regard to the variable nature of the husband’s absence, the statistical significance in the social and economic dimensions came in favor of the wives of the martyrs first, then in favor of the wives of the prisoners secondly, compared to the wives of the wounded. As for the variable of the presence of children, the differences in the economic dimension were in favor of the wives who had children. The researcher recommended the necessity of conducting survey studies on the subject for all regions of Palestine and also recommended the necessity of facilitating the task of institutions to provide social support to all families individually and collectively.

Abstract: In the summer of 1906 at the age of twenty-one, Mariia Spiridonova, a Russian Socialist Revolutionary (SR) assassin was transported with five other convicted female SR terrorists by railway from Moscow to the Nerchinsk prison complex in eastern Siberia. Only Spiridonova was known as a martyr-heroine to opponents of tsarism across the empire, however, because national newspapers had published her story of physical abuse by police and Cossacks at the time of her arrest. Patterning themselves after an earlier generation of populist terrorists in the 1870s and 1880s, male and female SR terrorists in the revolution of 1905–07 attempted to kill government officials whom the SR party accused of oppressive actions against helpless civilians. Although SR terrorists expected to sacrifice their own lives as compensation for committing political murder, the tsarist government commuted the women’s death sentences to penal servitude for life. In Siberian imprisonment, Spiridonova and her five terrorist comrades followed the tradition of preceding generations of revolutionaries by joining a ‘socialist collective’ or ‘commune’ of political prisoners with a code of conduct and a shared economy. Male and female socialist prisoners lived by such compacts to prepare themselves for the future revolution and to deepen the political consciousness of their fellow inmates by personal example. Only Spiridonova among the women ‘politicals’ took no visible role in upholding the prison commune but rather lived in semi-isolation as an invalid throughout her eleven years in the Nerchinsk complex. Suffering from tuberculosis, Spiridonova, who had anticipated a martyr’s death on the scaffold, seemingly succumbed to the martyrdom of chronic illness. Yet the fall of the tsarist autocracy in February 1917 did not just liberate Spiridonova from penal servitude but simultaneously restored her health, her energy and her drive to engage in radical politics. Her pattern of revolutionary behaviour thus alternated between active and passive self-sacrifice, the tuberculosis that enhanced her legend of martyrdom apparently waxing and waning according to the degree of her personal freedom.

Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern Mediterranean Region (EMRO). It induces both acute and chronic hepatic disorders with subsequent liver cirrhosis and hepatocellular carcinoma (HCC) in a considerable percentage of patients based on the age of exposure. In this review, hepatitis B virus (HBV) and HCC prevalence, distribution and prevalence of different genotypes, and male/female infection frequencies in relation to the vaccination status in the Mediterranean countries were reported. Study Design. This systematic review describes the prevalence of hepatitis B infection, genotype distribution of hepatitis B virus, and prevalence and incidence of hepatocellular carcinoma in Mediterranean countries belonging to three different continents: Southern Europe (Spain, France, Italy, Croatia, and Greece), North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt), and the Near East region (Syria, Lebanon, Turkey, Israel, and Palestine). We tried to collect new data from electronic databases: PubMed, ScienceDirect, ResearchGate, Google Scholar, and public health reports between 1980 and 2019. For each publication, we recorded reference, publication year, study characteristics (date, locations, sample size, and study population), and participant characteristics (population group, year, age, and sex). No language limitation was imposed, and articles or reports from non-peer-reviewed sources were not considered for this analysis. The main keywords were HBV prevalence, hepatitis B infection, HBV genotype, and HCC. Inclusion and Exclusion Criteria. Healthy population-based studies included the following sample populations: (i) voluntary blood donors, (ii) pregnant women, (iii) community studies, (iv) hemodialysis patients, (v) hospitalized patients, (vi) healthcare workers, (vii) sex workers, (viii) drug abusers, and (ix) prisoners. We excluded studies from the following special groups who were assumed to be at a special high risk: patients from sexually transmitted disease clinics and thalassemia clinics and professional or paid blood donors.

The problem of gender-based violence in the conditions of armed conflict (martial law) in Ukraine is urgent and important. It has been stressed that the definition “gender-based violence” is used in international law, Ukrainian legislation and in scientific researches. Simultaneously this term is being applied in description of any harmful effect caused against human’s will and is based on socially determined differences between men and women. Whereas men and boys can be victims of certain types of gender-based violence (in particular sexual), usually such violence is directed against women and girls. After consideration of scientists’ approaches concerning determination of forms (types) of gender-based violence it has been noted that they allow to establish that only certain ones emphasizes on their commission during armed conflicts (namely violence during war, conflict and post-conflict situations). Provisions of international humanitarian law are not being taken into account as well.With regard to the provisions of international humanitarian law based on international legal acts in the fields of human rights protection and protection of the victims of armed conflicts a classification of gender-based violence in the conditions of armed conflict (martial law) has been suggested as follows: 1) on the type of the conflict – international and non-international; 2) on the person of the victim – against women, men and children; 3) on the status of the victim – civil population and prisoners of war; 4) on the type of violence – physical (violence against life and health, namely all types of homicide, mutilation, abuse and torture; hostage taking; conviction and application of punishment without prior court decision made by a proper established court which provides judicial guarantees recognized by civilized nations as necessary); sexual (rape; threats and attempts of any type of rape or any other sexual assaults; genital mutilation; sexual slavery; sexual torture; forced prostitution; forced pregnancy; forced sterilization and forced abortion; forced nudity, forced to contemplate sexual acts; sexual violence and other acts of sexual nature); psychological (insult to human dignity, in particular offensive and humiliating treatment); economic (deprivation of housing, food, clothes, other property, money or documents).

Sabe-se que a população de mulheres em situação de prisão está aumentando a cada dia. Nesse contexto, existe uma vulnerabilidade quanto à saúde dessa mulher e no tratamento de algumas doenças como o HIV/AIDS. Entre os principais fatores de risco que favorecem a disseminação do HIV/ AIDS entre mulheres privadas de liberdade estão: abuso sexual, superlotação de celas e o uso de drogas. O estudo tem como objetivo analisar a percepção de mulheres em situação de prisão vivendo com HIV sobre o tratamento do HIV/AIDS. Trata-se de um estudo de campo com enfoque qualitativo com a população carcerária feminina com diagnóstico de HIV positivo em um presídio localizado em Salvador- Bahia. Foi utilizada como instrumento de pesquisa entrevista semiestruturada realizada com quatro mulheres. A partir da análise de conteúdo, foram determinadas 01 categoria e 03 subcategorias: percepção sobre a adesão ao tratamento do HIV/AIDS, que teve como subcategorias: adesão ao tratamento como uma necessidade, adesão ao tratamento como sacrifício e sentimentos relacionados a viver com HIV/AIDS. Os resultados mostraram que as mulheres em situação de prisão com diagnóstico de infecção pelo HIV apresentam resistência ao tratamento por conta dos efeitos adversos dos antirretrovirais, discriminação perante as outras presidiárias e da falta de orientação dos profissionais de saúde sobre a importância da regularidade do tratamento. Dessa forma, existe uma insegurança da mulher perante as companheiras de cela descobrir sua condição de vítima do HIV/AIDS e quanto aos efeitos adversos dos antirretrovirais e a necessidade de que os profissionais de saúde tenham maior interação com essas mulheres, para que elas sejam acompanhadas e orientadas quanto à importância da continuidade do tratamento. É preciso que sejam intensificadas políticas públicas direcionadas a essa população, bem como que essas iniciativas sejam efetivadas.ABSTRACTIt is known that the population of jailed women is increasing every day. In this context, there is a vulnerability about the health of this woman and to the treatment of some diseases such as HIV/AIDS. Among the main risk factors that favor the spread of HIV/AIDS among women deprived of their liberty are: sexual abuse, overcrowding in prison and use of drugs. The study aims to analyze the perception of women living in prison with HIV about HIV/AIDS treatment. This is a field study with a qualitative approach carried out with the female prison population with diagnosis of HIV positive in a prison located in Salvador-Bahia. A semi-structured interview with four women was used as a research tool. From the content analysis we determined 01 category and 03 subcategories: perception about adherence to HIV/AIDS treatment, which had as subcategories: treatment adherence as a necessity, treatment adherence as sacrifice and feelings related to living with HIV/AIDS. The results showed that women in prison with a diagnosis of HIV infection are resistant to treatment because the adverse effects of antiretrovirals, discrimination from other prisoners, and lack of guidance from health professionals about the importance of regular treatment. Thus, the jailed woman with HIV are insecurity her cell mate discover her condition about HIV/AIDS and the adverse effects of antiretrovirals, in addition to the necessity of interact more closely with the health professional to be monitored and guided about the importance of continuity of treatment. It is necessary to intensify public policies directed to this population, as well as to ensure that these initiatives are implemented.

