Dying in Prison. Exploration of experiences and needs of prisoners and the reality of care

• Applicant: Professorin Dr. Stephanie Stiel
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 558417502

Background: Caring for prisoners at the end of life goes along with a great responsibility and special challenges due to the vulnerability of this group. In Germany, dying prisoners are usually released from prison prematurely. However, until that point, and in some cases also until they die, they have the need and the right to receive palliative care in custody. In the German prison system, palliative care is not structurally anchored and the lack of routines results in uncertainty in medical staff. There is growing evidence that there are deficits in palliative care of prisoners compared to the public health system, resulting in social disadvantages for prisoners. Gap in knowledge: For the German context, there are hardly any studies on the provision of palliative care in prison and on the perspectives of prisoners at the end of life. Explorative research is needed in order to reveal the field of dying in prison, to identify potential problems and to empirically prove existing needs for action and further research. Aims: The two primary aims of the explorative study are (i) to identify the experiences, needs, and wishes of dying prisoners or those released from prison at the end of life, and (ii) to capture the reality of palliative care in prison. The overall aim of the study is (iii) to determine whether and to what extent there are deficits or unmet needs in palliative care in prison. Methods: The exploratory qualitative study is guided by an inductive logic. To achieve the first aim of the study (i), narrative interviews will be conducted with seriously ill and dying prisoners and those released at the end of life. The interviews will be evaluated using the method of narrative analysis. To achieve the second aim (ii), expert interviews will be conducted with prison internal and -external staff who have already been involved in the care of seriously ill and dying prisoners. Qualitative content analysis will be used for the evaluation. (iii) Finally, the results will be combined to identify deficits and unmet needs. Expected benefits: Within the project, the field of palliative care in prison can be explored with a focus on the perspective of dying prisoners themselves. The study will reveal to what extent there are deficits or unmet needs in palliative care in prison. In this respect, the results of the project can provide a direction for further research, which can finally serve as a basis for improving palliative care.

• DFG Programme: Research Grants