"Dying in Prison: End-of-Life Care Services in a State Correctional Facility" (by Brooke Colley Webb, Mollee K. Steely Smith, and Tusty ten Bensel): Review 4

Overall, the article “Dying in Prison: End-of-Life Care Services in a State Correctional Facility” adds to our limited knowledge base on the practical implementation of End-of-Life (EOL) care for aging correctional populations using primary data collected from correctional and medical professionals in a state prison. While research examines ethical, legal, and medical considerations surrounding EOL care within corrections, few studies provide detailed information about implementation as it is contextualized within the prison environment. Webb and colleagues’ use of correctional and healthcare provider perceptions of relevant implementation components (inclusion criteria, services, challenges, and future directions) of EOL services highlight important policy implications (e.g., increased formal training for officers). The following suggestions are provided to improve the manuscript through increased engagement with the existing literature on EOL care in prisons within the literature review and discussion sections.

On page 6, The first paragraph of the “Barriers to EOL Care Treatment in Prison” summarizes the following common barriers to successful implementation, “…mistrust between staff and inmates, potential misuse of pain medications, understaffing and safety concerns, and negative public attitudes toward compassionate end of life care for the prison population…” While the remainder of the section delves into the role of staffing and agency collaboration, the other barriers are not unpacked in similar ways. Additional examples or explanations of how issues of mistrust or safety concerns might compromise the quality of EOL care could be included here. Given that some of the participants in the study acknowledged the potential for PREA violations.

Within the “Discussion” section, little reference is made to research mentioned in the literature review revolving around various implementation themes. Comparing the current findings to prior research on this topic would clarify and strengthen the suggested policy implications.