About Us

Scopes and Shields was created out of our team’s shared interest in helping providers in health care lift up all of our patients, including those in law enforcement custody or experiencing incarceration.
These vulnerable patients face discrimination when accessing and receiving health care, as well as violations of their privacy and confidentiality, disregard for their autonomy in health care decision making and inappropriate use of shackles in certain health care situations. These practices further chip away at our patients’ dignity and personhood and are far too common. These practices are also unlikely to change if unchallenged by clinicians. Those challenges will only occur if providers and patients are aware that these practices are happening and have the skills and tools to address them. We hope that this site will increase awareness of the issues affecting these patients and educate the providers caring for them.
We do not endorse disregarding rules that are in place to keep health care professionals safe. In some circumstances, patients pose a risk to health care providers, staff, visitors, or themselves, justifying the use of restraints and a continuous law enforcement presence at the bedside. In other circumstances, when these practices are in place out of habit or policy, rather than necessity, our patients are deprived of the full benefits of the care they need and deserve.
This website cannot provide answers to address the nuances of every circumstance you may encounter. Please consider it a general call to question what is necessary and appropriate.
While we have legal experts among us, Scopes and Shields is first and foremost created by health care providers for our colleagues. We ourselves have struggled to find guidance on the care of incarcerated patients in non-correctional settings. Our Q&A pages are derived from real dilemmas and challenges we have faced at the bedside or questions posed to us by colleagues. We think of this as a “2 AM” resource; a place to share foundational knowledge and provide ground-level guidance and practical tips for navigating interactions with law enforcement officers.

A note on person-first language

You will notice that throughout our materials we refrain from using common terms like “prisoner” and “inmate”, which define individuals by their current criminal status rather than who they are to us: our patients.
Language that foregrounds a person’s criminal history immediately focuses the health care team’s attention on the worst moment of a person’s life. This is stigmatizing and invites judgment, or even the devaluation of that life. In the health professions we are called to heal, and to serve each individual with dignity. We invite you to join us in adopting person-first language for justice-system-involved patients.

Our Team

Bruce L. Adelson, Esq.

Federal Compliance Consulting
CEO/Attorney at Law

Bruce L. Adelson, Esq., is CEO of Federal Compliance Consulting LLC. He is a former U.S Department of Justice (DOJ) Senior Trial Attorney.  During Bruce’s federal career, he was responsible for enforcing many federal laws, including Title VI of the Civil Rights Act of 1964, which requires federally funded organizations and governments to provide language access for limited English proficient (LEP) people. At DOJ, Bruce had responsibility for enforcement and the enactment of federal policy.  For example, Bruce approved for Federal Register publication the U.S. Department of Transportation’s Policy Guidance Concerning Recipients’ Responsibilities to Limited English Proficient Persons. 

In private practice, Bruce has assisted and consulted with local and state governments, non-profits, courts, law enforcement agencies, and many of the largest health care systems in the United States. He has assisted health care and government clients negotiate ADA and Title VI resolution and compliance agreements with the U.S. Department of Justice, U.S. Department of Health & Human Services (HHS), Federal Aviation Administration, and Federal Transit Administration.

Professor Adelson is a faculty member at Georgetown University School of Medicine and University of Pittsburgh School of Law where he teaches implicit bias in health care, civil rights, cultural awareness, and organizational culture. He has also taught at Harvard, Cornell, and Auburn Universities, The Johns Hopkins University School of Public Health, and University of Baltimore School of Law. He is the Americans with Disabilities Act (ADA) Consultant to the Idaho Supreme Court and the New Mexico Administrative Office of the Courts.

He has been the keynote speaker and trainer about the ADA, Title VI, Affordable Care Act, HIPAA, federal compliance, implicit bias, organizational culture, federal civil rights laws and more for: Kaiser Permanente; Memorial Hermann Health System; Memorial Health System; Minnesota Hospital Consortium; University of Minnesota; Minnesota Department of Health Services; Washington Department of Children, Youth, and Families; Region V Systems; Vizient Southeast; Sentara Health System; Greater Manchester Mental Health Center; Frederick Memorial Hospital; Kaleida Health; Moffitt Cancer Center; Northern Inyo Hospital; Advocate Christ Medical Center; Olympic Medical Center; City of Loveland (CO); City of Pittsburgh; City of Houston; Wayne County (MI) Airport Authority; Columbus (OH) Airport Authority; City & County of Honolulu; and National Association of Counties.

Bruce holds a BA in International Studies from The Johns Hopkins University and a JD from The University of Pittsburgh School of Law.  He is licensed to practice law in the District of Columbia, Maryland, Michigan, and Virginia (inactive).  He is licensed to practice before many federal courts and the U.S. Supreme Court.

Kathleen Akgün, MD, MS

Yale School of Medicine
Associate Professor

Dr. Kathleen Akgün is a board-certified physician in pulmonary medicine, critical care and hospice and palliative medicine. She is a health services researcher with particular research interests in outcomes and health disparities in pulmonary medicine, critical care and palliative care.

She has done extensive epidemiologic work determining MICU admission and outcomes for persons aging with HIV and the impact that living with alcohol use disorder and other substance use disorders have on health outcomes. She is an advocate for health care equity through enhanced access to and delivery of evidence-based medicine for patients in the United States and around the world.

David Chooljian, MD, JD

Loma Linda University
Associate Professor of Pulmonary and Critical Care Medicine
Academic Educator in Medical Ethics

Dr. David Chooljian is an Associate Professor of Pulmonary and Critical Care Medicine and an Academic Educator in Medical Ethics at Loma Linda University. He obtained his undergraduate degree in Anthropology from UCLA, after which he became the first student to complete the joint degree program in medicine and law at Vanderbilt University. He then received internal medicine training at the Cleveland Clinic and became a member of the State Bar of California during his internship year. He came to Loma Linda after completing his pulmonary and critical care medicine training at Stanford University.

