How Should Physicians Manage Traumatic Injuries Sustained During Incarceration?

Patients who are incarcerated experience severely restricted autonomy and are thus extremely vulnerable. This commentary on a case offers longitudinal, long-term postsurgical trauma-informed care recommendations and starts with a working assumption that, when injuries sustained during incarceration require surgery and hospitalization, patients' rights to evidence-based standard of care that would be given to any other patient should not be compromised. Yet surgical care of traumatically injured patients who are incarcerated can be ethically and clinically complex due to their status as wards of the state, which abrogates their liberty to make their own health decisions. Patients who are incarcerated also have preexisting trauma and are at risk for violence and persistent traumatic stress.