Profs Gautam Gulati and Brendan Kelly wrote for the Irish Examiner about the loss of doctor-patient confidentiality in prison, which impacts prisoners’ right to privacy and can have impacts both in- and out-side the justice system. Some may avoid mental health services entirely to avoid these repercussions.
Read the article in its entirety on the Irish Examiner website here. Read a selected passage below.
The consequences are profound. Some individuals disengage entirely from mental health services. Some experience increased victimisation in custody. A small but significant number may attempt suicide. What is intended as justice risks compounding harm — not only for the individual, but for families and communities.
At the heart of this issue lies a simple but vital principle: medical confidentiality. It is not a courtesy. It is the foundation of trust between patient and doctor. Without it, people do not speak freely. Without it, care breaks down.
International ethical standards are clear: doctors involved in a person’s care should not also be asked to prepare reports for court. The roles of therapist and evaluator must remain separate.
Courts have alternatives. Where medico-legal reports are required, they can and should be prepared by independent practitioners, with explicit consent. The practice of asking prison psychiatrists for reports must cease.