<p><em>Abstrak –</em><strong> </strong><strong>Dewasa ini permasalahan pidana pada narapidana wanita terus meningkat jumlahnya. </strong><strong>L</strong><strong>embaga pemasy</strong><strong>a</strong><strong>rakat</strong><strong>a</strong><strong>n (Lapas) </strong><strong>W</strong><strong>anita</strong><strong> Tangerang</strong><strong> merupakan </strong><strong>salah satu</strong><strong> </strong><strong>usaha </strong><strong>pembinaan bagi para wanita yang </strong><strong>memiliki masalah </strong><strong>hukum</strong><strong> pidana</strong><strong>. Namun, kehadiran lapas tidak serta merta dapat mereduksi masalah yang terjadi sebelumnya. </strong><strong>Malah s</strong><strong>eringkali ditemukan </strong><strong>masalah baru, seperti </strong><strong>ketakutan tidak diterima masyarakat, stress karena tidak mampu menyesuaikan diri dengan kehidupan di dalam lapas, kerinduan terhadap keluarga, kekhawatiran akan karir dan pekerjaan setelah keluar dari lapas, demotivasi, trauma akan kasus yang menimpa, dan lain sebagainya. Untuk mengatasi berbagai masalah tersebut, maka diperlukan pelayanan konseling bagi warga binaan. Konseling merupakan salah satu teknik dalam pelayanan bimbingan dan merupakan alat yang penting dari usaha pelayanan konseling bagi warga binaan, yang mana akan terjadi serangkaian hubungan langsung dengan warga binaan, yang bertujuan membantunya untuk mengubah sikap dan tingkah lakunya dalam kelangsungan kehidupan selanjutnya. Metode pelayanan konseling yang dilakukan di Lapas Wanita Tanggerang ini, dilakukan dengan dua cara. Pertama, Konseling Individual adalah pemberian proses bantuan perorangan, yang dilakukan melalui wawancara oleh seorang konselor kepada individu. Kegiatan konseling individu dilakukan melalui pendekatan konseling Eksistential Humanistik, Kognitif Behavior dan Transaksional. Kedua, konseling kelompok adalah layanan konseling yang diselenggarakan dalam suasana kelompok yang memanfaatkan dinamika kelompok, serta terdapat hubungan konseling yang hangat, terbuka, permisif dan penuh keakraban. Kegitan konseling di Lembaga Pemasyarakatan Wanita Tangerang ini dapat membantu mengentaskan masalah yang dialami oleh sebagian warga binaan. Dengan demikian, Lembaga Pemasyarakatan Wanita Tangerang perlu terus menjalin kerjasama dengan pihak-pihak penyedia layanan konseling dengan memfasilitasi sarana dan prasarana yang diperlukan, sehingga pelayanan dapat dilakukan secara berkesinambungan dan terarah. Diperlukan pula dukungan sarana dan prasarana agar pelayanan konseling dapat terlaksana secara optimal.</strong></p><p><em>Abstract<strong> -</strong></em><strong> </strong><strong>Nowadays, criminal matters in women prisoners keep increase in number. Tangerang Women Prison</strong><strong> </strong><strong>(</strong><strong>L</strong><strong>embaga pemasyrakat</strong><strong>a</strong><strong>n </strong><strong>W</strong><strong>anita</strong><strong> Tangerang</strong><strong>) is one of the solution to nuture women in criminal law issues. However, the existence of this institution does not guarantee reduction to the problematic matters. Often found in prisons there are acts of abuse that ultimately lead to new problematic matters, thus harming not only for her but also for her surroundings. To overcome these problems, counseling services are necessary for the assisted citizens.</strong><strong> </strong><strong>Counseling is one of the techniques use in guidance services and is one of the important tool in counseling services for the assisted citizens, which will occur a series of direct relationships with the targeted citizens, with the intention to help them improve their attitude and behavior in the next life (after</strong><strong> </strong><strong>they got released). The counseling services in th</strong><strong>e</strong><strong> </strong><strong>Tangerang </strong><strong>Women </strong><strong>Prison</strong><strong> use two methods. The first one, individual counseling is a personal guidance which is done through interviews by a counselor to the individual. Individual counseling activities are conducted through the Existential Humanistic, Behavior Cognitive and Transactional approach. The second one, group counseling is a form of counseling services organized in a group atmosphere utilizing group dynamics, as well as a warm, open, permissive and intimate counseling relationship.</strong><strong> </strong><strong>The activites in </strong><strong>the Tangerang Woman Prison </strong><strong>should be able to help annihilate the problems experienced by some of the assisted citizens. Therefore, </strong><strong>this </strong><strong>Institution must establish cooperation with the providers of counseling services by supporting them with the neccesary facilities and infrastructure, so the services can be optimally implemented.</strong></p><p><strong></strong><strong><em>Keywords – </em></strong><em>Prison, Individual Counseling, Group Counseling</em></p>

