Case Study: Ethical and Clinical Management of Suspected Concealed Heroin in a Prison Inmate Following a Request for Enema by Custodial Officers

This case highlights the ethical and clinical challenges in managing suspected rectal concealment of heroin in a custodial setting. A non-consensual request for an enema was declined on ethical and clinical grounds, and the patient was managed conservatively with observation and imaging. The case reinforces the primacy of informed consent, patient safety, and independent clinical judgment over non-medical enforcement pressures.