After visiting countless prisons around the world, I have pledged not to be silent on the atrocity of this unjust system. My heart bleeds whenever I read another tragic story of abuse. Unfortunately, they are all too common. Recently a 57-year-old mentally disturbed inmate at the Kentucky State Penitentiary starved to death after the prison staff failed to treat his anxiety and suicidal thoughts.
Thankfully, both the prison doctor and the two other staffers implicated have been fired. How can it be that an inmate isn't given necessary anxiety medications and isn't eating for months? Most of us would not be surprised to hear that repressive regimes such as Iran have been accused of withholding prescription drugs from inmates. However, contrary to movies and cable TV shows, corruption and harmful practices in America often do not see the light of scrutiny, as government officials and the public often prefer to assume that prisoners deserve what is done to them and that the Constitution protects prisoners from the most serious abuses. In reality, prison corruption is not uncommon, as guards and other officials frequently use their position to take money in exchange for allowing drugs and other contraband to be smuggled into jail. As for withholding drugs and other medical treatment for prisoners, consider that if a prisoner is not receiving adequate health treatment, the avenue of complaint is to the very people who are withholding treatment.
In theory, U.S. law protects even prisoners. Under the Constitution, the 8th Amendment, which prohibits "cruel and unusual punishment," has been interpreted by the courts to guarantee prisoners the right to adequate medical care, including the right to have their medications while in prison. However, in order to sue, prisoners have to prove that prison authorities were guilty of "deliberate indifference to serious medical needs." While this is a gray area, prisoners can win if they can show that prison officials did not offer ready access to medical attention or ignored obvious health deterioration -- at least in theory.
However, a combination of a "get-tough" attitude coupled with ignorance of medical issues can result in tragedy, in which the prisoner has no redress. In New York City in February 2014, during an (unusually) extremely cold winter, Jerome Murdough, a former Marine who was homeless and on antipsychotic medication, tried to sleep in a Harlem public housing stairwell. The police arrested him, sent him to jail at Rikers Island, and he then literally died of heat stroke and dehydration after his cell reached a temperature greater than 100 degrees. Why Murdough, who was in need of psychiatric care, was arrested and sent to Rikers Island, and then allowed to dehydrate (it is well known that patients on antipsychotic medication are more prone to heat stroke, as they dehydrate quickly) without being under observation for hours (also a violation of prison rules for psychiatric inmates), is a question that New York City authorities have only promised to investigate. One anonymous official, fearful of the consequences of questioning police activity, admitted that "He basically baked to death."
In other cases, prison authorities can withhold medication and then punish the prisoner for her subsequent behavior that was caused by the withdrawal of that medication. In 2000, Wendy Pyburn was imprisoned in Iowa for prostitution. Although her schizophrenia symptoms had been controlled through medication before she entered the prison system, the authorities withheld medication once she was in the system, and she began to suffer classic symptoms of schizophrenia, such as hallucinations and disordered thinking, leading to disciplinary problems. About half a year later, she was finally brought to a medical facility, where she again received medication and her symptoms subsided. Incredibly, when she was transferred back to the women's prison a month later, she was put in a detention facility as punishment for her behavior when her medications were withheld. It took an intervention from the state's Mental Health Advocate to get the prison system to review their decision, and eventually Pyburn was released from prison in 2001.
While these examples are bad enough, the current trend toward privatization may bring about even more pressure to economize and withhold medications from prisoners. As of 2012, approximately 20 states had privatized at least some of their prison health care systems. State officials claimed that this would save money (mostly through lower pay and benefits to employees) but not hurt inmate care, since state law mandated adequate medical treatment. There have been many claims of inadequate medical care against private prison corporations and their health care services:
• Carol Lester, a 73-year-old gambler who was imprisoned for embezzlement in New Mexico, was allegedly denied her thyroid cancer drug while she was in solitary confinement by the Corrections Corporation of America, and its health care company, Corizon, Inc. Both corporations have been cited for cutting costs at the expense of prisoner health, including allegations of decisions that resulted in death.
• In Idaho, allegations of inadequate medical care of prisoners by Corizon in 2012 led the courts to compel the corporation to hire more staff and provide oversight while a federal judge oversees the process.
• In 2006, a U.S. District Court, citing estimates that inadequate care was killing one inmate per week, appointed a receiver to take over control of medical treatment at all 33 California prisons. In 2012, a federal judge refused to lift the receivership, indicating that the state had still not completed needed reforms.
• Arizona was sued by the ACLU in 2012 for "grossly inadequate" medical care that put prisoners "in grave danger of suffering serious and preventable injury, amputation, disfigurement and even death." A year later, an American Friends Service Committee (a Quaker organization) report documented that the Arizona Department of Corrections and its health care services continued to either not provide or delay medical attention to prisoners, and maintained low staff numbers that contributed to this deficiency. For example, some prisoners were told to "pray" when they repeatedly asked for medications and care. Ferdinand Dix, a lung cancer patient, was only told to consume energy drinks, and over time his cancer metastasized and he died. While lung cancer is often fatal, the lack of attention undoubtedly shortened his life. In another case, a prisoner with psychiatric illness did not receive his psychotropic medication for a month due to a series of clerical errors, and he hanged himself. Even though this health service was replaced, the new company (Corizon) has also been cited for delays in care due to its cost-cutting policies.
We must act now to reverse the tremendous influx of prisoners we've witnessed over the past generation. If there are fewer prisoners, and more who have psychiatric conditions might be treated in mental institutions rather than penal institutions, there should be fewer instances where necessary medications are denied to prisoners.
Prisoners are very vulnerable, since they have been removed from the care of their families and are ordered under the regimented orders of their prison authorities. Sick inmates are, of course, the most vulnerable. Historically, once the prison door closes, the prisoner has no control over what happens, and many times there has been no oversight from the government as well. We must ensure their basic rights and needs are met. Now is the time to radically revolutionize the prison system in America to create more alternatives to incarceration, create more responsible prisons with more oversight, and ensure the most vulnerable are cared for.
Rabbi Dr. Shmuly Yanklowitz is the Executive Director of the Valley Beit Midrash, the Founder &President of Uri L'Tzedek, the Founder and CEO of The Shamayim V'Aretz Institute and the author of five books on Jewish ethics. Newsweek named Rav Shmuly one of the top 50 rabbis in America."