List of abstacts and authors:1. Integrating the art and science of psychiatryEugene Allers2. Chronic pain as a predictor of outcome in an inpatient Psychiatric populationEugene Allers and Gerhard Grundling3. Recent advances in social phobiaChrister Allgulander4. Clinical management of patients with anxiety disordersChrister Allgulander5. Do elephants suffer from Schizophrenia? (Or do the Schizophrenias represent a disorder of self consciousness?) A Southern African perspectiveSean Exner Baumann6. Long term maintenance treatment of Bipolar Disorder: Preventing relapseCharles L. Bowden7. Predictors of response to treatments for Bipolar DisorderCharles L. Bowden8. Aids/HIV knowledge and high risk behaviour: A Geo-graphical comparison in a schizophrenia populationP Buckley, S van Vuuren, L Koen, J E Muller, C Seller, H Lategan, D J H Niehaus9. Does Marijuana make you go mad?David J Castle10. Understanding and management of Treatment Resistant SchizophreniaDavid J Castle11. Workshop on research and publishingDavid J Castle12. From victim to victor: Without a self-help bookBeatrix Jacqueline Coetzee13. The evaluation of the Gender Dysphoric patientFranco Colin14. Dissociation: A South African modelA M Dikobe, C K Mataboge, L M Motlana, B F Sokudela, C Kruger15. Designated smoking rooms...and other "Secret sins" of psychiatry: Tobacco cessation approaches in the severely mentally illCharl Els16. Dual diagnosis: Implications for treatment and prognosisCharl Els17. Body weight, glucose metabolism and the new generation antipsychoticsRobin Emsley18. Neurological abnormalities in first episode Schizophrenia: Temporal stability and clinical and outcome correlatesRobin Emsley, H Jadri Turner, Piet P Oosthuizen, Jonathan Carr19. Mythology of depressive illnesses among AfricansSenathi Fisha20. Substance use and High school dropoutAlan J. Flisher, Lorraine Townsend, Perpetual Chikobvu, Carl Lombard, Gary King21. Psychosis and Psychotic disordersA E Gangat 22. Vulnerability of individuals in a family system to develop a psychiatric disorderGerhard Grundling and Eugene Allers23. What does it Uberhaupt mean to "Integrate"?Jürgen Harms24. Research issues in South African child and adolescent psychiatryS M Hawkridge25. New religious movements and psychiatry: The Good NewsV H Hitzeroth26. The pregnant heroin addict: Integrating theory and practice in the development and provision of a service for this client groupV H Hitzeroth, L Kramer27. Autism spectrum disorderErick Hollander28. Recent advances and management in treatment resistanceEric Hollander29. Bipolar mixed statesM. Leigh Janet30. Profile of acute psychiatric inpatients tested for HIV - Helen Jospeh Hospital, JohannesburgA B R Janse van Rensburg31. ADHD - Using the art of film-making as an education mediumShabeer Ahmed Jeeva32. Treatment of adult ADHD co-morbiditiesShabeer Ahmed Jeeva33. Needs and services at ward one, Valkenberg HospitalDr J. A. Joska, Prof. A.J. Flisher34. Unanswered questions in the adequate treatment of depressionModerator: Dr Andre F JoubertExpert: Prof. Tony Hale35. Unanswered questions in treatment resistant depressionModerator: Dr Andre F JoubertExpert: Prof. Sidney Kennedy36. Are mentally ill people dangerous?Sen Z Kaliski37. The child custody circusSean Z. Kaliski38. The appropriatenes of certification of patients to psychiatric hospitalsV. N. Khanyile39. HIV/Aids Psychosocial responses and ethical dilemmasFred Kigozi40. Sex and PsychiatryB Levinson41. Violence and abuse in psychiatric in-patient institutions: A South African perspectiveMarilyn Lucas, John Weinkoove, Dean Stevenson42. Public health sector expenditure for mental health - A baseline study for South AfricaE N Madela-Mntla43. HIV in South Africa: Depression and CD4 countM Y H Moosa, F Y Jeenah44. Clinical strategies in dealing with treatment resistant schizophreniaPiet Oosthuizen, Dana Niehaus, Liezl Koen45. Buprenorphine/Naloxone maintenance in office practice: 18 months and 170 patients after the American releaseTed Parran Jr, Chris Adelman46. Integration of Pharmacotherapy for Opioid dependence into general psychiatric practice: Naltrexone, Methadone and Buprenorphine/ NaloxoneTed Parran47. Our African understanding of individulalism and communitarianismWillie Pienaar48. Healthy ageing and the prevention of DementiaFelix Potocnik, Susan van Rensburg, Christianne Bouwens49. Indigenous plants and methods used by traditional African healers for treatinf psychiatric patients in the Soutpansberg Area (Research was done in 1998)Ramovha Muvhango Rachel50. Symptom pattern & associated psychiatric disorders in subjects with possible & confirmed 22Q11 deletional syndromeJ.L. Roos, H.W. Pretorius, M. Karayiorgou51. Duration of antidepressant treatment: How long is long enough? How long is too longSteven P Roose52. A comparison study of early non-psychotic deviant behaviour in the first ten years of life, in Afrikaner patients with Schizophrenia, Schizo-affective disorder and Bipolar disorderMartin Scholtz, Melissa Janse van Rensburg, J. Louw Roos53. Treatment, treatment issues, and prevention of PTSD in women: An updateSoraya Seedat54. Fron neural networks to clinical practiceM Spitzer55. Opening keynote presentation: The art and science of PsychiatryM Spitzer56. The future of Pharmacotherapy for anxiety disordersDan J. Stein57. Neuropsychological deficits pre and post Electro Convulsive Therapy (ECT) thrice a week: A report of four casesUgash Subramaney, Yusuf Moosa58. Prevalence of and risk factors for Tradive Dyskinesia in a Xhosa population in the Eastern CapeDave Singler, Betty D. Patterson, Sandi Willows59. Eating disorders: Addictive disorders?Christopher Paul Szabo60. Ethical challenges and dilemmas of research in third world countriesGodfrey B. Tangwa61. The interface between Neurology and Psychiatry with specific focus on Somatoform dissociative disordersMichael Trimble62. Prevalence and correlates of depression and anxiety in doctors and teachersH Van der Bijl, P Oosthuizen63. Ingrid Jonker: A psychological analysisL. M. van der Merwe64. The strange world we live in, and the nature of the human subjectVasi van Deventer65. Art in psychiatry: Appendix or brain stem?C W van Staden66. Medical students on what "Soft skills" are about before and after curriculum reformC W van Staden, P M Joubert, A-M Bergh, G E Pickworth, W J Schurink, R R du Preez, J L Roos, C Kruger, S V Grey, B G Lindeque67. Attention deficit hyperactivity disorder (ADHD) - Medical management. Methylphenidate (Ritalin) or Atomoxetine (Strattera)Andre Venter68. A comprehensive guide to the treatment of adults with ADHDW J C Verbeeck69. Treatment of Insomnia: Stasis of the Art?G C Verster70. Are prisoners vulnerable research participants?Merryll Vorster71. Psychiatric disorders in the gymMerryl Vorster72. Ciprales: Effects on anxiety symptoms in Major Depressive DisorderBruce Lydiard

