Transcript Chapter 16

Part II
Constitutional Law of Corrections
Chapter 16 – Eighth Amendment:
Health Care

Introduction: This chapter examines
the government’s obligation to
provide inmates with health care
Chapter Outline
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Estelle v. Gamble
West v. Atkins
Washington v. Harper; Sell v. United States
Other Involuntary Medication Cases
Inmate Suicides
Logue v. United States
HIV and AIDS
Tuberculosis in Prisons
An Aging Prison Population
Opening Comments
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Correctional facilities must provide
inmates with health care
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Confinement cuts inmates off from
ordinary sources of health care
Most prisons do not allow inmates to
obtain own health care from a provider
of their choice
Opening Comments: cont’d
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Health care is provided, at a minimum
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For treatment of injuries
For the diagnosis and treatment of those
medical conditions that require ongoing care
For a serious medical problem that must be
looked after before the inmate’s release
Opening Comments: cont’d
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Recent development – charging inmates for
routine health care
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Accommodations made for inmates who lack
funds
Reason for charges
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Soaring medical costs for health care, would
result in small reduction of these costs
Greater impact – reduce unnecessary visits
Charging would bring closer to real-life situation
Opening Comments: cont’d
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Lower court cases have upheld charging an
inmate a fee – no constitutional right to
free medical care. Charging a fee
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Assures inmates don’t abuse their access to
limited medical sources
Teaches inmates financial responsibility
Deters the abuse of sick call
Above reasons within the scope of legitimate
government purpose and penological
objectives
Opening Comments: cont’d
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Chapter looks at the constitutional
requirements
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Is an inmate entitled to medical care and
treatment for any health problem
How much health care does the state have to
provide
In what circumstances will a prison official be
liable for failing to provide health care
Estelle v. Gamble (1976)
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Governing constitutional case on prison health care
Gamble, a Texas inmate, injured at work (bale of cotton
fell on him)
 Sent to the hospital, then his cell to rest
 Pain did not subside; over two day period, given pain
pills, pain reliever and a muscle relaxant
 Placed, on medical orders, on “cell pass” – remained
in cell except for showers
 After a week, doctor prescribed another pain reliever,
told could return to light work
 Gamble refused, citing pain
Estelle v. Gamble: cont’d
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He was taken before disciplinary committee, which
directed he be seen by another doctor
Saw second doctor, & given additional medication
Ordered back to work several times, again refused,
citing the pain
Eventually placed in solitary confinement as a
disciplinary sanction for refusing to work
He then claimed chest pains and “blank outs”, and
was seen one time in the hospital for these
He reported continuing pain to the officers in
administrative segregation, and was twice refused
permission to see a doctor
Estelle v. Gamble: cont’d
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Inmate sued under § 1983, claiming cruel
and unusual punishment in his medical care
Supreme Court opinion based on a concern
over denial of medical care to inmates
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Can lead to unnecessary pain and suffering
This is inconsistent with “contemporary
standards of decency”
Estelle v. Gamble: cont’d
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Court held that deliberate
indifference to serious medical needs
of inmates constitutes the
“unnecessary and wanton infliction
of pain” barred by the Eighth
Amendment
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Need more than an “inadvertent failure
to provide adequate medical care”
Estelle v. Gamble: cont’d
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In this case, Court held there was no
deliberate indifference
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Seen by medical personnel on 17 occasions
during a three-month period
Treated for three conditions after examination
and testing
Failure to order certain tests, or medications,
does not constitute cruel and unusual
punishment
At most, would be negligence or medical
malpractice, but not a constitutional violation
West v. Atkins (1988)
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Question in West was whether a
physician under contract with the State
to provide medical services to inmates
at a state prison hospital on a parttime basis acts “under color of state
law” within the meaning of 42 USC §
1983, when he treats an inmate
West v. Atkins: cont’d
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West tore his Achilles tendon playing volleyball
Taken to Central Prison Hospital
Saw Dr. Atkins, a private physician under contract
with the state to provide inmate medical services
Dr. provided orthopedic services; inmate’s leg was
placed in a series of casts
West claims Dr. told him that surgery was needed,
but refused to schedule it
West sued under § 1983, claiming Dr. was
deliberately indifferent when he failed to schedule
the surgery
West v. Atkins: cont’d
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Court said it was Dr.’s function for prison system,
not nature of employment, that decides whether
actions are attributable to the state
 Court held Dr. Atkins, in the state’s employ,
worked as a physician at the prison hospital
 Dr. fully vested with state authority to fulfill
essential job aspects, placed on State by Eighth
Amendment and state laws, to give essential
medical care to those persons state incarcerated
 Court held Dr. must be considered a state actor
 Court remanded to pursue the § 1983 action in
the trial court
Washington v. Harper (1990);
Sell v. U.S. (2003)
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Cases deal with involuntary treatment
of the patient; especially important in
the care of mentally ill patients
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Staff need to know when they are allowed
to intervene without the patient’s consent
to provide treatment
Related question is when do inmates have
the right to refuse treatment
Washington v. Harper; Sell v.
U.S.: cont’d
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Harper provides a partial answer
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Harper was a Washington state inmate
who was given antipsychotic medication
despite his refusal to take it
Decided as a due process case under the
Fourteenth Amendment – Court held
inmate had a constitutional right to refuse
medication, but
Washington v. Harper; Sell v.
