Dignity Denied: Life and Death in Prison

Sunday, January 10, 2016

What Is It

According to the Treatment Advocacy Center, there are more people living with mental illness in prisons than in psychiatric hospitals across the country. Despite the fact that prisoners can have significant medical needs, healthcare services are often woefully inadequate, which can turn a minor sentence into a death sentence. And for those dying in prison, few receive any hospice or palliative care. So what kinds of patients’ rights should prisoners have? Could improved healthcare in prisons actually reduce recidivism rates? How can we ensure dignity for prisoners in the age of for-profit prisons? John and Ken maintain their dignity with filmmaker Edgar Barens, whose documentary Prison Terminal: The Last Days of Private Jack Hall was nominated for an Academy Award.

Listening Notes

Facts first: because of very harsh sentencing laws, the U.S. imprisons a large number of people, many without the possibility of parole. John and Ken explain that we have one quarter of the world’s total prison population, yet we are not even 5% of the world’s total population. The U.S. prison population is also rapidly aging and getting sicker with age, and many prisoners die alone in their cells from conditions which are often times treatable. Ken says it sounds like cruel and unusual punishment which should be prohibited, and yet it happens all too frequently. They discuss the merits of the Eight Amendment via questions like: is a longer-than-necessary parole cruel and unusual? John brings up the example of a man who in his youth commits a serious crime, then in his forties is a completely different person, and then finds out he has a terminal illness. Surely the most humane thing to do would be to release said prisoner so that he can die with dignity. What about compassionate release, programs, Ken brings up? John explains that even where there are those programs, the backlog of applications makes it so most prisoners still die alone. And who experiences these dire situations? For the most part, non-violent drug offenders or mentally ill individuals. Hospitals are being closed but prisons are being built, and healthcare in prisons is a tricky thing, Ken says. Sometimes it even takes a lawsuit to get things moving!  

John and Ken welcome guest Edgar Barens, whose documentary Prison Terminal: The Last Days of Private Jack Hall was nominated for an Academy Award. John asks Edgar how he became interested in making documentaries about prison, death in prison in particular. Edgar explains that he is interested in making social issue documentaries to try to change systems that aren’t working very well. He made a short film while he was working in New York City in the late 1990s on the hospice program at the Angola prison in Louisiana. For that prison – one of the worst in the country – to have a progressive hospice program was unique. The issue highlighted in the documentary has become more severe over time, and so he decided to revisit the topic. The prison population has doubled since the 90s, and prisoners are aging out 7 to 10 years faster than a person on the outside. Many prisoners arrive already sick because they did not have healthcare prior to incarceration. For the most part, correctional facilities miss the mark and people fall through the cracks, thus dying from otherwise treatable conditions.

Ken asks Edgar how thinking about dignity helps us figure out which rights prisoners ought to be given and which they might forfeit. Edgar explains that once you commit a crime and are put in prison, that freedom is the right you are losing. But prolonged torture once imprisoned is a violation of human rights. Healthcare is indeed a human right, he explains, and we should not deny it to a prisoner regardless of how heinous a crime he or she committed. But does said right involve only minimal, basic healthcare, or something more? And how do we determine what is basic healthcare? Edgar does believe there are certain limits we should keep in mind in delineating basic healthcare rights, but he admits it is a tough line to draw. If the main problem is that the healthcare system as a whole is dicey, then that is what we should fix while at the same time granting to prisoners their full rights.

Edgar, John, and Ken welcome questions from the audience, and they continue the discussion by tackling questions such as: should priority be given to prisoner healthcare when there are equally sick individuals who have not committed crimes? Would a system of paying prisoners minimum wage and allowing them to purchase insurance be viable (or even desirable)? The intricacies of hospice care for prisoners are also discussed in depth.

  • Roving Philosophical Reporter (Seek to 5:01): Shuka Kalantari talks to Rene Alvarez, the Primary Care doctor at a major state prison in Northern California, about inadequate care in prisons, receivership programs, and whether everyone – regardless of circumstance – is entitled to medical care.
  • 60-Second Philosopher (Seek to 49:00): Ian Shoales speeds through just how extensively concerns about prison - is the death penalty justified? What does humane killing mean? – permeate our culture.