EXPERIMENTING WITH HUMANS AND ANIMALS: From Aristotle to CRISPR, second edition by Anita Guerrini. Baltimore, MD: Johns Hopkins University Press, 2022. viii + 208 pages. Paperback; $28.95. ISBN: 9781421444055. *There has been a haunting thought ever since I began to use live mammals for my research in neurophysiology: "Will my descendants accuse me of cruelty towards animals as much as we do to the scientists under the Nazis?" A number of neurophysiologists have been threatened and attacked to stop their research, and, as a consequence, there are few neurophysiologists left using rhesus monkeys along the West coastline of the US and Canada. Research with rats is increasingly of concern to some, and mice might be the next subject of attention. Research staff and students, who are required to remain on budget with their projects, are put under increasing pressure and stress in order to take better care of their laboratory animals without receiving compensation or support. In the meantime, almost nobody seems to care to know how many animals were sacrificed to develop the celebrated COVID-19 vaccines. Are we, biomedical researchers, ever going to have a resolution to this ethical tension around us? Are we going to be viewed by future historians as the heroes of science--or as abusers of living creatures? *Anita Guerrini's Experimenting with Humans and Animals: From Aristotle to CRISPR does not answer the question. As the author states in the beginning of her book, her objective is to tell the history of "trial and error, prejudice and leaps of faith, clashing egos and budget battles," to help us evaluate "the value, and the values, of Western science," and to "influence the future." In other words, the purpose of the book is not to make ethical arguments or to appraise a certain aspect of historical development, such as the progress of ethical care for human and animal subjects. It is, rather, to reveal the reality that ethical views and sentiments have changed, collided, merged, and contradicted each other across time and political landscapes. *This text poses questions, implicitly and explicitly, to enable us to address some of the issues and challenges we are facing at present. A first question arises from the history of vivisection (chap. 1). Vivisection refers to experimenting with (mostly dissecting) live animals, and sometimes even humans. This appears for the first time in recorded history back in ancient Greece, meaning it was practiced for two millennia without anesthesia, a discovery not made until the eighteenth century. More strikingly, vivisection was done as part of "edutainment" shows in ancient times. Criticism of the practice was not necessarily about the cruelty but rather about the usefulness of the knowledge obtained from dying or dead animals. The rights or well-being of animals were not much of an issue in the ancient age as human dominion was a firmly held belief. Such an ethical view continued to be dominant until early Modernity (seventeenth-century Europe) when human and animal bodies alike were viewed as machines, and animal experimentation began to be accepted as a cardinal method for biomedical sciences (chap. 2). At that time, ethical concerns on the use of animals did arise, but the concern lay rather in the human virtues of kindness and compassion rather than the rights of animals. *Eighteenth-century Europe slipped into a new stage of biomedical science after Queen Mary II of England died of smallpox, from which experimentation with humans becomes central (chap. 3). Inoculation, adopted from the Eastern world with initial suspicions, was slowly gaining credibility through parents who were unwilling to put their children at the risk of falling ill to smallpox. The validation of its effectiveness eventually came about upon testing with the socially marginalized, including prisoners, orphans, patients, and slaves. Yet criticisms around the "science" of inoculation were not made for using the marginalized as test subjects but rather for superseding God's authority to cause one to be ill or healed. While an increasing number of animal experiments were conducted routinely, and mathematical descriptions of the body became of greater interest to scientists, the emerging utilitarian ethics began to awaken Europeans, especially the British, to the suffering of animals. While elevated sensitivity to animal suffering led to "antivivisection" movements in England, experimental medicine and physiology were established as scientific fields. During this period nation-states also began to be involved in science. This was also the time when anesthesia was discovered, and pain perception became an important topic in physiology. Eventually, common beliefs about racial or sexual differences in pain perception were also tested, by experimenting with women and black slaves. *In the late nineteenth century, animal experimentation made a strong comeback as the germ theory of disease was solidly validated by scientists such as Pasteur, Koch, and Ehrlich (chap. 5). As scientists began to conquer many diseases such as anthrax, rabies, syphilis, and tuberculosis, the victory of science quenched the antivivisectionist movement. A number of animals, including rabbits, guinea pigs, dogs, and monkeys, were used to test theories, vaccines, and drugs during this period. At the same time, human experimentation begins to be regulated by states, but the regulation was so elementary that practices were allowed that would not be tolerated in our time. Concerns with animal experimentation reemerged in the twentieth century when polio research, strongly advocated by Franklin Roosevelt, a victim of polio himself, claimed a striking number of rhesus monkey lives (chap. 6). As an example, in the 1950s, the United States imported from India 200,000 rhesus monkeys per year for polio research. Despite the polio vaccine's success, primate research appalled the public, especially when behavioral research on primates revealed the emotional depth and social intelligence of these animals. Animals came to be seen no longer just as machines, but as our cousins who, like us, have consciousness. *The last chapter begins by depicting the Nuremberg War Crimes Tribunal of 1946, which led to the first written set of guidelines for human experimentation. Up until this time, there had been little consensus or regulation in using humans for experiments, let alone with the requirement that they must be mentally competent, uncoerced, and fully aware of possible consequences. It is hence not surprising that scientists under the Nazis defended themselves against charges of abuse and euthanasia of human subjects by paralleling their conduct with the practices of contemporary American scientists. American practice was exemplified by the Tuskegee Study of Untreated Syphilis in the Negro Male, conducted from the 1930s to the 1970s, in which the United States Public Health Service left four hundred black syphilis-infected males untreated, without telling them that their treatment had been stopped, in order to study the natural development of untreated syphilis. More than one hundred died as a result. Inconsistency in research ethics can also be found in the case of Japanese scientists, who, in contrast to Germans, were pardoned for their research conduct during World War II in return for providing information to the United States. Nonetheless, through the twentieth century until today, the level of public awareness and national regulations on the use of animal and human subjects has been progressively elevated. Yet, accelerated advances in research technology, including the latest breakthrough of gene editing, and expansion of research fields, continue to add complexity to ethical discourses. *I was impressed by Guerrini's vast knowledge of the historical development of biomedical science, including the events that matter to ethical issues around use of animal and human subjects in research. At the same time, she manages to make the book concise. While the book concerns the ethics of animal and human experimentation, it is certainly not an ethics or philosophy book but rather a story book. That is, while the book raises ethical questions in an unbiased manner, the chronological organization of this story does not conveniently lend itself to efforts to systematically examine or establish ethical principles on these matters. Nonetheless, a deeper understanding of the historical background to the different perspectives encountered in these stories enables one to make more-informed assessments of present-day perspectives. The book can be particularly helpful for those who do not have a biomedical background but wish to engage in contemporary ethical discourses, as well as for those who have rarely thought about the issues at all, often under the assumption that science has justly treated human or animal subjects. Finally, reading these accounts from ancient to contemporary times will certainly help one realize that what is the norm today was not necessarily the norm in the past, nor will it be in the future. Therefore, scientists like me need to humbly accept that we will someday be judged; I believe this knowledge will help us use our best conscience in the present. *Reviewed by Kuwook Cha, Postdoctoral researcher in Physiology, McGill University, Montreal, QC H3A 0G4.

Background: Women prisoners are a population that is vulnerable to mental health problems. Women prisoners have a higher risk of mental health problems than women in the general population. So far, there have been very few studies with specific on women prisoner populations discussing mental health needs in prisons. The high prevalence of mental health problems in women prisoners is inseparable from meeting the mental health needs of women prisoners in prison. This review aimed to identify the mental health needs of women prisoners. Methods: A scoping review was used, a systematic search of the articles on Oxford Academic Journals, Emerald Insight, Science Direct, PubMed, and Google Scholar using the keywords “Mental Health” OR “Health” AND “Needs” OR “Needs Assessment” OR “Addressing Needs” AND “Female” OR “Woman” OR “Women” AND “Inmates” OR “Prisoners” OR “Offenders” OR “Convicts”. Results: A total of 10 out of 254 selected, were considered eligible for inclusion and the results showed that the six major themes of mental health needs of women prisoners were treatment of substance, drug, and alcohol abuse, support system, empathy, training, mental illness treatment and access to health services, and health intervention: therapy and counselling. Conclusion: It is recommended for further research to focus more on the problem of access to gender-based mental health services in prisons.

Purpose This study aims to provide an overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among sentenced female prisoners. Design/methodology/approach A mixed-methods systematic literature review. Findings A total of 4 reviews and 39 single studies met the inclusion criteria for the review. Mental disorders were the main area of investigation in the majority of single studies, with substance abuse, particularly drug abuse, as the most consistently gender biased disorder, with higher prevalence among women than men in prison. The review identified a lack of updated systematic evidence on the presence of multi-morbidity. Originality/value This study provides an up-to-date overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among female prisoners.

Native American women are at an especially high risk of lifetime violence, including childhood abuse, intimate partner violence (IPV), and sexual assault, and are overrepresented in the criminal justice system. Yet few studies have examined how the long-term effects of child maltreatment and other adverse childhood experiences (ACEs) affect Native American women prisoners’ perpetration of physical violence in adult intimate relationships. This is surprising because ample research illustrates that childhood adverse events, particularly childhood abuse and neglect, have far-reaching effects across the life course and that these experiences are especially apparent in the lives of women involved in the criminal justice system. Using data from a stratified random sample of Native American ( n = 92) and non-Native American ( n = 264) women prisoners in Oklahoma, we explore the relationships between individual, cumulative, and clusters of ACEs as they relate to the use of physical violence in adult intimate relationships. Utilizing a feminist life course theoretical framework, our findings indicate that ACEs are not only critical to understanding adult IPV but also that the mechanisms and processes underlying the relationships between ACEs and the perpetration of physical violence in adult intimate relationships differ for Native American and non-Native American women. The findings of the current study demonstrate that it is imperative that prison programming includes trauma-informed and trauma-specific interventions targeting Native Americans.

During Hurricane Katrina, which struck the US Gulf Coast in August 2005, thousands of men, women and children were abandoned in Orleans Parish Prison (OPP), the New Orleans jail. As the floodwaters rose in the OPP buildings, prisoners were trapped for days in locked cells without food, some standing in sewage-tainted water up to their chests, while guards left their posts. Predominantly poor African-American pre-trial detainees, held on minor charges, such as failure to pay court fees, the prisoners were eventually evacuated to various receiving facilities around the state of Louisiana, only to face systematic racial abuse, assaults and further brutality. The experiences of the OPP prisoners lay bare the routine injustices that permeate a system of incarceration that is effectively run as a profitmaking concern.

