The Real Lethal Punishment: The Inadequacy of Prison Health Care and How It Can Be Fixed

Article excerpt


There are over two million people incarcerated around the country in local, state, and federal jails and prisons. (1) Although prisoners do not have the full slate of constitutional rights as most American citizens, they do have some. (2) Prisoners have the right to due process, to be free from discrimination, to have access to parole, and to be free from cruel and unusual punishment. (3) However, inmates also have one right that no other American citizen enjoys: the right to health care. (4) Therefore, it is up to the Government to fund, staff, and administer health care for all incarcerated individuals. However, most of the health care provided at correctional facilities can hardly be considered adequate. (5) Many facilities are understaffed, poorly funded, and severely overcrowded. (6) Thus, the question becomes whether the health care provided to prisoners is adequate and, if not, whether prisoners are entitled to relief under the U.S. Constitution, particularly the Eighth Amendment. (7)

However, the problems that plague the prison health care system can likely be improved without much intervention from the legislature. First, physicians can be encouraged to work in prisons with steadier pay and more flexible hours. Second, funding for prisons has been a perennial problem for many years. Privatization of health care can reduce costs while providing better health care to prisoners. Finally, overcrowding is a problem that has recently arisen due to a "crack down" on crime across the country. Governments can alleviate this problem without jeopardizing criminal enforcement by instituting various measures of sentencing reform.

Part I of this article focuses on the quality of health care that is to be provided to prisoners and reasons why the health care that is currently being provided is inadequate. Part II examines the issue through an ethical lens and summarizes Kantian ethics and how that theory shapes this issue. Part III focuses on exactly what quality of health care prisoners are entitled to and what their remedies are if the health care is found to be inadequate. Part IV focuses on three primary reasons prison health care is considered inadequate: understaffing, underfunding, and overcrowding. Additionally, each of these problems will be analyzed and possible solutions to the problems will be offered. Lastly, Part V will examine a particular group of prisoners: the mentally ill. This focus provides a more detailed view on a specific group of individuals in prison, how the inadequacies directly affect them, and what the Government has done to fix the inadequacies of the care provided to them in prison.


Although people in prison need to be punished for their wrongdoing, they still deserve respect as living people. Immanuel Kant is famous for his "Categorical Imperative," which placed moral demands on all persons to perform. (8) Kant also believed that all human beings possess dignity because of their rational autonomy and because they follow various moral laws. (9) Kant's theory "demands equal respect for all persons and forbids the use of another person merely as a means to one's own ends." (10) Thus, regardless of a person's appearance or past acts, that person should be treated with the same respect and dignity as everyone else.

Kant's theory serves as the basis on which most of this article is founded. Murdering or raping another individual does not waive the right to be treated and respected as a person. Richard Jaffe, a prominent criminal defense attorney in Birmingham, Alabama, wrote, "no one is as bad as his worst acts or as good as his best. We are all human beings with relative coping skills, flaws and imperfect personalities." (11) Providing medical care to inmates may seem nominal, but in reality, it is usually not implemented in a manner that promotes Kantian respect. Too often, judges, politicians, and other community leaders believe that the guilty should be punished by inhumane and barbaric treatment. …