307392
Beyond compassionate release
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Compassionate release is the process by which certain seriously ill prisoners are allowed to die in the community prior to completing their sentence. A form of health-based advocacy, compassionate release (CR) has received increased attention in light of challenges posed by an aging prison population and the rising cost of the criminal justice system. However, compassionate release remains a late-stage, time-consuming and infrequently successful process. Less well defined is the potential contribution of health-based advocacy for detainees in jails who are awaiting trial or sentencing. Patients with serious illness often cannot fully participate in court proceedings, and jails have intrinsically greater flux than the prison system leaving them poorly equipped to care for seriously ill or dying patients. For these reasons, health-based advocacy in the jail system occurs frequently, but the exact nature and value of the work remains poorly understood.
Objective
To better understand health-based advocacy in the jail system.
Methods
There were 58 letters written by the medical director on behalf of detainees in the NYC jails from September 2010 through July 2013. These letters were reviewed and categorized according to the objective of the letter. The prevalence of cited disease processes was noted for each.
Results
Of the 58 letters reviewed, 21% were for patients with serious illness requesting CR; 40% were for patients with serious illness not requesting CR and 26% confirmed diagnosis appropriate for structured alternative to incarceration. A small percentage (<5%) described catastrophic illness diagnosed in jail and conditions difficult to treat in jail setting. Regarding common diseases, 41% of patients had cancer, 22% of patients had HIV/AIDS and 17% had substance abuse documented.
Discussion
In the case of compassionate release, medical information is clearly relevant to the criminal justice process. These letters suggest that this may be true in many other situations, and the nature and scope of the information deemed relevant may vary in a detainee population versus prison. Requests for medical information to be provided to the court come from many sources including patients, defense attorneys, judges, correctional officials and treating physicians. Though medical information is often communicated, analysis reveals that in our system most letters are not formal requests for CR. Better understanding the ways in which medical information can be useful to the courts would allow correctional health providers to better align with the criminal justice system in providing safe, effective sentencing options for detained patients.
Learning Areas:
Public health or related laws, regulations, standards, or guidelinesPublic health or related organizational policy, standards, or other guidelines
Learning Objectives:
List justifications for incarceration currently used by the criminal justice system
Describe compassionate release as it is traditionally applied in the prison system
Identify important differences between jails and prisons with regard to health-based advocacy
Describe examples of health-based advocacy currently taking place in the jail system Discuss which information would be most useful to further optimize health-based advocacy in the jail system
Keyword(s): Prisoners Health
Qualified on the content I am responsible for because: I have participated in the activity reviewed in this abstract. I have assisted with analysis of and findings from this research.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.