2022: Disproportionate restraint of detainees and prisoners in medical centers

On November 23, 2022, the annual conference of the Patient Rights Association took place at Cinema City in Glilot.

During the conference, the Health Minister's Award for rights promoters in the healthcare system was granted.

In the honorable second place was Professor Dan Turner, whose candidacy we submitted for his activities on behalf of our Ethics committee and the Israel Nurses' Organization.

Professor Dan Turner, Deputy Director of the Shaare Zedek Medical Center in Jerusalem, was and remains the driving force behind one of the major and important projects of the Ethics committees of the Israeli Medical Association and the Israel Nurses' rganization – the fight against the disproportionate shackling of prisoners and detainees within the walls of hospitals in Israel.

The shackling of prisoners and detainees brought for medical treatment is done systematically, in almost 100% of cases, so it is clear that individual assessments as required by law and regulations are not being conducted.

Professor Turner witnessed this phenomenon, which unfortunately affects every medical institution, he showed great vigilance and resourcefulness, and could not stand idly by. He turned to the Ethics committees and enlisted their support for a determined fight against the phenomenon.

For the past two and a half years, the Ethics committees, led by Professor Turner, have been working in collaboration to address this improper practice.

Fourteen medical centers across the country have been enlisted to participate in the effort and collect data on prisoners and detainees arriving shackled for treatment and hospitalization.

It is clear to all that proper shackling should be done in specific cases where there is a danger to or from the prisoner, and in a way that minimizes damage to their medical treatment and recovery. Unfortunately, this is not the case in practice, and many patients receive treatment and even spend extended periods hospitalized while shackled in a disproportionate and even inhumane manner, for instance, by being shackled to a bed by hand and foot diagonally, with no ability to move or turn in bed.

Under Professor Turner's leadership, the Ethics Offices held meetings with representatives from the Ministry of Health, including the Director General of the Ministry, who supported the initiative and assisted in providing guidance for nurses in hospitals to collect data in an organized manner. Additionally, recurring meetings were held with representatives from the Ministry of Public Security, the Ministry of Justice, the police, and the Israel Prison Service. Information sheets, articles, and reports on the subject were also published.

Thanks to the significant and important actions taken, and the extensive data collected from various medical centers, the Israel Prison Service recognized the importance of the issue and developed a revised procedure to reduce the number of shackled patients.

The graph below shows that following the pressure applied and the change in the Prison Service’s procedure, there was indeed a decrease in the rate of shackling. However, after the escape of prisoners from Gilboa Prison, the rate of shackling increased again.

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(The sharp rise following the event emphasizes, in our opinion, that this is not a high rate of shackling due to individual dangerous assessments but rather a result of a general desire to prevent escape by the “easier” method, even though it involves widespread harm to the shackled individuals.)