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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)