In addition to practicing pulmonary and critical care medicine at the VA, he became one of the ethics consultation fellows of the VA’s National Center for Ethics in Health Care and completed a fellowship in clinical medical ethics at the MacLean Center for Clinical Medical Ethics at the University of Chicago. He is the Chief of the Ethics Consultation Service and Chair of the Consultative Ethics Committee for the VA Loma Linda Healthcare System. Along with his ethics consultation activities, he teaches courses at Loma Linda University including Advanced Medical Ethics for the School of Medicine and the School of Religion. He is also a past Chair of the Ethics and Conflict of Interest Committee of the American Thoracic Society and a member of its Health Policy Committee.

Erin DeMartino, MD

Mayo Clinic
Assistant Professor of Medicine

Dr. Erin DeMartino is a pulmonary and critical care physician and clinical medical ethicist. Her research focuses on the intersection of health policy and ethics at the bedside of her patients, particularly critically ill patients. She investigates fairness in scarce resource allocation and how state policies influence medical decision making for patients lacking decisional capacity. 

She is the equity, inclusion and diversity leader for her Division, and has a long-standing interest in the wellbeing of incarcerated patients. This dates from her earliest experience of the medical profession, when she was a high school student shadowing an emergency medicine physician as he cared for an incarcerated person. 

Her interest and advocacy have grown through her medical training and her practice in the intensive care unit, where she observes and confronts many indignities suffered by patients in custody. It is a distinct honor to collaborate with a group of social justice-oriented clinicians who share a drive to educate and advocate for just treatment of the justice-involved.

E. Wesley Ely, MD, MPH

Vanderbilt University Medical Center
Professor of Medicine and Critical Care
Associate Director of Aging Research, VA GRECC

Dr. Ely, the Grant W. Liddle Chair in Medicine, is a sub specialist in Pulmonary and Critical Care Medicine who conducts patient-oriented, health services research as a Professor of Medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine at Vanderbilt University Medical Center in Nashville, TN. He is also a practicing intensivist with a focus on Geriatric ICU Care, as the Associate Director for Research for the VA Tennessee Valley Geriatric Research and Education Clinical Center.  

Dr. Ely’s research has focused on improving the care and outcomes of critically ill patients with ICU-acquired brain disease (manifested acutely as delirium and chronically as long-term cognitive impairment). He is co-director, along with Dr. Pratik Pandharipande, of the Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, which consists of over 90 investigators from Departments of Medicine, Surgery, Neurology, Anesthesia, and Psychiatry.  The CIBS Center has amassed thousands of patients into cohort studies and randomized controlled trials, who together built the methodology for ICU acquired brain disease research and newly adopted treatment paradigms including the ABCDEF Bundle.  His team developed the primary tool (CAM-ICU, translated into 35 languages) by which delirium is measured in ICU-based trials and clinically at the bedside in ICUs worldwide.  Dr. Ely has been continuously federally funded (NIA and/or VA) for nearly 20 years and is now embarking with the CIBS Center and Rush University Medical Center on the NIA-funded BRAIN-ICU-2 R01 to establish a brain bank and determine the exact nature of post-ICU Dementia.  Dr. Ely has over 550 peer-reviewed publications.

Dr. Ely graduated from Tulane University in New Orleans, Louisiana, Summa Cum Laude, with a BS in Biology in 1985. He continued at Tulane to receive his MPH in Public Health, graduating in 1989. For two years in New Orleans, he served weekly overnight shifts at a high-security Louisiana Federal prison as the on-site "medical student physician." Feelings of inadequacy as a health care provider in this challenging setting continue to drive Dr. Ely's resolve to improve equity for these vulnerable women and men. He completed his medicine residency program and his postdoctoral fellowship in Pulmonary and Critical Care Medicine in Winston-Salem, North Carolina at Bowman Gray School of Medicine. However, he will be the first to say that his most amazing accomplishments are his three daughters, Taylor, and twins, Blair and Brooke Ely. His wife, Kim Ely, is an Anatomic and Clinical Pathologist who specializes in Head and Neck Cancer pathology at Vanderbilt University Medical Center in Nashville.

Matt Griffith, MD

University of Colorado School of Medicine
Assistant Professor, Medicine-Pulmonary Sciences & Critical Care

Dr. Matt Griffith is a pulmonary and critical care medicine physician. Dr. Griffith’s research focuses on developing novel methods to evaluate disparities in the delivery of medical specialty care that results from the misalignment of patient access and health system capacity, and to design interventions that create value from realignment. In other words, how to make sure that medical specialty providers spend their time taking care of patients most likely to benefit from their care, regardless of patient resources, rather than the worried well.

Few face the consequences of this misalignment more than those in the justice system, who experience just as much suffering from advance stage chronic diseases as all other humans, yet are frequently denied access to the medical services they need – or are forced to suffer indignity in exchange for the privilege of accessing these services. Teaching others, and ensuring they have access to the resources they need to provide ethical and patient-centered care, is the purpose of my involvement with this project.

Amen Sergew, MD

Dr. Amen Sergew is a pulmonary and critical care medicine physician. She previously worked as the Director of Outpatient Education at an academic center. There she discovered her commitment for developing and providing timely, efficient, and effective educational material for providers and patients to facilitate more informed and improved care. 

In her role as Co-Director of Diversity, Equity and Inclusion for her Division, she focused on understanding the pulse of the Division and advocating for real and impactful changes that would lead to more just and equitable care of her patients and colleagues. This project is the result of her pursuing both of her passions—education and justice. She is honored to be part of this group.