To resist the Israeli military occupation of the West Bank, Palestinian prisoners are smuggling sperm samples out of Israeli prisons to enable their wives to undergo fertility treatment. Bodies and bodily matter figure as central actors in this practice of resistance. In this article, I draw from fieldwork I conducted with Palestinian women and medical staff in the occupied West Bank to examine the tension between carcerality and matter(ing). I argue that bodies and bodily matter are constitutive of the relationship between oppression and resistance. I analyze how Israeli military authorities assign evidentiary status to Palestinian bodies and illustrate how Palestinian families challenge the Israeli carceral system through new modes of embodied resistance. This article demonstrates how intersecting forms of oppression shape and are being shaped by bodies and their materiality. It also suggests that theorizing the materiality of power from Palestine offers new ways of understanding the political work that bodies do.

Purpose Young prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners’ experiences and perceptions of mental health and well-being, their determinants and their coping strategies. Design/methodology/approach Six focus group discussions were carried out in three prisons with a total of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semi-structured questions guided the discussions, and thematic analysis was applied to analyse the data. Findings Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partly influenced by the socio-economic support from outside the prisons and previous involvement or not in drug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms. Originality/value This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings in this study underline the importance of prison authorities tackling overcrowding to promote well-being and reduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions.

Photo by niu niu on Unsplash ABSTRACT Shackling prisoners has been implemented as standard procedure when transporting prisoners in labor and during childbirth. This procedure ensures the protection of both the public and healthcare workers. However, the act of shackling pregnant prisoners violates the principles of ethics that physicians are supposed to uphold. This paper will explore how shackling pregnant prisoners violates the principle of justice and beneficence, making the practice unethical. INTRODUCTION Some states allow shackling of incarcerated pregnant women during transport and while in the hospital for labor and delivery. Currently, only 22 states have legislation prohibiting the shackling of pregnant women.[1] Although many states have anti-shackling laws prohibiting restraints, these laws also contain an “extraordinary circumstances” loophole.[2] Under this exception, officers shackle prisoners if they pose a flight risk, have any history of violence, and are a threat to themselves or others.[3] Determining as to whether a prisoner is shackled is left solely to the correctional officer.[4] Yet even state restrictions on shackling are often disregarded. In shackling pregnant prisoners during childbirth, officers and institutions are interfering with the ability of incarcerated women to have safe childbirth experiences and fair treatment. Moreover, physicians cannot exercise various ethical duties as the law constrains them. In this article, I will discuss the physical and mental harms that result from the use of restraints under the backdrop of slavery and discrimination against women of color particularly. I argue that stereotypes feed into the phenomenon of shackling pregnant women, especially pregnant women of color. I further assert that shackling makes it difficult for medical professionals to be beneficent and promote justice. BACKGROUND Female incarceration rates in the United States have been fast growing since the 1980s.[5] With a 498 percent increase in the female incarceration population between 1981 and 2021, the rates of pregnancy and childbirth by incarcerated people have also climbed.[6],[7] In 2021, over 1.2 million women were incarcerated in the United States.[8] An estimated 55,000 pregnant women are admitted to jails each year.[9],[10] Many remain incarcerated throughout pregnancy and are transported to a hospital for labor and delivery. Although the exact number of restrained pregnant inmates is unclear, a study found that 83 percent of hospital prenatal nurses reported that their incarcerated patients were shackled.[11] I. Harms Caused by Shackling Shackling has caused many instances of physical and psychological harm. In the period before childbirth, shackled pregnant women are at high risk for falling.[12] The restraints shift pregnant women’s center of gravity, and wrist restraints prevent them from breaking a fall, increasing the risk of falling on their stomach and harming the fetus.[13] Another aspect inhibited by using restraints is testing and treating pregnancy complications. Delays in identifying and treating conditions such as hypertension, pre-eclampsia, appendicitis, kidney infection, preterm labor, and especially vaginal bleeding can threaten the lives of the mother and the fetus.[14] During labor and delivery, shackling prevents methods of alleviating severe labor pains and giving birth.[15] Usually, physicians recommend that women in labor walk or assume various positions to relieve labor pains and accelerate labor.[16] However, shackling prevents both solutions.[17] Shackling these women limits their mobility during labor, which may compromise the health of both the mother and the fetus.[18] Tracy Edwards, a former prisoner who filed a lawsuit for unlawful use of restraints during her pregnancy, was in labor for twelve hours. She was unable to move or adjust her position to lessen the pain and discomfort of labor.[19] The shackles also left the skin on her ankles red and bruised. Continued use of restraints also increases the risk of potentially life-threatening health issues associated with childbirth, such as blood clots.[20] It is imperative that pregnant women get treated rapidly, especially with the unpredictability of labor. Epidural administration can also become difficult, and in some cases, be denied due to the shackled woman’s inability to assume the proper position.[21] Time-sensitive medical care, including C-sections, could be delayed if permission from an officer is required, risking major health complications for both the fetus and the mother.[22] After childbirth, shackling impedes the recovery process. Shackling can result in post-delivery complications such as deep vein thrombosis.[23] Walking prevents such complications but is not an option for mothers shackled to their hospital beds.[24] Restraints also prevent bonding with the baby post-delivery and the safe handling of the baby while breast feeding.[25] The use of restraints can also result in psychological harm. Many prisoners feel as though care workers treat them like “animals,” with some women having multiple restraints at once— including ankles, wrists, and even waist restraints.[26] Benidalys Rivera describes the feeling of embarrassment as she was walking while handcuffed, with nurses and patients looking on, “Being in shackles, that make you be in stress…I about to have this baby, and I’m going to go back to jail. So it’s too much.”[27] Depression among pregnant prisoners is highly prevalent. The stress of imprisonment and the anticipation of being separated from their child is often overwhelming for these mothers.[28] The inhumane action has the potential to add more stress, anxiety, and sadness to the already emotionally demanding process of giving birth. Shackling pregnant prisoners displays indifference to the medical needs of the prisoner.[29] II. Safety as a Pretense While public safety is an argument for using shackles, several factors make escape or violence extremely unlikely and even impossible.[30] For example, administering epidural anesthesia causes numbness and eliminates flight risk.[31] Although cited as the main reason for using shackles, public safety is likely just an excuse and not the main motivator for shackling prisoners. I argue that underlying the shackling exemplifies the idea that these women should not have become pregnant. The shackling reflects a distinct discrimination: the lawmakers allowing it perhaps thought that people guilty of crimes would make bad mothers. Public safety is just a pretense. The language used to justify the use of restraint of Shawanna Nelson, the plaintiff in Nelson v. Correctional Medical Services, discussed below, included the word “aggressive.”[32] In her case, there was no evidence that she posed any danger or was objectively aggressive. Officer Turnesky, who supervised Nelson, testified that she never felt threatened by Nelson.