ETHICS, LAW, AND MEDICINE Dementia in prison: ethical and legal implications

As the number of elderly prisoners increases in the UK and other Western countries, there will be indi-viduals who develop dementia whilst in custody. We present two case vignettes of men with dementia in English prisons, and explore some of the ethical implications that their continuing detention raises. We find little to support their detention in the various purposes of prison put forward by legal philoso-phers and penologists, and conclude by raising some of the possible implications of The Human Rights Act 1998. There are about nine million people held in penalinstitutions around the world. America now detains overtwo million persons in custody (a rate of 680 per 100 000 population), and there are about 65 000 people in prisons in England and Wales (a rate of 125 per 100 000).1 These numbers are projected to rise, and the British government expects there will be another 18 000 prisoners by 2007. The number of elderly prisoners is also rising. There are now more than 1 000 men aged 60 and over in English and Welsh prisons, more than three times the level of a decade ago.2 The proportion of elderly compared to younger adults in prison