The Limits of Equivalence

This article, from the International Journal of Prisoner Health, documents the difficult decisions health care providers face as countries have increasingly turned to detention as a means for drug treatment over the past decade. Under this model, particularly prevalent in much of Asia, people suspected of using drugs are often rounded up on suspicion or a positive urine test, and imprisoned without due process or means of appeal. Inside, detainees frequently receive no effective drug treatment, little medical care, and insufficient food. Indeed, they are more likely to face what amounts to torture—cruel, inhuman, and degrading treatment. This includes, in certain countries, being forced to work or risking severe punishment.

Organizations that provide health care, food, or education within such institutions must fully consider whether their assistance is legitimizing an abusive system or even building its capacity to detain more people. In this paper, the authors supply the tools needed for practitioners to evaluate the ethical risks versus the humanitarian benefits of their aid.