The prison watchdog has expressed serious concern about how an inmate at the Midlands Prison with a terminal illness died in his cell when a hospice setting had been recommended by medical staff.
The Inspector of Prisons, Patricia Gilheaney, said the treatment of terminally ill prisoners in the custody of the Irish Prison Service (IPS) was a very important issue.
A report by the inspector found Justice Minister Charlie Flanagan had approved hospice care for the prisoner, known as Mr P, but no bed was available.
Following his discharge from Portlaoise General Hospital on November 8, 2018, the 47-year-old prisoner remained in the Midlands Prison in Portlaoise where he died six days later - around four months after he was first diagnosed with skin cancer and a year after he was committed to prison.
The IPS informed Ms Gilheaney that there was no community hospice bed available at the time a hospital consultant said Mr P no longer required an acute hospital bed.
A prison doctor had recommended Mr P should have been allowed to stay in Portlaoise General Hospital until a hospice bed was found due to his complex care needs and the inability of the prison medical staff to meet them.
The IPS said the only dignified response it could afford the prisoner in such circumstances was to make the best possible arrangements for him to be nursed in the Midlands Prison.
It said a community palliative care team, as well as extra nursing and healthcare assistant supports on nights, had been put in place.
Continued efforts were made to secure a hospice bed but none became available.
The inspector said a case conference to discuss Mr P's condition, held on October 10, 2018, following his return from a stay in hospital, was a positive planning event at a time when medical opinion considered he had between two and three weeks to live.
However, she noted healthcare staff were concerned that Mr P had not signed any document to confirm his wish not to be resuscitated given their role in the preservation of life.
The inspector said the end-of-life treatment which the prisoner received in the Midlands Prison was commendable.
She pointed out that the prisoner's family were only able to visit him in his cell when around 50 other prisoners had been locked in their cells.
His brother, who was also a prisoner in the Midlands Prison, was allowed to pay him separate visits.