Healthcare in the Prison System
Aakriti Dave
Fall 2020
Healthcare is an essential system within any country; it encompasses the provision of a variety of medical services for the population. However, not all healthcare is created equal, particularly in prisons. There’s much debate about healthcare reforms for the average American, but not enough discussion pertaining to healthcare for the incarcerated--a deficit that demands swift action.
In Estelle v Gamble, the Supreme Court ruled in 1976 that healthcare was a basic right for anyone in custody, as the deprivation of this right violates the Eighth Amendment’s prohibition of cruel and unusual punishment (Paris, 2008). Unfortunately, while healthcare is technically offered in prisons, its inadequacy and ineffectiveness make it a cruel punishment itself.
The inadequacy of prison healthcare can be seen in the example of Jeremy Laintz. Laintz was arrested in October of 2016 for failing to show up to his court-ordered drug test and was booked into the Pueblo County jail, where he received a medical evaluation. During the evaluation, when he informed the nurses that he was a heroin user and suffered from Hepatitis C, the staff gave him loperamide and meclizine for his withdrawal. However, loperamide and meclizine, are normally used to treat diarrhea and nausea respectively; as such, these did not ease Laintz’s pain, and he continued in his attempts to seek proper medical assistance to no avail. It took a full month of his family’s desperate pleas for help for Laintz to finally get checked into a hospital, and once there, he was diagnosed with sepsis, pneumonia, and acute renal and respiratory failure.. Laintz was then airlifted to a hospital in Denver where he underwent multiple surgical procedures, including not only the partial removal of his lung but also the loss of six toes from gangrene (Coll, 2019).
As shocking as it may seem, Laintz is not alone. Sheneque Proctor was 18 years old when she died from multiple drug overdose while in custody at Alabama’s Bessemer City Jail, even though there were “numerous treatments available to paramedics, such as Naloxone or intubation” (Reutter, 2017, p. 44). In another case, Jamycheal Mitchell, who had a history of mental illness, was found dead in his cell after a four-month confinement to his cell with little food, water, or consistent mental health wellbeing checkups (Reutter, 2017).
As these examples show, the greatest challenge in the arena of prison healthcare is medical negligence. Part of this oversight can be attributed to the deficiency of medical professionals attending to inmates. For example, in the state of Virginia, there are 30,000 prisoners in the care of only 40 doctors, and these inmates are collectively cared for by a total of around 700 nurses, who only undergo a year of medical training to earn licensed practical degrees (Hausman, n.d). Consequently, in Virginia--and many other prisons across the nation--there are too many inmates and too few experienced medical professionals to help them.
Additionally, the core infrastructure of prison healthcare plays a role in this medical negligence. The process of getting in contact with a certified physician is extremely lengthy and complicated, making it difficult for inmates to get medical attention quickly. Nurses who have licensed practical degrees are prohibited from making diagnoses or prescribing medicine; to do this, they must get in touch with the supervising nurse, who then has to reach out to the doctor. In addition, when nurses are trained, they are told that they have a 3 day period to check on prisoners who are reportedly ill, as long as the situation isn’t considered an emergency. In fact, prisoners who are feeling sick must themselves call out for help or submit a written request--two methods that can be inaccessible for weak, sickly inmates (Hausman, n.d.).
The incompetence of prison healthcare is especially unacceptable when we consider the fact that many inmates have underlying conditions that are not being treated due to a lack of insurance. According to the article “Examining health care in U.S. Prisons”, “70 percent to 90 percent of the approximately 10 million individuals released from U.S. prisons and jails each year are uninsured, and about 40 percent of incarcerated people have at least one chronic health condition, such as diabetes or hypertension.” (Ellis, 2017). Thus, the majority of incarcerated individuals with a chronic health condition coming into prisons are uninsured and have not received prior treatment. Their health can then be worsened by the unhygienic environment of prisons: the lack of proper sanitation can worsen or cause new health conditions to develop and spread, such as HIV/AIDS and tuberculosis (Ellis, 2017).
In the infographic above, purple highlighted areas represent the most access to mental healthcare, while red highlighted areas represent the least access to mental healthcare.
Additionally, many incarcerated people have a history of mental illness. The infographic above from Mental Health America compares the proportion of inmates per state with the access to mental health care in 2015 for all 50 states. Six out of ten of the states with the highest incarceration rates also are highlighted in red, signifying they have the least access to mental health care. The strong correlation between a lack of mental health care and high incarceration rates indicates that this is yet another problem in prison healthcare that deserves more attention.
Recently, the issue of prison healthcare has come under scrutiny as a result of the COVID-19 pandemic. Prisons house arguably some of the most vulnerable populations: individuals with underlying health conditions existing in crowded, unsanitary quarters with multiple other individuals, all of whom receive little medical attention regularly. This circumstance is reflected by the statistics: “Reuters collected data from 37 state prison facilities across the country that have done mass testing for COVID-19 among all inmates, including those with no symptoms, and found more than 10,000 confirmed cases among the 44,000 tested.” (Eisler, et al., 2020). Evidently, prisoners are extremely high-risk for COVID-19, but with a fragile and inefficient healthcare system in place, it’s difficult to save prisoners both from contracting the disease and dying from it.
Since acquiring sufficient test kits and masks for prisons has turned out to be challenging, many prisons have begun releasing inmates instead in an attempt to slow the spread of COVID-19 and to reduce the number of inmates affected. The Vera Institute of Justice found that more than 37,000 state and federal prisoners have been released since March 31 , which poses another problem, as most prisons can only afford to test symptomatic individuals (Eisler, 2020). This begs the question of whether released inmates may have been asymptomatic and unknowingly spread the virus outside of the prisons.
Now, more than ever, we need to rally together as a nation and focus our attention on the plight of prisoners. Incarcerated people are just as deserving of quality healthcare as anyone else, and it’s time that we practice the equality we preach.
References
Access to Mental Health Care and Incarceration. (n.d.).
http://www.mhanational.org/issues/access-mental-health-care-and-incarceration
Coll, S. (2019, Feb25). The jail health-care crisis. The New Yorker.
https://www.newyorker.com/magazine/2019/03/04/the-jail-health-care-crisis
Eisler, P., So, L., Parker, N., & Heath, B. (2020, May 18). Special Report: 'Death Sentence' - the hidden coronavirus toll in U.S. jails and prisons. Reuters. https://www.reuters.com/article/us-health-coronavirus-usa-jails-specailr/special-report-death-sentence-the-hidden-coronavirus-toll-in-u-s-jails-and-prisons-idUSKBN22U1V2
Ellis, G. (2017, March 25). Examining health care in U.S. prisons. The Philadelphia Tribune.
Hausman, S. (n.d.). Investigating alleged medical neglect in U.S. prisons. Center for Health Journalism.
Paris, J. E. (2008). Why Prisoners Deserve Health Care. AMA Journal of Ethics, 10 (2), 113-115. doi:10.1001/virtualmentor.2008.10.2.msoc1-0802
Reutter, D. (2017, January 10). “Deaths Due to Neglect in U.S. Jails Reflect Nation’s Values.” Prison Legal News.
http://www.prisonlegalnews.org/news/2017/jan/10/deaths-due-neglect-us-jails-reflect-nations-values