A Decision Making Case: Ethics in Prison Psychology Practice

Describe the ethical issue that you identified from this case study:

Case Study
You are a staff psychologist working in a medium security prison. You have just returned back to work after six weeks of paternity/maternity leave and you meet with your supervisor, the chief psychologist of the facility. She informs you she is going on two weeks of leave the following day and you will be left in charge. She briefs you about many things; the most important concerning an inmate she had placed on suicide watch three weeks earlier. He cut his wrist and had to be taken to a hospital outside of the prison over-night due to the seriousness of the cut. She informs you that to meet policy requirements the inmate will need to be seen by a psychologist each day he continues to be on suicide watch. She tells you the inmate is manipulative and is threatening to "kill" himself if he is transferred to a segregated housing unit (the hole). She reports the inmate has a long history of manipulative suicidal gestures to obtain what he desires.

The following week you go to see the inmate for the first time and when you ask him if you can do anything for him he states, "Give me a razor so I can kill myself." He is in a cell with nothing but a tear-proof blanket and smock. He then refuses to talk to you any more that day. As you continue to see the inmate on a daily basis that week he starts to talk to you. He has many complaints including not being allowed to take a shower. Policy requires that an inmate should have a shower at least every three days, but the chief psychologist wrote orders that stated he should not receive a shower while on suicide watch. The inmate knows the policy and is stating he will sue the chief psychologist. You also find out that week from many staff members you know and trust that the inmate angered a staff member by not saying hello to her. In response, the staff member had the inmate sent to segregated housing (the hole) for "insubordination." The inmate became angry, refused to go to segregated housing, and subsequently cut his wrist leading to his hospitalization and subsequent placement on suicide watch. By being direct and honest with the inmate you earn his trust over a week and-a-half. Mid-way through the second week you are present when a mid-level manager (non-psychology staff) admits to the inmate that staff were wrong for locking up the inmate in the first place. However, the manager tells the inmate he is going to have to "do time in segregation" for being disruptive when initial attempts were made to put him in segregation. He tells the inmate if he agrees to go to segregation, the inmate will only stay for 10 days and then be released to a different housing unit away from the staff member he refused to greet several weeks earlier. The inmate's response is he will not spend "10 seconds" in segregated housing because he did nothing to deserve punishment. He also states repeatedly to you that if he is taken to segregated housing "you all will be carrying me out of there in a box. I don't give a . . . I'll be dead!!!" You strongly believe he will engage in serious self-harm if placed in segregated housing. However, the inmate states he is more than willing to return to regular housing away from the staff member he refused to greet several weeks earlier.
Later that day the warden of the facility discusses this inmate with you in an open staff meeting. He not so subtly says he feels the inmate should not be on suicide watch. You know from past history the warden is concerned about paying staff members 24 hours a day to watch this inmate. You feel he does not want to continue to pay over-time, but he doesn't actually say so. He continues to put pressure on you to take the inmate off of suicide watch. What do you do? How do you respond to the warden?

Describe two possible solutions to the problem presented.
Explain at least one consequence associated with each solution.
Briefly describe the one solution you would use from the two you previously identified and explain why you think this is the best course action for this particular situation.
Share your insights or draw conclusions on the value of using an ethical decision making model to address ethical issues.