[33] The lack of documented attempts of escape and violence from pregnant prisoners suggests that shackling for flight risk is a false pretense and perhaps merely based on stereotypes.[34] In 2011, an Amnesty International report noted that “Around the USA, it is common for restraints to be used on sick and pregnant incarcerated women when they are transported to and kept in hospital, regardless of whether they have a history of violence (which only a minority have) and regardless of whether they have ever absconded or attempted to escape (which few women have).”[35] In a 2020 survey of correctional officers in select midwestern prisons, 76 percent disagreed or strongly disagreed with restraining pregnant women during labor and delivery.[36] If a correctional officer shackles a pregnant prisoner, it is not because they pose a risk but because of a perception that they do. This mindset is attributed to select law enforcement, who have authority to use restraints.[37] In 2022, the Tennessee legislature passed a bill prohibiting the use of restraints on pregnant inmates. However, legislators amended the bill due to the Tennessee Sherriff Association’s belief that even pregnant inmates could pose a “threat.”[38] Subjecting all prisoners to the same “precautions” because a small percentage of individuals may pose such risks could reflect stereotyping or the assumption that all incarcerated people pose danger and flight risk. To quell the (unjustified) public safety concern, there are other options that do not cause physical or mental harm to pregnant women. For example, San Francisco General Hospital does not use shackles but has deputy sheriffs outside the pregnant women’s doors.[39] III. Historical Context and Race A. Slavery and Post-Civil War The treatment of female prisoners has striking similarities to that of enslaved women. Originally, shackling of female slaves was a mechanism of control and dehumanization.[40] This enabled physical and sexual abuses. During the process of intentionally dehumanizing slaves to facilitate subordination, slave owners stripped slave women of their feminine identity.[41] Slave women were unable to exhibit the Victorian model of “good mothering” and people thought they lacked maternal feelings for their children.[42] In turn, societal perception defeminized slave women, and barred them from utilizing the protections of womanhood and motherhood. During the post-Civil War era, black women were reversely depicted as sexually promiscuous and were arrested for prostitution more often than white women.[43] In turn, society excluded black women; they were seen as lacking what the “acceptable and good” women had.[44] Some argue that the historical act of labeling black women sexually deviant influences today’s perception of black women and may lead to labeling them bad mothers.[45] Over two-thirds of incarcerated women are women of color.[46] Many reports document sexual violence and misconduct against prisoners over the years.[47] Male guards have raped, sexually assaulted, and inappropriately touched female prisoners. Some attribute the physical abuse of black female prisoners to their being depicted or stereotyped as “aggressive, deviant, and domineering.”[48] Some expect black women to express stoicism and if they do not, people label them as dangerous, irresponsible, and aggressive.[49] The treatment of these prisoners mirrors the historical oppression endured by black women during and following the era of slavery. The act of shackling incarcerated pregnant women extends the inhumane treatment of these women from the prison setting into the hospital. One prisoner stated that during her thirty-hour labor, while being shackled, she “felt like a farm animal.”[50] Another pregnant prisoner describes her treatment by a guard stating: “a female guard grabbed me by the hair and was making me get up. She was screaming: ‘B***h, get up.’ Then she said, ‘That is what happens when you are a f***ing junkie. You shouldn’t be using drugs, or you wouldn’t be in here.”[51] Shackling goes beyond punishing by isolation from society – it is an additional punishment that is not justified. B. Reproductive Rights and “Bad Mothers” As with slaves not being seen as maternal, prisoners are not viewed as “real mothers.” A female prison guard said the following: “I’m a mother of two and I know what that impulse, that instinct, that mothering instinct feels like. It just takes over, you would never put your kids in harm’s way. . . . Women in here lack that. Something in their nature is not right, you know?”[52] This comment implies that incarcerated women lack maternal instinct. They are not in line with the standards of what society accepts as a “woman” and “mother” and are thought to have abandoned their roles as caretakers in pursuit of deviant behaviors. Without consideration of racial discrimination, poverty issues, trauma, and restricted access to the child right after delivery, these women are stereotyped as bad mothers simply because they are in prison. Reminiscent of the treatment of female black bodies post-civil war and the use of reproductive interventions (for example, Norplant and forced sterilization) in exchange for shorter sentences, I argue that shackles are a form of reproductive control. Justification for the use of shackles even includes their use as a “punitive instrument to remind the prisoner of their punishment.”[53] However, a prisoner’s pregnancy should have no relevance to their sentence.[54] Using shackles demonstrates to prisoners that society tolerates childbirth but does not support it.[55] The shackling is evidence that women are being punished “for bearing children, not for breaking the law.”[56] Physicians and healthcare workers, as a result, are responsible for providing care for the delivery and rectifying any physical problems associated with the restraints. The issues that arise from the use of restraints place physicians in a position more complex than they experience with regular healthy pregnancies. C. Discrimination In the case of Ferguson v. City of Charleston, a medical university subjected black woman to involuntary drug testing during pregnancy. In doing so, medical professionals collaborated with law enforcement to penalize black women for their use of drugs during pregnancy.[57] The Court held the drug tests were an unreasonable search and violated the Fourth Amendment. Ferguson v. City of Charleston further reveals an unjustified assumption: the medical and legal community seemed suspicious of black women and had perhaps predetermined them more likely to use drugs while pregnant. Their fitness to become mothers needed to be proven, while wealthy, white women were presumed fit.[58] The correctional community similarly denies pregnant prisoners’ medical attention. In the case of Staten v. Lackawanna County, an African American woman whose serious medical needs were treated indifferently by jail staff was forced to give birth in her cell.[59] This woman was punished for being pregnant in prison through the withholding of medical attention and empathy. IV. Failure to Follow Anti-Shackling Laws Despite 22 states having laws against shackling pregnant prisoners, officers do not always follow these laws. In 2015, the Correctional Association of New York reported that of the 27 women who gave birth under state custody, officers shackled 23 women in violation of the anti-shackling laws.[60] The lawyer of Tracy Edwards, an inmate who officers shackled unlawfully during her twelve-hour labor stated, “I don’t think we can assume that just because there’s a law passed, that’s automatically going to trickle down to the prison.”[61] Even with more restrictions on shackling, it may still occur, partly due to the stereotype that incarcerated women are aggressive and dangerous. V. Constitutionality The Eighth Amendment protects people from cruel and unusual punishment. In Brown vs. Plata, the court stated, “Prisoners retain the essence of human dignity inherent in all persons.”[62] In several cases, the legal community has held shackling to be unconstitutional as it violates the Eighth Amendment unless specifically justified. In the case of Nelson v. Correctional Medical Services, a pregnant woman was shackled for 12 hours of labor with a brief respite while she pushed, then re-shackled. The shackling caused her physical and emotional pain, including intense cramping that could not be relieved due to positioning and her inability to get up to use a toilet.[63] The court held that a clear security concern must justify shackling. The court cited a similar DC case and various precedents for using the Eighth Amendment to hold correctional facilities and hospitals accountable.[64] An Arkansas law similarly states that shackling must be justified by safety or risk of escape.