Behind Bars and Bottom Lines: The Human Rights Crime of Medical Neglect in the U.S. Prison System
PHILADELPHIA, PA - Imagine a life where someone else has near complete control over your body, what you eat, when you sleep, how many hours you will work each day, if you will receive medical care and to what extent, this is the life of a prisoner in the U.S. prison system. It doesn't matter what part of that system they are in, those with the power over human life express that control through a variety of methods from direct physical violence to neglect and for many there is no escape.
The latest data from the US Bureau of Justice Statistics show that there are at least 2.2 million adults and approximately 250,000 children incarcerated under the “custody, care and control,” of the state, nearly 3000 of these children will live the rest of their lives under this sort of control. Millions of human lives have been subjected to this dehumanizing condition before the current 2.2 million enduring it.
The key word in these two paragraphs is Human.
This word is so powerful because it implies at least two things relevant to the subject at hand, first is that guilt or innocence is irrelevant, the only thing that matters as qualification is membership of the species known as Homo Sapien. The second implication is that because of that membership each of them are endowed with Human Rights which we as a species have said that all human beings deserve.
Understanding this and understanding that the ability to secure these rights for themselves have been stripped from each of the human beings under the control of this system of incarceration is where we find the heart of the problem we face with this system of mass incarceration, its implications for society and the effect they have on its victims.
I know Human Rights, that's such a monstrously huge subject, that's why I'm going to narrow the scope of this article down to just one aspect of the Human Rights situation in the U.S. prison system which presents a particular and special problem for the incarcerated; Medical Neglect. Otherwise we could get lost in a labyrinth of inhumanity that could take generations to sort out at the current rate of social evolution.
There are some out there that will inevitably argue that those who are incarcerated don't deserve any sort of consideration with the also inevitable argument “jail isn't the Holiday Inn,” the ignorance of the statement notwithstanding. We can quickly dispel the argument right here. First, U.S. courts from bottom to top have ruled that there is a specific obligation on the State to provide adequate medical care to inmates under its care and control. Secondly, the Constitution protects inmates from “cruel and unusual punishment,” otherwise known as torture. Thirdly, the Convention on Human Rights and a whole host of subsequent treaties since have explicitly guaranteed adequate medical care as a human right.
Nearly a quarter of all incarcerated persons in Federal, State and Local facilities were have found to have one or more mental health conditions, nearly half of all inmates were found to have at least one chronic illness according to research published in the peer reviewed American Journal of Public Health.
Among inmates with serious mental health issues such as Bipolar and Schizophrenia two thirds were not receiving treatment for their condition at the time of their arrest and nearly a third of them continued not to receive treatment during their period of incarceration. The lack of adequate treatment for mental health conditions has made suicide the leading cause of death in U.S. jails since 2000, according to the Bureau of Justice Statistics.
According to Human Rights Watch this lack of adequate treatment for major mental health conditions also puts these inmates at an increased likelihood of being physically abused by prison staff and inmates which in turn leads to other forms of medical neglect. Often times these abuses are in response to non-threatening symptoms of the inmate's mental health condition, which could have been resolved through other means or would have not occurred at all if the inmate had been treated for their condition in the first place.
In the case of mental health the use of so-called solitary confinement can be considered another form of medical neglect as it is sometimes used in place of treatment of symptoms of mental illness, this form of punishment is considered to be a form of torture in and of itself and there is consensus among the psychiatric community that this response to symptoms of mental illness only makes the underlying condition worse for the inmate suffering it.
In September of 2005, Anthony McManus died alone in an inch of water mixed with urine and feces, weighing only 75 pounds having dropped from 140 pounds in a period of five months. He died in a Michigan state prison, he had been incarcerated for indecent exposure and was serving an 8 year sentence. Previously he had been diagnosed with Schizophrenia and Bipolar Disorder, but was incarcerated at a facility that had no mental health department.
Over the years of his sentence his condition became increasingly worse “During the last six months of his life, he was constantly disruptive and noisy, was difficult to communicate with, talked about the devil, and would cover his body with food he had chewed up. He would also spread feces and urine around his cell and on himself and even mixed it with his food. Although he would not eat, he begged for food,” according to a lawsuit against the Michigan Department of Corrections over the circumstances that led to his death.
As one expert witness in the case pointed out even animals in animal shelters receive better care and attention than Anthony received. If he had received proper mental health care his condition likely wouldn't have deteriorated to the point that it did and he might still be alive today.
There are thousands of Anthony McManus's that have died suffering both physically and mentally that might not otherwise have died so cruelly if given the care they needed and deserved.
As horrifying as the mental health crisis is in the U.S. Prison system the neglect of women's reproductive health and other chronic illnesses are far more prevalent and often times can be equally as torturous.
Imagine yourself as one of the 111,300 women incarcerated in 2013, now step a little deeper down the rabbit hole and imagine yourself one of the 3-5 percent of those women who were pregnant when they were locked behind those walls. Sounds pretty terrifying; right, well it gets worse, women are far less likely than their male counterparts to receive adequate medical attention while incarcerated in spite of being more likely to be severely injured during arrest or their incarceration, having a higher likelihood of mental illness, being more seriously affected by disease and the potential of being pregnant.
