Deaths into prisons: experience of the Institute of Legal Medicine of Milan from 1970 to 2008

The health of imprisoned population is not only a ‘political issue’ and neither a technical or medico-legal problem, but the ground on which we measure and compare the degree of evolution of that complex or rules known under the name of penal system. We therefore found interest to carry out a scientific work on the deaths which occurred in prisons, when judges always order autopsy and therefore of cases who are examined at the Institute of Legal Medicine of the University of Milan. Our analysis focuses on imprisoned subjects who died in four prison structures of Milan ad surrounding area. Imprisoned subjects also at home jail or under police supervision during hospitalizazion into a civil hospital were also considered. Among 55.699 necroscopy performed at the Institute of Legal Medicine of the University of Milan during 38 years of observation from jannuary 1970 to December 2008, imprisoned subject died for any reason were. Specifically: 197 cases were due to violence death (133 suicides, 13 homicides, 12 death for accidentaly reason, 39 acute heart failure suspect to be due to drug abuse). 171 were due to natural reasons. (53,5% of total) whereas in 171 cases it was attributable to natural causes (46,5% of total). Among the violent causes suicide deserves particular attention since it was the second cause of death after all natural causes, corresponding to 36,1% of total cases. In this study the incidence and the reasons of death into prison will be discussed and carefully analyzed. One of the more relevant finding is the higher incidence of death in jail due to violence when compared to natural reasons. Of particular importance is also the problem of death related to drug abuse. Finally, our results seem to offer clues that deserve reflection and useful elements in order to implement a correct and an effective protection of imprisoned subjects' health.