Right to Medical Care in Prison

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Background

Failure to provide adequate medical care continues to pose one of the greatest threats to prisoner's around the world. In some parts of the world, HIV and other prison diseases pose the greatest threat to life. In some of these places, a sentence is the functional equivalent of the death penalty.

HIV/AIDS and Tuberculosis

In prisons located in developing countries the preventing the spread of and treating HIV/AIDS and Tuberculosis (TB) is a constant struggle. Overcrowding, deteriorating facilities, and a lack of proper medical care continue to plague prison systems in African countries like Zambia, foiling any attempt to bring HIV/AIDS and TB under control.

Currently, about 15% of the adults in Zambia are infected with HIV.[1] The percentage of people infected in prison is significantly higher. About 27% of the men and 33% of the women are infected.[2] From 1995 to 2000, roughly 2,400 inmates and 260 prison staff died from illnesses related to AIDS. [3]

TB is the most common opportunistic infection upon HIV infected people in Africa. TB's rate of occurrence is greatly increased in prisons in southern Africa because overcrowding, poor ventilation, and poor medical care.[4] While the precise rate of infection is impossible to determine a 2000-2001 study suggests as many as 20% of the prisoners are infected with pulmonary TB.[5]

Despite the prevalence of HIV/AIDS and TB in Zambia prisons, as of Oct. 2009, Zambia only employed 14 health staff (only one physician) to serve over 15,000 prisoners.[6] Of its 86 prison, only 15 had a sick bay or health clinic. [7]

International Law

Under United Nations' General Assembly Resolution 44/111, "Prisoners shall have access to the health services available in the country without discrimination on the grounds of their legal situation." [8]

Despite this promise, prisoner continue to suffer some of the worst health care in the world.

Specific Country Examples

United States

Prisoners are the only Americans with a Constitutional right to medical care. [9]

The right to medical care in prison is found within the 8th Amendment's protection against cruel and unusual punishment. The 8th "Amendment embodies 'broad and idealistic concepts of dignity, civilized standards, humanity, and decency . . .,' against which [the Court] must evaluate penal measures." [10] Therefore, the Court has held repugnant to the 8th Amendment punishments that "involve the unnecessary and wanton infliction of pain."[11] Failure to provide adequate medical results in the infliction of unnecessary suffering that is inconsistent with the 8th Amendment. [12]

A constitutional challenge to the adequacy of correctional health care is governed by the test established in Estelle v. Gamble. Under Estelle, a inmate must show that he has a serious medical need and that the institution has been deliberately indifferent to that need. [13] Satisfying this test creates a cause of action under section 1983. [14]

References

  1. Unjust and Unhealthy (HIV, TB, and Abuse in Zambian Prisons), Human Rights Watch, 19 (2010)
  2. Unjust and Unhealthy (HIV, TB, and Abuse in Zambian Prisons), Human Rights Watch, 19 (2010)
  3. Unjust and Unhealthy (HIV, TB, and Abuse in Zambian Prisons), Human Rights Watch, 19 (2010)
  4. Unjust and Unhealthy (HIV, TB, and Abuse in Zambian Prisons), Human Rights Watch, 5 (2010)
  5. Unjust and Unhealthy (HIV, TB, and Abuse in Zambian Prisons), Human Rights Watch, 48 (2010)
  6. Unjust and Unhealthy (HIV, TB, and Abuse in Zambian Prisons), Human Rights Watch, 5 (2010)
  7. Unjust and Unhealthy (HIV, TB, and Abuse in Zambian Prisons), Human Rights Watch, 5 (2010)
  8. A/RES/45/111 Basic Principles for the Treatment of Prisoners, passed 14 Dec. 1990, available at http://www.un.org/documents/ga/res/45/a45r111.htm
  9. Estelle v. Gamble, 429 U.S. 97, 103 (1976)
  10. Estelle v. Gamble, 429 U.S. 97, 102 (1976)(quoting Jackson v. Bishop, 404 F.2d 571, 579 (C.A.8 1968))
  11. Estelle v. Gamble, 429 U.S. 97, 103 (1976)(quoting Gregg v. Georgia, 428 U.S. 153, 173 (1976))
  12. Estelle v. Gamble, 429 U.S. 97, 103 (1976)
  13. Estelle v. Gamble, 429 U.S. 97, 104 (1976)
  14. Estelle v. Gamble, 429 U.S. 97, 105 (1976)