48 Chapter 2 I. Security risks The first theme in Figure 2 ‘security risks’, contains cases in which prison staff experienced moral dilemmas related to the safety of either prison staff or prisoners. The subtheme ‘manageability’ is related to prisoners causing a commotion or showing risk of escape. This leads to dilemmas related to the manageability of the situation, and whether the prisoner should be transferred to a special department or not. Dilemmas about whether and how to ‘report’ a possible threat to security are often related to immediate colleagues. For example, should I report a colleague who against the rules decided to remove a prisoner from solitary confinement on her/his own, or should I confront my colleague personally? The subtheme ‘act appropriately when understaffed’ contains dilemmas where situations must be controlled and kept as safe as possible, despite non-ideal circumstances. We mainly encounter staff being on their own with a group of prisoners, wondering about risks and whether to follow or ignore protocols while waiting for assistance from colleagues. E.g., to lock up the prisoners when you are alone with them or continue the daily schedule and take them to the labor department. The final subtheme, ‘breaching professional confidentiality’, is a distinctive category; medical staff experience dilemmas when they see or hear information from prisoners that may pose a safety risk to prisoners or colleagues. (When) Should they breach their code of confidentiality? For example, when a prisoner talks about a fight or when there are signs of the presence of an illegal tattoo needle? II. Working with prisoners Prison staff experience moral dilemmas related to the specific situation of ‘working with prisoners’. In the subtheme ‘coercion and threats’ questions arise whether to give in to prisoners who manipulate or even threaten staff, e.g., when prisoners insist on seeing a doctor. In the subtheme ‘refusal of care’, staff wonder whether to keep offering help to a prisoner who refuses all kind of care. As to dilemmas regarding the ‘degree of independence’ of prisoners, staff question what to allow within specific departments, e.g., can a prisoner call the hospital himself? The subtheme ‘feelings of involvement’ shows staff feeling concern toward prisoners and how far this may reach. For example, should I tell a prisoner about earlier treatment of his father? The subtheme ‘impact on private life’ contains one specific case, about a dilemma of a correctional officer who is in doubt whether to let his young daughter go to a children’s birthday at a former prisoner’s home.