[65] If the Thirteenth Amendment applied to those convicted of crimes, shackling pregnant incarcerated people would be unconstitutional under that amendment as well as the Eighth. In the Civil Rights Cases, Congress upheld the right “to enact all necessary and proper laws for the obliteration and prevention of slavery with all its badges and incidents.”[66] Section two of the Thirteenth Amendment condemns any trace or acts comparable to that of slavery. Shackling pregnant prisoners, stripping them of their dignity, and justification based on stereotypes all have origins in the treatment of black female slaves. Viewed through the lens of the Thirteenth Amendment, the act of shackling would be unconstitutional. Nonetheless, the Thirteenth Amendment explicitly excludes people convicted of a crime. VI. Justice As a result of the unconstitutional nature of shackling, physicians should have a legal obligation, in addition to their ethical duty, to protect their patients. The principle of justice requires physicians to take a stand against the discriminatory treatment of their patients, even under the eye of law enforcement.[67],[68] However, “badge and gun intimidation,” threats of noncompliance, and the fear of losing one’s license can impede a physician’s willingness to advocate for their patients. The American College of Obstetricians and Gynecologists (ACOG) finds the use of physical restraints interferes with the ability of clinicians to practice medicine safely.[69] ACOG, The American Medical Association, the National Commission on Correctional Health Care, and other organizations oppose using restraints on pregnant incarcerated people.[70] Yet, legislators can adopt shackling laws without consultation with physicians. The ACOG argues that “State legislators are taking it upon themselves to define complex medical concepts without reference to medical evidence. Some of the penalties [faced by OBGYNs] for violating these vague, unscientific laws include criminal sentences.”[71] Legislation that does not consider medical implications or discourages physicians’ input altogether is unjust. In nullifying the voice of a physician in matters pertaining to the patient’s treatment, physicians are prevented from fulfilling the principle of justice, making the act of shackling patients unethical. VII. Principle of Beneficence The principle of beneficence requires the prevention of harm, the removal of harm, and the promotion of good.[72] Beneficence demands the physician not only avoid harm but benefit patients and promote their welfare.[73] The American Board of Internal Medicine Foundation states that physicians must work with other professionals to increase patient safety and improve the quality of care.[74] In doing so, physicians can adequately treat patients with the goal of prevention and healing. It is difficult to do good when law enforcement imposes on doctors to work around shackles during labor and delivery. Law enforcement leaves physicians and healthcare workers responsible not only to provide care for the delivery, but also rectify any ailments associated with the restraints. The issues arising from using restraints place physicians in a position more complex than they experience with other pregnancies. Doctors cannot prevent the application of the shackles and can only request officers to take them off the patient.[75] Physicians who simply go along with shackling are arguably violating the principle of beneficence. However, for most, rather than violating the principle of beneficence overtly, physicians may simply have to compromise. Given the intricate nature of the situation, physicians are tasked with minimizing potential harm to the best of their abilities while adhering to legal obligations.[76] It is difficult to pin an ethics violation on the ones who do not like the shackles but are powerless to remove them. Some do argue that this inability causes physicians to violate the principle of beneficence.[77] However, promoting the well-being of their patients within the boundaries of the law limits their ability to exercise beneficence. For physicians to fulfill the principle of beneficence to the fullest capacity, they must have an influence on law. Protocols and assessments on flight risks made solely by the officers and law enforcement currently undermine the physician’s expertise. These decisions do not consider the health and well-being of the pregnant woman. As a result, law supersedes the influence of medicine and health care. CONCLUSION People expect physicians to uphold the four major principles of bioethics. However, their inability to override restraints compromises their ability to exercise beneficence. Although pledging to enforce these ethical principles, physicians have little opportunity to influence anti-shackling legislation. Instead of being included in conversations regarding medical complexities, legislation silences their voices. Policies must include the physician's voice as they affect their ability to treat patients. Officers should not dismiss a physician's request to remove shackles from a woman if they are causing health complications. A woman's labor should not harm her or her fetus because the officer will not remove her shackles.[78] A federal law could end shackling pregnant incarcerated people. Because other options are available to ensure the safety of the public and the prisoner, there is no ethical justification for shackling pregnant prisoners. An incarcerated person is a human being and must be treated with dignity and respect. To safeguard the well-being of incarcerated women and the public, it is essential for advocates of individual rights to join forces with medical professionals to establish an all-encompassing solution. - [1] Ferszt, G. G., Palmer, M., & McGrane, C. (2018). Where does your state stand on shackling of Pregnant Incarcerated Women? Nursing for Women’s Health, 22(1), 17–23. https://doi.org/10.1016/j.nwh.2017.12.005 [2] S983A, 2015-2016 Regular Sessions (N.Y. 2015). https://legislation.nysenate.gov/pdf/bills/2015/S983A [3] Chris DiNardo, Pregnancy in Confinement, Anti-Shackling Laws and the “Extraordinary Circumstances” Loophole, 25 Duke Journal of Gender Law & Policy 271-295 (2018) https://scholarship.law.duke.edu/djglp/vol25/iss2/5 [4] Chris DiNardo (2018) [5] U.S. Bureau of Justice Statistics. 1980. " Prisoners in 1980 – Statistical Tables”. Retrieved April 20, 2023 (https://bjs.ojp.gov/content/pub/pdf/p80.pdf). [6] U.S. Bureau of Justice Statistics. 2022. " Prisoners in 2021 – Statistical Tables”. Retrieved April 20, 2023 (https://bjs.ojp.gov/sites/g/files/xyckuh236/files/media/document/p21st.pdf). [7] U.S. Bureau of Justice Statistics (1980) [8] Sufrin C, Jones RK, Mosher WD, Beal L. Pregnancy Prevalence and Outcomes in U.S. Jails. Obstet Gynecol. 2020;135(5):1177-1183. doi:10.1097/AOG.0000000000003834 [9] Kramer, C., Thomas, K., Patil, A., Hayes, C. M., & Sufrin, C. B. (2022). Shackling and pregnancy care policies in US prisons and jails. Maternal and Child Health Journal, 27(1), 186–196. https://doi.org/10.1007/s10995-022-03526-y [10] House, K. T., Kelley, S., Sontag, D. N., & King, L. P. (2021). Ending restraint of incarcerated individuals giving birth. AMA Journal of Ethics, 23(4). https://doi.org/10.1001/amajethics.2021.364 [11] Goshin, L. S., Sissoko, D. R., Neumann, G., Sufrin, C., & Byrnes, L. (2019). Perinatal nurses’ experiences with and knowledge of the care of incarcerated women during pregnancy and the postpartum period. Journal of Obstetric, Gynecologic &amp; Neonatal Nursing, 48(1), 27–36. https://doi.org/10.1016/j.jogn.2018.11.002 [12] Shackling and separation: Motherhood in prison. (2013). AMA Journal of Ethics, 15(9), 779–785. https://doi.org/10.1001/virtualmentor.2013.15.9.pfor2-1309 [13] King, L. (2018). Labor in chains: The shackling of pregnant inmates. Policy Perspectives, 25, 55–68. https://doi.org/10.4079/pp.v25i0.18348 [14] King, L. (2018). [15] AMA Journal of Ethics (2013) [16] Lawrence, A., Lewis, L., Hofmeyr, G. J., & Styles, C. (2013). Maternal positions and mobility during first stage labour. Cochrane database of systematic reviews, (8). [17] Association of Women’s Health, Obstetric and Neonatal Nurses. (2011). AWHONN position statement: Shackling incarcerated pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40(6), 817–818. doi:10.1111/j.1552-6909.2011.01300.x [18] Ferszt, G. G., Palmer, M., & McGrane, C. (2018). Where does your state stand on shackling of Pregnant Incarcerated Women? Nursing for Women’s Health, 22(1), 17–23. https://doi.org/10.1016/j.nwh.2017.12.005 [19] Thompson, E. (2022, August 30). Woman sues NC state prison system for mistreatment while pregnant. North Carolina Health News. Retrieved March 12, 2023, from https://www.northcarolinahealthnews.org/2022/05/25/woman-sues-nc-state-prison-system-for-mistreatment-while-pregnant/ [20] CBS Interactive. (2019, March 