Reclaiming The Right To Privacy:

Ending the Carceral Clinical Encounter

SIGN ON IN SUPPORT!

There is a carceral crisis in American hospitals. Each day thousands of patients' most fundamental medical right, a right to privacy, is ignored. These patients, in the custody of various police agencies, sheriffs’ offices, prison systems, and increasingly Immigration and Customs Enforcement are seen in healthcare settings outside of carceral facilities.

Hospitals have abdicated their responsibility to center the needs and rights of in custody patients, allowing this most sacred medical-legal right - a right to privacy - to be systemically eroded. With little protest, the unquestioned status quo has become a guard, or at times two, stationed permanently in the rooms of in custody patients.

Tens of thousands of clinical encounters take place this way each year. With carceral staff able to see and hear all interactions between patient and providers, any semblance of privacy has been shattered. This elimination of privacy, done under the guise of safety, is not based on a careful weighing of evidence, thoughtful interpretation of the law, or nuanced quality improvement initiative. Rather, it is a result of uncritically following the preferences of carceral agencies. With significant harm to patients and no proven necessity, this practice is exceptional for its departure from standard hospital decision making.

At the core of the issue is subjective interpretation of patient privacy law. While carceral actors claim all in custody patients have lost all rights guaranteed under HIPAA, any reasonable interpretation of the law makes clear that elimination of patient privacy should be a rare exception, not the rule.

Why is this practice allowed to endure? It is only possible due to the sheer dehumanization of those who are criminalized. Labeled as felons, inmates, convicts, and criminals - they are no longer seen as patients first. They are framed as dangerous and manipulative - treated as a risk to be monitored, not a patient to be cared for.

While there are a number of pressing concerns regarding the treatment of in custody patients in healthcare settings, the right to patient privacy stands out as it is fundamental to patient dignity, mutual respect, and the building of a therapeutic relationship.

Here are a few steps hospitals should take to improve the quality of care for patients in custody.

1. Remove all carceral agents from patient rooms.

2. Establish a committee, including formerly incarcerated local community members, to oversee the continued expansion of patient centered practices for in custody patients.

3. Any privacy violation request should be submitted with clear rationale to the in custody care committee, making infringements the rare exception not rule.

4. Clear and transparent data collection to ensure policies are based on evidence, not carceral preferences.

Enough is enough - Let’s reclaim the clinical encounter and end the carceral creep into our hospitals.

