The physician–prisoner relationship is different from the traditional
physician–patient relationship. The physician–prisoner relationship is not a
fiduciary relationship. Legally, it most closely resembles the relationship
between a public health physician and a patient. In both cases, the physician’s
first duty is to the health and safety of the community rather than to the
patient. Prison officials have broad discretion to preserve order in the prison.
Prisoners lose most of their rights to privacy along with their liberty. Prison
officials have a right to any information a physician may obtain that would
affect the health and safety of the prison community.
Although prisoners have little expectation of privacy, they do have an
expectation that their physician will exercise independent medical judgment
regarding the diagnosis and treatment of their medical conditions. The
correctional staff should not be in the position of dictating medical care
decisions. Under no circumstances should access to proper medical care be
used as a disciplinary tool. The prison officials do have the right to ensure that
prisoners do not use untreated illness to avoid prison discipline and that
prisoners’ medical conditions do not interfere with prison order.