Specific content areas and special populations.

The United States has one of the highest incarceration rates in the world. Carceral status can complicate clinical encounters in community and academic settings for an already medically vulnerable population. While it is likely physicians will encounter patients experiencing incarceration in their practice, there are few educational opportunities dedicated to ensuring delivery of healthcare that protects patient dignity, autonomy, and privacy. Professional medical associations can play a role in filling this physician knowledge gap. The goal of this analysis is to catalogue and analyze the current landscape of official medical association documents addressing healthcare of people experiencing incarceration. A systematic Internet search was conducted of American Medical Association House of Delegates associations and their existing documents. Out of 116 associations included in the systematic search, 16 groups published materials on incarceration. From these 16 associations, 44 documents were identified and coded thematically. Documents served four main purposes: education on incarceration (28/44), clinical guidance (25/44), logistical guidance (27/44), and policy advocacy (30/44). Common topics included medical conditions of people experiencing incarceration, patient factors antecedent to incarceration, and specialty or population-specific information. Few medical associations have published material on incarceration and the paucity of pragmatic clinical guidance was particularly pronounced. A lack of resources from medical associations can lead to variability and lapses in best healthcare practices when treating patients experiencing incarceration. Medical associations should consider developing guidance for clinicians to maximize this patient population’s autonomy and dignity.

美国是全球监禁率最高的国家之一。监禁状态会使本就属于医疗脆弱群体的人群，在社区与学术医疗场景中的临床诊疗过程变得更为复杂。尽管医师在执业过程中大概率会接触到处于监禁状态的患者，但目前鲜有专门的教育项目，以确保医护人员能够提供守护患者尊严、自主权与隐私权的医疗服务。专业医学协会可在填补医师这一知识空白的过程中发挥重要作用。本分析旨在对当前针对监禁人群医疗照护的官方医学协会文件现状进行系统编目与分析。研究人员针对美国医学协会（American Medical Association）众议院代表团下属的医学协会及其现有文件开展了系统性网络检索。在本次系统性检索纳入的116家协会中，仅有16家发布了与监禁相关的材料。研究人员从这16家协会中共筛选出44份文件并进行主题编码。这些文件主要涵盖四大类用途：监禁相关教育（28/44）、临床诊疗指南（25/44）、后勤保障指南（27/44）与政策倡导文件（30/44）。常见议题包括监禁人群的健康状况、监禁前的患者相关风险因素，以及针对专科或特定人群的专属信息。目前仅有极少数医学协会发布了与监禁相关的材料，且务实性临床指南的匮乏尤为突出。医学协会的资源缺失可能导致在治疗监禁状态患者时，最佳医疗实践出现执行差异与疏漏。医学协会应考虑为临床医师制定相关指南，以最大化保障该患者群体的自主权与尊严。