Sean Stielow, MD, MPH candidate - Atlanta, GA

Elizabeth Nguyen, MD candidate - Scranton, PA

Nora Singh, MPH, MD candidate - Atlanta, GA

Natalie Sanchez Farez, MD - Atlanta, GA

Kamron Woods, MD, PhD Candidate - Decatur, GA

Talia Coopersmith, MD Candidate - Atlanta, GA

Mandy Feenstra, MD Candidate - Atlanta, GA

Isabella Siesel, MD Student - Atlanta, GA

Daniel Resnick, MD - Boston, MA

Supriya Jain, MD Candidate - Atlanta, GA

Elikplim Akaho, MD - Boston, MA

Arielle Lawson, MD - Minneapolis, MN

Nabojeet Das, MD candidate - Atlanta, GA

Elizabeth Beveridge, MD candidate - Atlanta, GA

Margot Sarkozy, MD candidiate - Atlanta, GA

Rebecca Clyburn, MD Candidate - Atlanta, GA

Tate - MD candidate, Atlanta, GA

Ruby Ladd, MD - New York, NY

Kemi Oladuja, MD - Philadelphia, PA

Michael Sportiello, MD, PhD - Atlanta, GA

Alaura Cunningham, MD Candidate - Atlanta, GA

Tamia Ross, MD Candidate - Atlanta, GA

Liam Hackett, MD candidate - Atlanta, GA

Amy Spencer, NP - Pineville, NC

Alyssa Greenhouse, MD, MPH - Atlanta, GA

Mia Hurts, MPH - Atlanta, GA

Mihir Chaudhary, MD - Atlanta, GA

Natalie Gresham, MD - Atlanta, GA

JP Mikhaiel , MD - New Haven, CT

John Pollack, MD - Baltimore, MD

Sophia Ma, MD candidate.- Atlanta, GA

Joseph Roberts, DO - Suwanee, GA

Myriam Shehata, MD - Atlanta, GA

Daniel Kim, MD - Atlanta, GA

Maya Karkare, MD Student - Atlanta, GA

Amy Zeidan, MD - Atlanta, GA

Vida Lugo, MD Candidate - Atlanta, GA

Ben Maxey, MD - Atlanta, GA

Colleen Tope, PA - Atlanta, GA

Zachary Lakkis, MD - Atlanta, GA

Morsal Tahouni, MD - Charleston, SC

Nell Hawkins, MD - Aurora, CO

Joan Chen, MD - Oakland, CA

Ify Ogu, MD Candidate - Atlanta, GA

Joseph Richardson, PhD - College Park, MD

Zizi Ohamadike , MD candidate - Atlanta, GA

Mishka Terplan, MD - Washington DC

Abhi Kole, MD - Atlanta, GA

Mercy Olowoyo, MD Candidate - Atlanta, GA

Sophie Harris, MPH - Atlanta, GA

Judy Fustok, MD - Baltimore, MD

Michael Liska, MD - Washington, DC

Zain Khalifeh, MD - Los Angeles, CA

Rachel Drummey, MD - Washington, DC

Harris Jamal MD, MPH - Atlanta, GA

Ariyaporn Haripottawekul, MD - Atlanta, GA

Richard Vuong, MD - Atlanta GA

Adiva Ahmad , MPH - Atlanta, GA

Ally Rosenthal, MD - Atlanta, GA

Hannah Weisman, MD Candidate - Atlanta, GA

Kaitlin Piper PhD, MPH - Atlanta, GA

Fatima Rahim, MD - Atlanta, GA

Ella Leeth, MD Candidate - Atlanta, GA

Janhavi Dubhashi, MD MPH - Atlanta GA

Teresa Durham, MD - Atlanta, GA

TaRessa Wills, MD - Atlanta, GA

Peter Kim, MD - Atlanta, GA

Rachel Mather, MD - Atlanta GA

Maggie Sullivan, FNP-BC, DrPH - Boston, MA

Annie Peacock MD, MSW - Atlanta, GA

Owen Cooper, MD Candidate - Atlanta, GA

Wendi Ehrman, MD - Milwaukee, WI

Andres Camacho-Gonzalez, MD - Atlanta, GA

Anna Stone, MD Candidate - Atlanta, GA

Michaela Whitelaw MD, MPH , Chicago, IL

Marisol Cora, MD-PhD Candidate - Atlanta, GA

Samira Asseh, MD Candidate - Atlanta, GA

Caitlin Nygren, MD Candidate - Atlanta, GA

Amy Hunt, MPH - Grand Rapids, MI

Rachel Eloy, MPH - Atlanta, GA

Sarah Paprotna, BS - New Haven, CT

Victoria Ostebo, MPH - Atlanta, GA

Kaitlin Dang, MPH - Lilburn, GA

Mackenzie Hines-Wilson, MD Candidate - Decatur, GA

Emily Pinto Taylor, MD - Atlanta, GA

Katerina Saker, MD - Atlanta, GA

Mikhail Akbashev, MD -Atlanta, GA

Nirisha Commodore, MD - Atlanta, GA

Anjuli Shah, MD - Ann Arbor, MI

Ashley Urrutia, MD, MPH - Atlanta, GA

Amelia Baxter-Stoltzfus, MD, MA - Albuquerque, NM

Renae Badruzzaman, MPH - Durham, NC

Emily K, NCMA, CPC - Los Angeles, CA

Natalie Bornstein, MSW, LCSW - Portland, ME

Sebastian Horbulewicz, MD Candidate - Atlanta, GA

Anjali Kunavarapu, MD Candidate - Atlanta, GA

Graciela Razo - Brooklyn, NY

Jacquel Clemons , MPH - Atlanta, GA

Robert Wright, MSW - Atlanta, GA

Willow Cox, MD Candidate - Columbus, OH

Amritha Gourisankar, MD, MPH - Minneapolis, MN

Toby Terwilliger, MD - Atlanta GA

*Signatures updated weekly

Atsuko Koyama, MD, MPH - Phoenix, AZ