It's insane enough to ignore or provide inadequate treatment to a single victim, when a woman is pregnant there are two lives hanging in the balance. “Pregnancy is such a delicate process that medical care can not end in the doctor's office, they also need more nutritious food more often and more intense monitoring on the cell block, neither of which are provided,” says Tracey Johnstone a Washington DC Certified Midwife who has helped deliver hundreds of babies for incarcerated women in Maryland and DC.
Currently there is no data for the number of women who have given birth, had miscarriages, stillbirths or abortions in the U.S. jail and prison system, the most recent data was from almost 20 years ago. Given the vulnerability of many of the women in the prison system to high risk pregnancy, the lack of data alone is sufficient evidence of systemic negligence on the part of local, state and federal systems, as well as, for-profit corporations such as Corrections Corporation of America and other similar companies contracted at various levels to provide medical care to the most vulnerable among us.
The measure of whether a doctor employed by the prison system or one of the corporations that contract with that system is very subjective to say the least, the procedure for filing suit is long, onerous, and very much designed to make it all but impossible for the victims of systemic abuse to find relief. Yet, every year thousands of suits do find their way to the courts, perhaps two of the most important of these cases are Chimenti V. Pennsylvania Department of Corrections and Mumia Abu-Jamal V. Kerestes, both in Pennsylvania.
Both cases argue that the Department of Corrections have a legal obligation to provide inmates with Hepatitis C with the current treatment for the disease.
According to court records during a routine blood work up in 2012, Mumia tested positive for Hepatitis C antibodies. According to the Centers for Disease Control the doctors at the state correctional institute he was being housed in should have done further testing to see if he had a viral load and whether the disease was “Active.”
Instead Mumia's doctors didn't follow up, nor did they even inform him of his status. It took several years, a persistent rash covering 70 percent of his body and going into a diabetic shock that could have been avoided if the doctors had acted several weeks earlier when it was found by the facility's medical staff Dr. John Lisiak, Dr. Shaista Khanum and Physician's Asst. Scott Saxon that his glucose levels were dangerously high at 419, with no prior record of high glucose levels.
He was allowed to persist in this condition from March 06 to March 30, 2015 when he was admitted unconscious into Schuylkill Medical Center with a glucose level of 507. At any point during those several weeks Mumia could have died. However; if it hadn't been for the negligence of the prison medical staff in regards to the onset of diabetes he wouldn't have even known he had Hepatitis C, which the release papers the hospital provided him informed him of.
It took almost five months for the medical staff at SCI Mahanoy to do the test and inform Mumia that he had active Hep. C even as he continued to suffer from a whole host of medical conditions related to the underlying viral infection which left him in constant agony and with no end to the pain in sight. The persistent itch from the rash and the pain in his lower extremities has led to sleep deprivation; widely recognized as a form of low grade torture, has left him fatigued, disorientated and emotionally distressed.
“This isn't just about the pain and suffering of one man, though that should be enough to shock the conscious in and of itself, as every life should be seen as precious, this is about tens of thousands of human beings denied a treatment that would not only end their immeasurable suffering but save countless lives;” said Mumia Abul-Jamal during a short phone conversation from his cell block at SCI Mahanoy, “and a system that callously denied them a treatment that would cure them.”
The CDC recommends and the Federal Bureau of Prisons has adopted clinical guidelines for treatment of Hep. C that include the latest Direct Acting Antiviral Drugs, Sovaldi, Olysio and Harvoni which research indicates has a 90 to 95 percent cure rate and reduces treatment time by 75 percent.
The struggle for adequate treatment for Hep. C that these two cases represent are just the tip of the Human Rights iceberg. The standard of ignoring dangerous medical problems or minimizing the treatment to just enough to say that they did something, even if it had no positive impact on the outcome for the patient is just par for course for the Department of Corrections and their contractors.
One has to ask themselves, how another human being, especially those that have taken an oath to do no harm, can allow such gross violations of human rights conventions to persist unabated? The answer is profit.
“Hundreds of thousands of people in the prison system of the U.S. are denied medical treatment everyday for deadly and chronic illnesses, this is torture and murder for the sake of profit plain and simple,” said Pam Africa a long time Mumia advocate and Human Rights Activist in Philadelphia.
The prison system in the U.S. is a profit making business on all sides, whether it's the DOC, or companies like Corizon, Advanced Correctional Healthcare and an endless parade of others, human life and dignity means next to nothing because the bottom line is king to their investors.
It's time for us to stop telling ourselves that prisons are about justice and reforming the broken members of our society, as long as we are using their suffering as a means of profit, neither justice nor rehabilitation is possible. Only when we have gotten private for profit corporations out of the prison system even as vendors can we even begin to look at smart policies and only when we begin to treat even the most broken in our society with human dignity can we begin to heal ourselves and our future.
