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Criminal Justice Reform Must Include Better Medical Treatment in Prisons and Jails

We cannot pretend to have adequately humanized our criminal justice system until we address incarceration’s atrocious medical care.

May 24, 2015

It’s heartening these days to hear the bipartisan cries for criminal justice reform, whether they emanate from Capitol Hill or state capitals all across the nation. And it is indisputable that some reform has come in just the past few weeks to some of the places that need it the most, states like Alabama and Florida. But we won’t be able even to pretend that we have adequately humanized our criminal justice systems until we deal with the atrocious medical care we now provide prisoners and on that score the news of the past weeks seems as dire as it ever has been.

A new report made public last week in Illinois, the result of an independent investigation by medical experts, reveals that prison officials there aren’t coming close to providing constitutional standards of care to inmates despite the millions of dollars local taxpayers are paying for them to do so. Here are just two examples:

A patient at Menard Correctional Center (MCC), a downstate maximum-security facility which houses some 3,750 inmates, had his insulin discontinued by a doctor untrained in primary care after his blood sugar levels were found to be normal while on insulin. The report states a “failure to identify and appropriately manage a common primary care condition (diabetic foot ulcer) lead to actual harm of the patient (amputation).”

At Illinois River Correctional Center (IRCC), an inmate coughing up blood upon arrival was given a container for it by a nurse and told to call if the amount increased. For months, the 55 year-old man had a family history of lung cancer and smoked more than 40 packs a year, exhibited classic and worsening signs of lung cancer. He died just nine days after being properly diagnosed and given treatment.

And on and on it goes. There aren’t enough qualified medical professionals to handle the crush of cases. There is inadequate record-keeping. There are unanswered questions about the outsourcing use of private companies. There is no courageous leadership. And as a result of all of that ailing inmates who have Eighth Amendment rights wallow in fetid and unsanitary conditions. Worse, Illinois prison officials won’t even own up to the scope of the problem, instead trying for many months to block the public release of the report and now have sought to downplay its conclusions and import.

Last week also brought us grim news from Louisiana, where a new federal lawsuit has been filed alleging broad medical abuse and neglect at the Louisiana State Penitentiary, the notorious Angola prison, run by Warden Burl Cain, a larger-than-life character whose day of reckoning evidently has not yet come. The allegations in Louisiana are remarkably similar to the evidence uncovered in Illinois. There is the story of Joseph Lewis, an 81-year-old inmate there whose throat cancer went undiagnosed at Angola for two years. There is the story of Kentrell Parker, an inmate who was rendered a quadriplegic in prison in 2010. From the complaint:

Mr. Parker is completely dependent for his care on prisoner orderlies. The orderlies are not adequately trained. He used to have an air mattress that was appropriate for his condition, but it broke in or around 2011 and has not been replaced. In his experience, men on Ward 2 are often not cleaned at all unless there is a tour group visiting. Mr. Parker is excluded from attending church unless a nurse or EMT accompanies him.

 In summer 2014, Mr. Parker was accused of disobedience and put in an isolation cell where he could not be seen by staff, until attorneys expressed urgent concern for the health risks that posed. Around the same time, the Angola hospital underwent a severe shortage of hygiene supplies including bed mats, subjecting Mr. Parker to an increased risk of bedsores and other life-threatening complications. He is regularly left to sit in his own feces for several hours before an orderly comes to change his bedding. 

In May 2015, Mr. Parker was brought to LSU hospital with a blood infection. The doctor there told him that bacteria entered his blood from his stool. He has a tracheotomy hole in his neck. Angola regularly runs out of tracheal supplies, subjecting him to unnecessary risk of infection. Mr. Parker does not have a tracheal machine at his bedside that he can use in the event of choking. He never receives physical therapy and relies on prisoner-orderlies for feeding. For six of eight days in early April 2015, with only one orderly on the Ward, there was no one to feed Mr. Parker his breakfast and he went hungry. He is never weighed.

And on and on those stories go from a prison with a decades-long track record of abuse and neglect. Elderly and disabled men like Lewis and Parker shouldn’t be in prison to begin with—the idea that they are a threat to the community or need further retributive justice is absurd. But the lack of care they are receiving, and the callous way in which prison officials tolerate it year after year, is not just unconstitutional it’s immoral. And so is the political and judicial indifference to the problem, both in Illinois and in Louisiana.

The truth is that criminal justice reform cannot simply consistent of “easy” choices like letting petty marijuana users out of prison. It cannot be comprised of calls to reduce the impact of forfeiture laws for the benefit of property owners. It also must consist of harder choices, like requiring taxpayers to pay more for basic, humane medical treatment for the men and woman we decide must stay behind bars. This means more funding for more doctors and nurses inside our prisons. It means more funding for more medicine for inmates. And it means changing from the lowliest guard to the highest official the ugly, vicious, merciless dynamic that exists within these institutions, a dynamic whereby the ailing and ill are treated worse than animals.

The views expressed are the author’s own and not necessarily those of the Brennan Center for Justice.

(Photo: Thinkstock)