Alex Galloway, MD - Atlanta, GA

Sarah Torzone - MD, PhD Candidate - Atlanta, GA

Jordan John Lee, MD, PhD Candidate - Atlanta, GA

Sarah Wishloff, MD candidate - Atlanta, GA

Emily Graul, MD, PhD - Atlanta, GA

Jenna Heath, MD - Modesto, CA

Sakshi Dureja, MD - Atlanta, GA

Morgan Banks, MD - Atlanta, GA

Terrence Harris, MD - Atlanta, GA

Myriam Shehata, MD - Atlanta, GA

Hunter Block-Beach, MD Candidate - Cleveland, OH

Esme Trahair, MD MPH - Atlanta GA

Lane Kantor, MD, MPH - Philadelphia PA

Vivek Prasad, MD - Atlanta, GA

Emily K, NCMA - Los Angeles, CA

Lizeth Carrillo, MD, MPH - Los Ángeles, CA

Isabella Duan, MD Candidate - Los Angeles, CA

Amanuel Shitaye, MD - Springfield, VA

Hridaya Shah, MD Candidate - Augusta, GA

Zahra Khan, MSc - Arlington, Virginia

Karissa McCright, MD Candidate - Atlanta, GA

Advaith Subramanian, MD Candidate - Atlanta, GA

Grace S, BS - Los Angeles, CA

Alice Cai, MD Candidate - Los Angeles, CA

Megan L Schultz, MD - Milwaukee, WI

Kieran Kristensen, MD - Atlanta, GA

Bianca Tocci, PhD - Milwaukee, WI

Lauren Burgunder, MD - Wauwatosa, WI

Michelle Pickett, MD, MS - Milwaukee, WI

Claire Nussbaum, MD - Los Angeles, CA

Vi Nguyen, MD - Los Ángeles, CA

Aastha KC, MD Candidate - Atlanta, GA

Emma Lindemann, MD - Georgia

Megan Lucas, MD - Milwaukee, WI

Danielle Pitter, MD - Atlanta, GA

Sydney Erickson, MD - Atlanta, GA

AnnaClaire Osei-Akoto, MD - Atlanta, GA

Benjamin Zhu, MD - Atlanta GA

LaSara Bell, DO - Atlanta, GA

James Lioi, MD - Tucson, AZ

Samantha Bindner, MD - Atlanta, GA

Sahar Almansoori, MD - Atlanta, GA

Nicole Barcega, DO - Chula Vista, CA

Marlene MelzerLange, MD - Milwaukee WI

Lydia Watts, JD, MPH - Baltimore, MD

Evan Czulada, MD, Atlanta, GA

Andrea Zhang, MD - Atlanta GA

Ellie Murray, MN, RN - Portland OR

Beatriz Gonzalez, BSN, RN, PHN - Huntington Park, CA

Aakilah Brown, MD - Atlanta, GA

Maya Younker, MD - Atlanta, GA

Aminat Adewumi, MD - Atlanta, GA

Anna Bagley, MD Candidate - Atlanta, GA

Ryan Kann, MD , Candidate - Atlanta, GA

Meha Joshi, MD, MPH - Atlanta, GA

Marshall Fleurant, MD - Marietta, GA

Anish Sangari, MD - Atlanta, Georgia

Ivie Tokunboh, MD MPH - Decatur, GA

Matt Hing, MD-PhD Candidate - Los Angeles, CA

Ian Tamargo, MD - Atlanta, GA

Anwar Osborne, MD - Decatur, GA

Isabelle Blanchard, MD Candidate - Atlanta, GA

Emily Nagourney MD, MPH - San Diego, CA

Sarah Benett MD, MS - Washington, DC

Ruta Seitz, MD Candidate - Atlanta, GA

Joseph Kahn, MD Candidate - Atlanta, GA

India Hetherington, MD Candidate - Atlanta, GA

Juan Pablo Armes, MD Candidate - Atlanta, GA

Seth Cohen, MPH - Decatur, Georgia

Adam Krupick, BS - Gainesville, FL

Jasmin Jalali-Yazdi, PA - Oakland, CA

Shireen Jalali-Yazdi, JD - Seattle, WA

Andrea Abi-Karam, MD Candidate - Atlanta, GA

Danielle Reid RN, MD - Atlanta, GA

Brittany Brown, DO, MPH - Atlanta GA

Sudarshan Krishnamurthy MD, PhD Candidate Winston-Salem, NC

Laura Massarelli, MD - Atlanta, GA

Madeline Brown, MD - Atlanta, GA

Teresa Valencia, MD, MPH - Atlanta, GA

Lily Steele—Dadzie, MD - Philadelphia, PA

Scott Eisenberg, MD - Atlanta, GA

Anastasia Kolousek, MD - Atlanta, GA

Anna Rappaport, MD Candidate - Atlanta, GA

Maureen Ubani, MD - Atlanta, GA

Anna Jevtic, MD - Atlanta, GA

Sahar Alizada, MD - Atlanta, GA

Kaylajenna Dobin, MD - Atlanta, GA

Maria Krakovski, MD - Atlanta, GA

Zoe Merchant, MD Candidate - Atlanta, GA

Rob Shvarts, MD, MPH Candidate - Atlanta, GA

Christopher Lembo, MD Candidate - Atlanta, GA

Jonathan Jacques, BA - Cleveland, OH

Roberta Meyers, MS - Riverdale, GA

Kamron Woods, MD, PhD Candidate - Atlanta, GA

Marin McCoy, MD Candidate - Atlanta, GA

Zachary Lakkis, MD - Atlanta, GA

Max Silzle, MD Candidate - San Diego, CA

Molly McShane, CNM, WHNP - Philadelphia, PA

Christine Knight, MD - Chicago, IL

Madison de los Reyes, MD Candidate - Atlanta, GA

Erica Mattingly, MSW, LICSW - Seattle, WA

Amber Walker, MA - New Orleans, LA

Additional Supporting Organizations