Reproductive-Injustice-FULL-REPORT-FINAL-2-11-15

policies
The health policies issued by DOCCS Central Office are contained in two main documents: the
Health Services Policy Manual, which includes all Department policies related to the provision
of health care, and the Women’s Health Primary Care Practice Guideline, a booklet DOCCS first
published in 2000, and updated in 2008 and 2011, which discusses certain health concerns
specific to women. Although this booklet is not comprehensive and does not fully reflect
community standards, it is a positive addition to DOCCS’ policies and signals the Department’s
recognition of the specific health issues facing women in its custody.
Two documents of particular relevance in the Health Services Policy Manual are DOCCS’ Patient
Bill of Rights and DOCCS’ Professional Code of Ethics. Both documents lay out important
information aimed at safeguarding patients and providing quality health care. For example, the
Patient Bill of Rights includes items such as the patient’s right to “considerate and respectful
care,” the right to refuse treatment, and the right to “complete information regarding your
diagnosis, treatment and prognosis in terms you can understand.” 67 The Professional Code of
Ethics contains an impressive list of principles, including that staff should provide services “with
respect for human dignity and the uniqueness of the patient,” and establish “a professional,
trusting relationship with the inmate patient as their health advocate.” 68 It seems, however,
that DOCCS neither monitors adherence to these documents in a consistent fashion nor
imposes any consequences for staff who deviate from them. Additionally, it seems that DOCCS
does not sufficiently inform women about the Patient Bill of Rights, leaving many women
unaware of the document’s existence.
Some of DOCCS’ reproductive health policies are adequate, but others are incomplete and
outdated. Hardly any of the policies reference community standards and some stray from
those standards in key areas. In some cases, such as the starting age for yearly GYN check-ups
and the frequency of prenatal visits, the CA found that DOCCS’ practice is actually in sync with
community standards even though its written policies are not. All of these areas are discussed
in the relevant sections of this report.
Examples of areas where DOCCS has no written policies include:
• Pregnancy tests
• Pregnancy options counseling
• Any pregnancy outcome other than live birth, including abortion, ectopic pregnancy,
miscarriage and stillbirth
• Nutrition for pregnant and nursing women
• Hysterectomies
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