{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:16:54Z","timestamp":1783603014885,"version":"3.55.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:p>Incarcerated persons (IPs) retain the constitutional right to health care, yet they face unique challenges in accessing palliative care (PC) and designating surrogates, especially when incapacitated. We present two cases of hospitalized IPs with life-limiting illnesses who experienced significant barriers in identifying and engaging surrogates. Both cases underscore the effect of delays in communication with surrogates and restricted end-of-life (EOL) visitation due to correctional policies. These delays limited the delivery of optimal interdisciplinary PC and bereavement support. Despite clear legal guidance under the Tennessee Health Care Decisions Act, misinformation and procedural ambiguity among medical and correctional staff impeded timely and appropriate care. Our findings highlight the need for improved institutional policies and training to ensure IPs receive adequate EOL care. Enhanced awareness of legal frameworks, clearer surrogate identification protocols, and collaboration between health care and correctional systems are essential to upholding the rights and dignity of IPs facing serious illness or death.<\/jats:p>","DOI":"10.1177\/10966218251376433","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:13:38Z","timestamp":1773274418000},"page":"700-703","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Bars: Evaluating End-of-Life Care and Surrogate Decision-Making for Hospitalized Incarcerated Persons"],"prefix":"10.1177","volume":"29","author":[{"given":"Zack","family":"Watson","sequence":"first","affiliation":[{"name":"Section of Palliative Care, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Brown","sequence":"additional","affiliation":[{"name":"Section of Palliative Care, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Vyas","sequence":"additional","affiliation":[{"name":"Section of Palliative Care, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Tillman","sequence":"additional","affiliation":[{"name":"Section of Palliative Care, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumi","family":"Misra","sequence":"additional","affiliation":[{"name":"Section of Palliative Care, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA."},{"name":"Tennessee Valley Veterans Administration Medical Center, Geriatric Research, Education and Evaluation, and Clinical Center (GRECC) VISN 9, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Section of Palliative Care, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA."},{"name":"Division of Hematology-Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA."},{"name":"Vanderbilt-Ingram Cancer Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Gatto","sequence":"additional","affiliation":[{"name":"Vanderbilt Institute for Clinical and Translation Research, Vanderbilt University Medical Center, Nashville, TN, USA."},{"name":"Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA."},{"name":"Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohana","family":"Karlekar","sequence":"additional","affiliation":[{"name":"Section of Palliative Care, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Carson EA. Prisons Report Series: Preliminary Data Release. Bureau of Justice Statistics. 2023. Available from: https:\/\/bjs.ojp.gov\/library\/publications\/prisons-report-series-preliminary-data-release"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909118811899"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.5794"},{"key":"e_1_3_2_5_2","unstructured":"U.S. Supreme Court. Estelle v. Gamble 429 U.S. 97 (1976) [Internet]. Justia Law. 1976. Available from: https:\/\/supreme.justia.com\/cases\/federal\/us\/429\/97\/"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.1386"},{"issue":"1","key":"e_1_3_2_7_2","first-page":"119","article-title":"The prisoner in a private hospital setting: What providers should know","volume":"19","author":"Natterman J","year":"2017","unstructured":"Natterman J, , Rayne P. The prisoner in a private hospital setting: What providers should know. Journal of Health Care Law and Policy, 2017; 19(1):119\u2013147.","journal-title":"Journal of Health Care Law and Policy"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/jce2017284308"},{"key":"e_1_3_2_9_2","unstructured":"Tennessee Health Care Decisions Act. 2004."},{"key":"e_1_3_2_10_2","unstructured":"Administrative Policies and Procedures. State of Tennessee Department of Correction. Policy 113.51. 2022. 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