[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-422136-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-422136-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","incapacitated-incarcerated-patients-who-should-decide-for-them","Incapacitated, Incarcerated Patients: Who Should Decide for Them?","","Carceral healthcare systems face mounting challenges as the incarcerated population ages. Elderly patients are far less able to make their own medical decisions, creating a need for surrogate decision-makers in roughly 70% of cases. Prison officials serve as surrogates for about half of decisionally incapacitated incarcerated patients, while twelve states prohibit this role. The analysis evaluates qualities of appropriate surrogates—care, lack of conflicts of interest, and knowledge of patient wishes—and argues prison officials do not best meet these standards.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/incapacitated-incarcerated-patients-who-should-decide-for-them/422136/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/incapacitated-incarcerated-patients-who-should-decide-for-them/422136.png","ImageObject",300,407,{"name":42,"@type":43},"Franzy","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Why are surrogate medical decision-makers needed for many incarcerated patients?","Question",{"text":62,"@type":63},"Aging increases the likelihood that patients cannot make their own medical decisions, creating a need for surrogates in about 70% of cases.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How often do prison officials currently make medical decisions for incapacitated incarcerated patients?",{"text":67,"@type":63},"Prison officials participate in medical decision-making for about 50% of decisionally incapacitated incarcerated patients.",{"name":69,"@type":60,"acceptedAnswer":70},"What approach is recommended when no surrogate is available?",{"text":71,"@type":63},"Healthcare teams should rely on guidelines used for non-incarcerated, unrepresented patients, including decision-making by consensus among multiple physicians and ethics committee involvement.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},422136,1791612719,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":30,"preview_page_count":4},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Innovation in Aging, 2025, Vol. 9, No. S2 61  \nAbstract citation ID: igaf122.200  \nINCAPACITATED, INCARCERATED PATIENTS: WHO  \nSHOULD DECIDE FOR THEM?  \nAnurima Chattopadhyay, and Daniel Karel, National Institutes of Health, Bethesda, Maryland, United States  \nThe carceral healthcare system is reckoning with a rapidly aging patient population. This increase poses significant challenges because elderly patients are much less likely to be able to make their own medical decisions, requiring a surrogate decision-maker in about 70% of cases. Currently, prison officials–such as wardens or prison guards–are involved in making medical decisions for about 50% of decisionally incapacitated, incarcerated patients. In contrast, twelve states prohibit prison officials from serving as surrogates for incarcerated patients. This discrepancy highlights the need to more thoroughly examine which parties are appropriate surrogates for incarcerated patients. We consider what qualities make an appropriate surrogate decision-maker. They would, ideally: care about the patient, not have conflicts of interest, and know the patient’s interests and wishes or be otherwise trained to make surrogate decisions. We ultimately determine that prison officials do not best fit these criteria. We then explore alternative approaches that better protect both incarcerated patients and prison officials.  \nWe advocate for efforts to raise the rate of advance medical planning amongst incarcerated individuals; currently less than 1% of incarcerated individuals have filled out an advance directive. Healthcare teams should also work to involve incarcerated patients’ families (when appropriate) by addressing issues with security and travel that may prevent them from serving as surrogates. Lastly, when incarcerated patients have no available surrogates, we suggest healthcare teams rely on the relevant guidelines for non-incarcerated,‘unrepresented’ patients, where decision-making often requires consensus amongst multiple physicians and the involvement of an ethics committee.","cbCaivc59e5nWrBg","https://ap.wps.com/l/cbCaivc59e5nWrBg","pdf",115063,"English","# Background and problem\n## Surrogate decision-maker needs in aging incarcerated populations\n# Evaluation of surrogate suitability\n## Criteria for appropriate surrogates\n## Why prison officials may not fit\n# Alternative approaches\n## Increasing advance medical planning\n## Involving incarcerated patients’ families\n## Using guidelines for unrepresented patients and ethics support","[{\"question\":\"Why are surrogate medical decision-makers needed for many incarcerated patients?\",\"answer\":\"Aging increases the likelihood that patients cannot make their own medical decisions, creating a need for surrogates in about 70% of cases.\"},{\"question\":\"How often do prison officials currently make medical decisions for incapacitated incarcerated patients?\",\"answer\":\"Prison officials participate in medical decision-making for about 50% of decisionally incapacitated incarcerated patients.\"},{\"question\":\"What approach is recommended when no surrogate is available?\",\"answer\":\"Healthcare teams should rely on guidelines used for non-incarcerated, unrepresented patients, including decision-making by consensus among multiple physicians and ethics committee involvement.\"}]","Incapacitated, Incarcerated Patients: Who Should Decide for Them? | PDF",1790626316]