Prison medical staff
The extent that existing prison medical staff will be involved in the research project, and its effect on the ordinary therapeutic relationship between the doctor and the inmate should be carefully considered. Health services in prisons are usually under considerable pressure, and contact with medical staff is often at a premium. As discussed below, the impact of such factors on the voluntariness of consent should be considered by researchers. Prison medical staff should be aware that there can be a conflict between the role of the researcher and the role of the doctor. The role of the researcher is to produce scientifically robust data, and the role of the doctor is to aid the well-being of the individual inmate. The primary duty of medical staff is to the patient rather than to broader interests such as an increase in scientific knowledge or the wider social good. Prison medical staff must also avoid, directly or inadvertently, using their position and the prestige in which they may be held, to compel or manipulate inmates into taking part in research. The primary role of the prison doctor is to be the inmates' advocate and to help maintain, as far as possible, their physical and mental health.
The relationship, both perceived and actual, between prison medical staff participating in research, and the wider prison authorities may affect the way inmates regard the research programme. Prison health staff have to steer a difficult course between their obligations to prisoners and their obligations to prison staff. These difficulties can also be present when prison health staff are involved in research. Prisoners need to be reassured that the information that they give to researchers is confidential, and will not be passed to prison authorities. As discussed below, the only exception to this general rule is where there is a serious risk to another inmate or to the public good that can be averted by a disclosure of information.
Where prison medical staff are not involved in the research project, researchers should, with the participant's consent, keep them informed of the participant's involvement, and pass on any information necessary for the inmate's continuing care.