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The prison watchdog has expressed serious concern over the way a terminally ill Midlands prison inmate died in his cell when medical staff had recommended a hospice.
Prison Inspector Patricia Gilheaney said treating terminally ill prisoners in the custody of the Irish Prison Service and allowing them to be cared for in a hospice was a very important issue.
A report by the inspector found that the Minister of Justice, Charlie Flanagan, had approved the provision of hospice care to the prisoner, known as Mr. P, but that there was no bed available.
After his discharge from Portlaoise General Hospital on November 8, 2018, the 47-year-old prisoner remained in the Midlands Prison in Portlaoise, where he died six days later, about four months after he was first diagnosed with skin cancer. and a year later. committed to prison.
IPS informed Ms. Gilheaney that a community hospice bed was not available at the time a hospital consultant said that Mr. P no longer needed an acute hospital bed.
A prison doctor recommended that Mr. P be allowed to stay at Portlaoise General Hospital until a hospice bed was found due to his complex care needs and the inability of prison medical staff to meet them.
IPS said that the only decent response it could provide to the prisoner in such circumstances was to make the best possible arrangements for him to be cared for in the Midlands prison.
He said a community palliative care team had been established, as well as additional nursing support and medical care in the evenings. Continuous efforts were made to secure a hospice bed, but none were available.
The inspector said that a case conference to discuss Mr. P’s condition held on October 10, 2018 after his return from hospitalization was a positive planning event at a time when medical opinion believed he had between two and three weeks old.
However, he noted that health care personnel were concerned that Mr. P had not signed any documents to confirm his wish not to be resurrected given his role in preserving life.
The inspector said the end-of-life treatment the prisoner received in the Midlands prison was commendable.
“Every effort was made to make him comfortable and he was treated with as much compassion and respect as possible in an occupied prison wing,” he added.
The inspector said that a prison chief had demonstrated commendable proactivity by issuing an instruction that the prisoner’s cell should not be locked at night to allow rapid entry to his cell.
Ms. Gilheaney said the situation had been challenging for staff since they did not have the necessary equipment or personal care materials to care for a dying man, while hospice caregivers had to be brought in from outside the prison.
He noted that the prisoner’s family was only able to visit him in his cell when 50 other prisoners in his wing had been locked in their cells.
His brother, who was also a prisoner in the Midlands prison, was allowed to make separate visits.
“These practical burdens for IPS staff and family would have been unnecessary if Mr. P had had the opportunity to die in a hospice rather than in prison,” said Gilheaney.
The inspector said that IPS had accepted its recommendation that it should introduce a policy that requires the written consent of an inmate to confirm his wish not to be resurrected with the appropriate security measures in place to ensure that such consent was fully informed and provided. freely.
She said the implementation of the recommendation would be monitored in future investigations of deaths in custody.
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