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Another kind of life sentence

Yesterday I was asked to consult on a young boy of 20 who has chronic kidney disease and has been on hemodialysis for a few months. Why do I tell this, you may wonder? The point is that this guy is in jail, and I went to visit him there, Regina Coeli, an old prison in Rome.

Every other day he leaves the prison, handcuffed, escorted by three or more guards, on a armored car, and he goes to the hospital for his dialysis session.

I don’t have a solution for this young man. I have no doubt that if he is there, I mean in jail, there should be a sound reason. But as a physician I am really in trouble to accept that a frail patient like him is in such a condition.

During the last few months he has lost 18 kg, and is clearly malnourished. I doubt that a young man in jail gets the kind of food that a person on dialysis should eat. In a few months, he had two episodes of central venous catheter infections. Not a surprise if you live in an overcrowded place where the sanitary conditions are well below the expected standards. He has a living related donor who wishes to give him a kidney. I immagine how safe it would be to keep a young patient on chronic immunosuppressive therapy in such an environment. I don’t question that he deserves a sentence, I am not sure that he deserve an almost life-sentence.

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