13). Shackling pregnant inmates is still a practice in many states. CBS News. Retrieved March 12, 2023, from https://www.cbsnews.com/news/shackling-pregnant-inmates-is-still-a-practice-in-many-states/ [21] Griggs, Claire Louise. "Birthing Barbarism: The Unconstitutionality of Shackling Pregnant Prisoners." American University Journal of Gender Social Policy and Law 20, no. 1 (2011): 247-271. [22] American Civil Liberties Union. (2012, October 12). ACLU briefing paper: The shackling of pregnant women & girls in U.S ... American Civil Liberties Union (ACLU). https://www.aclu.org/wp-content/uploads/legal-documents/anti-shackling_briefing_paper_stand_alone.pdf [23] King.L (2018) [24] Griggs, Claire Louise (2011) [25] American Civil Liberties Union. (2012) [26] Clarke, J. G., & Simon, R. E. (2013). Shackling and separation: Motherhood in prison. AMA Journal of Ethics, 15(9), 779–785. https://doi.org/10.1001/virtualmentor.2013.15.9.pfor2-1309 [27] Berg, M. D. (2014, April 18). Pregnant prisoners are losing their shackles - The Boston Globe. BostonGlobe.com. Retrieved March 12, 2023, from https://www.bostonglobe.com/magazine/2014/04/18/taking-shackles-off-pregnant-prisoners/7t7r8yNBcegB8eEy1GqJwN/story.html [28] Levi, R., Kinakemakorn, N., Zohrabi, A., Afanasieff, E., & Edwards-Masuda, N. (2010). Creating the bad mother: How the U.S. approach to pregnancy in prisons violates the right to be a mother. UCLA Women's Law Journal, 18(1). https://doi.org/10.5070/l3181017816 [29] Chris DiNardo (2018) [30] Griggs, Claire Louise (2011). [31] Allen, J. E. (2010, October 21). Shackled: Women Behind Bars Deliver in Chains. ABC News. https://abcnews.go.com/Health/WomensHealth/pregnant-shackled-women-bars-deliver-chains/story?id=11933376&page=1 [32] Nelson v. Correctional, 533 F.3d 958 (8th Cir. 2009) [33] Nelson v. Correctional(2009) [34] House, K. T., Kelley, S., Sontag, D. N., & King, L. P. (2021). Ending restraint of incarcerated individuals giving birth. AMA Journal of Ethics, 23(4). https://doi.org/10.1001/amajethics.2021.364 [35] Amnesty International USA. (1999, March). “Not part of my sentence” Violations of the Human Rights of Women in Custody. Amnesty International USA. Retrieved March 12, 2023, from https://www.amnestyusa.org/reports/usa-not-part-of-my-sentence-violations-of-the-human-rights-of-women-in-custody/ [36] Pendleton, V., Saunders, J. B., & Shlafer, R. (2020). Corrections officers' knowledge and perspectives of maternal and child health policies and programs for pregnant women in prison. Health & justice, 8(1), 1. https://doi.org/10.1186/s40352-019-0102-0 [37] Elizabeth Alexander, Unshackling Shawanna: The Battle Over Chaining Women Prisoners during Labor and Delivery, 32 U. ARK. LITTLE ROCK L. REV. 435 (2010). Available at: https://lawrepository.ualr.edu/lawreview/vol32/iss4/1 [38] Hernandez, J. (2022, April 22). More states are restricting the shackling of pregnant inmates, but it still occurs. NPR. Retrieved March 12, 2023, from https://www.npr.org/2022/04/22/1093836514/shackle-pregnant-inmates-tennessee [39] Sufrin, C. (2012, June 24). End practice of shackling pregnant inmates. SFGATE. Retrieved March 12, 2023, from https://www.sfgate.com/opinion/openforum/article/End-practice-of-shackling-pregnant-inmates-3176987.php [40] Mullings, L. (1997). On our own terms: Race, class, and gender in the lives of African American women. Routledge [41] Ocen, Priscilla A., (2011). [42] Ladd-Taylor, M. (1998). "Bad" mothers: The politics of blame in Twentieth-century America. New York Univ. Press. [43] Hine, D. C. (1998). Hine Sight: Black women and the re-construction of American history. Indiana University Press. [44] Baldwin, L. (2019). Excluded from good motherhood and the impact of prison: Motherhood and Social Exclusion, 129–144. https://doi.org/10.2307/j.ctvk12qxr.13 [45] Ocen, Priscilla A., Punishing Pregnancy: Race, Incarceration, and the Shackling of Pregnant Prisoners (October 3, 2011). California Law Review, Vol. 100, 2012, Available at SSRN: https://ssrn.com/abstract=1937872 [46] Johnson, P. C. (2004). Inner lives: Voices of african american women in prison. New York University Press. [47] Thomas, D. Q. (1996). All too familiar: Sexual abuse of women in U.S. state prisons. Human Rights Watch. [48] Ocen, Priscilla A., (2011). [49] Ashley W. The angry black woman: the impact of pejorative stereotypes on psychotherapy with black women. Soc Work Public Health. 2014;29(1):27-34. doi: 10.1080/19371918.2011.619449. PMID: 24188294. [50] CBS Interactive. (2019, March 13). Shackling pregnant inmates is still a practice in many states. CBS News. Retrieved March 12, 2023, from https://www.cbsnews.com/news/shackling-pregnant-inmates-is-still-a-practice-in-many-states/ [51] Guardian News and Media. (2020, January 24). Pregnant and shackled: Why inmates are still giving birth cuffed and bound. The Guardian. Retrieved March 25, 2023, from https://www.theguardian.com/us-news/2020/jan/24/shackled-pregnant-women-prisoners-birth [52] Oparah, J. C. (2015). Birthing justice: Black women, pregnancy, and childbirth. Routledge. [53] Chris DiNardo (2018) [54] Griggs, Claire Louise (2011). [55] Chris DiNardo (2018) [56] Griggs, Claire Louise (2011). [57] Song, Ji Seon, Policing the Emergency Room (June 10, 2021). 134 Harvard Law Review 2646 (2021), Available at SSRN: https://ssrn.com/abstract=3864225 [58] Ocen, Priscilla A., (2011). [59] Staten v. Lackawanna Cnty., No. 4:07-CV-1329, 2008 WL 249988, at *2 (M.D. Pa. Jan. 29, 2008) [60] Lovett, K. (2018, April 9). Pregnant inmates at New York prisons will no longer be shackled under new law. New York Daily News. Retrieved March 12, 2023, from https://www.nydailynews.com/new-york/new-york-pregnant-inmates-no-longer-shackled-article-1.2474021 [61] Thompson, E. (2022, August 30). Woman sues NC state prison system for mistreatment while pregnant. North Carolina Health News. Retrieved March 12, 2023, from https://www.northcarolinahealthnews.org/2022/05/25/woman-sues-nc-state-prison-system-for-mistreatment-while-pregnant/ [62] Brown v. Plata, 563 U.S. 493 (2011) [63] Nelson v. Correctional Medical Serices, et al., Nelson v. Correctional Med. Servs, 583 F.3d 522 (8th Cir. 2009) [64] Nelson citing Women Prisoners of D.C. Dep't of Corr. v. District of Columbia, 877 F.Supp. 634, 668-69 (D.D.C. 1994), modified in part on other grounds, 899 F.Supp. 659 (D.D.C. 1995). [65] Ark. Dep't of Corr. Admin. Reg. 403 § V (1992) [66] Civil Rights Cases, 109 U.S. 3 (1883) [67] Physician charter. ABIM Foundation. (2022, October 18). Retrieved March 10, 2023, from https://abimfoundation.org/what-we-do/physician-charter#:~:text=Principle%20of%20social%20justice.&text=Physicians%20should%20work%20actively%20to,or%20any%20other%20social%20category. [68] Riddick FA Jr. The code of medical ethics of the american medical association. Ochsner J. 2003 Spring;5(2):6-10. PMID: 22826677; PMCID: PMC3399321. [69] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). Reproductive Health Care for Incarcerated Pregnant, Postpartum, and Nonpregnant Individuals: ACOG Committee Opinion, Number 830. Obstetrics and gynecology, 138(1), e24–e34. https://doi.org/10.1097/AOG.0000000000004429 [70] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). [71] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). [72] Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press. [73] Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119 [74] Medical professionalism in the new millennium: A physician charter. (2002). Annals of Internal Medicine, 136(3), 243. https://doi.org/10.7326/0003-4819-136-3-200202050-00012 [75] Allen, J. E. (2010, October 21). Shackled: Women Behind Bars Deliver in Chains. ABC News. https://abcnews.go.com/Health/WomensHealth/pregnant-shackled-women-bars-deliver-chains/story?id=11933376&page=1 [76] Jonsen, A. R. (2010). The Birth of Bioethics. Oxford University Press. [77] Beauchamp, T. L., & Childress, J. F. (2019). [78] Amnesty International USA. (1999, March). “Not part of my sentence” Violations of the Human Rights of Women in Custody. Amnesty International USA. Retrieved March 12, 2023, from https://www.amnestyusa.org/reports/usa-not-part-of-my-sentence-violations-of-the-human-rights-of-women-in-custody/

Women incarcerated in federal prisons are a small but growing proportion of Canada’s penal institutions and have needs, challenges, and health issues vastly different from those of incarcerated men. Women that come into conflict with the law often have experienced sexual abuse, utilize drugs and alcohol, and have poor health. Healthcare professionals in prison should be aware of these health markers and the associated difficulties of treating patients in prison. This article aims to catalyze conversation and further inquiry into the potential role of the carceral reality as a healing space, and the health professionals within it as healers.