ABSTRACT
This Viewpoint discusses legal provisions guiding health care delivery for incarcerated individuals, the impact of the First Step Act of 2018, and future federal criminal justice reform.
Subject(s)
Criminal Law , Health Care Reform , Patient Protection and Affordable Care Act , Humans , Mental Disorders , United StatesABSTRACT
In teaching and in practice, little attention is given to a low anion gap. This oversight can result in a missed opportunity to diagnose acute or chronic disorders requiring treatment. In this article, we review the constituents of the anion gap, build a differential diagnosis for a low anion gap using case examples, and provide a stepwise approach to diagnostic testing to evaluate this abnormal finding.
Subject(s)
Acid-Base Imbalance , Acidosis , Humans , Acid-Base Equilibrium , Acidosis/diagnosis , Acid-Base Imbalance/diagnosis , Diagnosis, DifferentialABSTRACT
Hospitalized incarcerated patients are commonly shackled throughout their duration of treatment in community medical centers to prevent escape or harm to others. In the absence of overarching policies guiding the shackling of non-pregnant, incarcerated patients, clinicians rarely unshackle patients during routine care. We provide a medical-legal lens through which to examine inpatient shackling, review the limited evidence supporting the practice, and highlight harms associated with shackling in the hospital. We conclude by offering guidance to advance evidence-based shackling practices that prevent physical harm, reduce prejudice towards incarcerated patients, and relinquish reliance on shackles in favor of tailored security measures.
