Deliberate Indifference: Inadequate Health Care in U.S. Prisons
Authors: Ashley Hurst, Brenda Castañeda, Erika Ramsdale
Journal: Annals of Internal Medicine (2019)

Ideas and Opinions16 April 2019Deliberate Indifference: Inadequate Health Care in U.S. PrisonsAshley Hurst, JD, MDiv, MA, Brenda Castañeda, JD, and Erika Ramsdale, MDAshley Hurst, JD, MDiv, MASchool of Nursing, University of Virginia Health System, Charlottesville, Virginia (A.H.), Brenda Castañeda, JDLegal Aid Justice Center, Charlottesville, Virginia (B.C.), and Erika Ramsdale, MDJames Wilmot Cancer Center, University of Rochester, Rochester, New York (E.R.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-3154 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Whether health care should be a fundamental right in the United States is an ongoing debate. However, one group—incarcerated persons—has a constitutionally protected right to adequate health care. Nevertheless, there is a growing epidemic of inadequate health care in U.S. prisons. Shrinking prison budgets, a prison population that is the highest in the world, and for-profit health care contracts all contribute to this epidemic. The medical community has an obligation to respond by providing and advocating for adequate health care for incarcerated persons.The Eighth Amendment of the U.S. Constitution prohibits the government from inflicting "cruel and unusual punishment." The ...References1. Klein SB. Prisoners' rights to physical and mental health care: a modern expansion of the Eighth Amendment's cruel and unusual punishment clause. Fordham Urban Law J. 1978;7:1-33. Google Scholar2. Estelle v. Gamble, 429 U.S. 97 (1976). Google Scholar3. Brown v. Plata, 563 U.S. 493 (2011). Google Scholar4. Institute for Criminal Policy Research. World Prison Brief. 2019. Accessed at www.prisonstudies.org/world-prison-brief-data on 18 January 2019. Google Scholar5. Williams BA, Stern MF, Mellow J, Safer M, Greifinger RB. Aging in correctional custody: setting a policy agenda for older prisoner health care. Am J Public Health. 2012;102:1475-81. [PMID: 22698042] doi:10.2105/AJPH.2012.300704 CrossrefMedlineGoogle Scholar6. Vincent BS, Hofer PJ. The consequences of mandatory minimum prison terms: a summary of recent findings. Federal Sentencing Reporter. 1994;7:33-8. CrossrefGoogle Scholar7. The Pew Charitable Trusts. Prison health care: costs and quality. October 2017. Accessed at www.pewtrusts.org/~/media/assets/2017/10/sfh_prison_health_care_costs_and_quality_final.pdf on 18 January 2019. Google Scholar8. Royse D. Medical battle behind bars: big prison healthcare firm Corizon struggles to win contracts. Modern Healthcare. 11 April 2015. Accessed at www.modernhealthcare.com/article/20150411/MAGAZINE/304119981 on 18 January 2019. Google Scholar9. Southern Poverty Law Center. SPLC files federal lawsuit over inadequate medical, mental health care in Alabama prisons. 2014. Accessed at www.splcenter.org/get-informed/news/splc-files-federal-lawsuit-over-inadequate-medical-mental-health-care-in-alabama-p on 18 January 2019. Google Scholar10. Braggs v. Dunn, Civ. Act. No. 2:14cv601 (N.D. Ala. June 27, 2017). Google Scholar Author, Article, and Disclosure InformationAffiliations: School of Nursing, University of Virginia Health System, Charlottesville, Virginia (A.H.)Legal Aid Justice Center, Charlottesville, Virginia (B.C.)James Wilmot Cancer Center, University of Rochester, Rochester, New York (E.R.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3154.Corresponding Author: Erika Ramsdale, MD, James P. Wilmot Cancer Center, 601 Elmwood Avenue, Box 704, Rochester, NY 14642; e-mail, [email protected]rochester.edu.Current Author Addresses: Ms. Hurst: University of Virginia School of Nursing, 202 Jeanette Lancaster Way, Charlottesville, VA 22908.Ms. Castañeda: Legal Aid Justice Center, 1000 Preston Avenue, Suite A, Charlottesville, VA 22903.Dr. Ramsdale: James P. Wilmot Cancer Center, 601 Elmwood Avenue, Box 704, Rochester, NY 14642.Author Contributions: Conception and design: A. Hurst, E. Ramsdale.Analysis and interpretation of the data: E. Ramsdale.Drafting of the article: A. Hurst, B. Castañeda, E. Ramsdale.Critical revision of the article for important intellectual content: A. Hurst, E. Ramsdale.Final approval of the article: E. Ramsdale.Collection and assembly of data: E. Ramsdale.This article was published at Annals.org on 2 April 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInadequate Health Care in U.S. Prisons Terry E. Hill Metrics Cited byImplementing Gender-Affirming Care in Correctional Settings: A Review of Key Barriers and Action Steps for ChangeCOVID-19 testing, infection, and vaccination among deported Mexican migrants: Results from a survey on the Mexico-U.S. borderLegal Reactivity: Correctional Health Care Certifications as Responses to LitigationOlder Adults Post-Incarceration: Restructuring Long-term Services and Supports in the Time of COVID-19Incarceration: The Intersection of Emergency Medicine and the Criminal Justice SystemInadequate Health Care in U.S. PrisonsTerry E. Hill, MD 16 April 2019Volume 170, Issue 8Page: 563-564KeywordsCancer chemotherapyDisclosureDrugsHealth careHealth care facilitiesHealth care providersHealth care qualityPatientsPsychiatry and mental healthShock ePublished: 2 April 2019 Issue Published: 16 April 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...