U.S.: cont’d
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That the right could be overcome by the state
based on the inmate’s confinement status
Held treatment could not be given just to
control or improve the inmate’s disruptive or
difficult behavior, but
Where the inmate’s mental disability is the root
cause of the threat to others
State’s interest in decreasing the danger to
others encompasses an interest in providing the
inmate medical treatment for his illness
Washington v. Harper; Sell v.
U.S.: cont’d
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Sell dealt with whether the government could
administer antipsychotic medication against the
inmate’s will, solely to render him competent to
stand trial for serious, but non-violent offenses
 Sell, a dentist, was charged with making false
representations in connection with health care
payments
 An initial mental health assessment found him
competent to stand trial, but with the potential
for a psychotic episode
Washington v. Harper; Sell v.
U.S.: cont’d
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While on bail, he was accused of attempting to
intimidate a witness and was brought before a
magistrate judge
His behavior at the hearing was “totally out of
control,” and included his spitting in the judge’s
face
His bail was subsequently revoked
A second indictment was later brought, charging
Sell with an attempt to kill a witness and an FBI
agent
Washington v. Harper; Sell v.
U.S.: cont’d
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Sell sent to Federal Medical Center where
two clinicians determined Sell needed
antipsychotic medication to restore him to
competency so he could stand trial
Sell did not want to take
Supreme Court followed its Harper
guidelines, recognizing inmate has a liberty
interest in avoiding the unwanted
administration of antipsychotic drugs
Washington v. Harper; Sell v.
U.S.: cont’d
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Court held Constitution permits the
government to involuntarily administer such
drugs to a mentally ill defendant facing
serious criminal charges in order to make the
defendant competent to stand trial, but only if
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The treatment is medically appropriate
Is substantially unlikely to have side effects that
may undermine the fairness of the trial, and
Taking account of less intrusive alternatives, is
necessarily significant to further important
governmental trial-related interests
Washington v. Harper ; Sell v.
U.S.: cont’d
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Court gave detailed directions, stating
what a court must find:
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Important governmental interests are at
stake
Administration of the drugs is substantially
likely to make the defendant competent to
stand trial
Washington v. Harper ; Sell v.
U.S.: cont’d
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Involuntary medication is necessary to
further those interests
No alternative, less-intrusive treatments
exist
Administration of the drugs is in the
patient’s best interests
With these detailed instructions, case was
remanded for a determination on whether
the guidelines were met
Other Involuntary Medication
Cases:
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In Thor v. Superior Court (1996), an
inmate serving a life sentence became
a paraplegic while in prison
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Inmate refused to be fed, and refused
treatment
Psychiatrists said inmate was depressed,
but mentally competent to understand
the consequences of his decision
(deterioration and ultimate death)
Other Involuntary Medication
Cases: cont’d
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Health staff went to court to get
permission to forcibly medicate and feed
the inmate
The California Supreme Court held for
the inmate, saying the competent inmate
had a right to refuse unwanted medical
treatment, even if it could result in his
death
Other Involuntary Medication
Cases: cont’d
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The court noted the absence of evidence
demonstrating a threat to institutional
security or public safety
In the absence of such evidence, prison
officials were held to have no affirmative
duty to administer such treatment and may
not deny the incarcerated person this
freedom of choice
Other Involuntary Medication
Cases: cont’d
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In Singletary v. Costello (1996), a Florida
inmate fasted to protect his punitive transfer
to another facility, and what he said was a
false disciplinary report
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Medical staff determined failure to intervene
would result in his death
Florida court saw the inmate, as long as he was
competent, as having a fundamental right to
refuse nonconsensual medical treatment
Other Involuntary Medication
Cases: cont’d
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The task was balancing this against the
state’s interests in the preservation of life
The court upheld the inmate’s right to
refuse life-sustaining medical treatment
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Refusal would not endanger public health
There was no interest in the protection of
any third parties (such as minor children
depending on the inmate)
Other Involuntary Medication
Cases: cont’d
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The Eight Circuit Appeals Court looked
at the issue of drug administration for
the purpose of rehabilitation of the
inmate (Knecht v. Gillman (1973))
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Inmates complained given the drug
apomorphine without their consent
Inmates were at a medical facility; were
sent there for treatment of mental
incompetency and mental illnesses
Other Involuntary Medication
Cases: cont’d
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Staff testified drug used for its negative,
adverse effects; for inmates who had disruptive
behavioral problems (in effect, for behavior
modification)
 Given to inmates who did not get out of bed,
or swore or lied to staff; induces vomiting for
15 minutes to an hour
Appeals court disapproved; to force a person to
vomit for 15 minutes for a minor rules breach
can only be regarded as cruel and unusual,
unless the inmate knowingly and intelligently
consented to it
Other Involuntary Medication
Cases: cont’d
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In Rutherford v. Hutto (1974), a
lower court in Arkansas looked at
whether an inmate could be forced
to attend school against his will
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Case involved no medical treatment,
but rather involuntary treatment for the
good of the inmate
Other Involuntary Medication
Cases: cont’d
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Inmate was 43, illiterate, with little formal
education
Claimed a constitutional right to remain
ignorant and illiterate
Prison required inmates to attend classes
until they reached the fourth-grade level,
with subsequent participation voluntary
Other Involuntary Medication
Cases: cont’d
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Federal district court supported program;
held the inmate had no “constitutional
right” to be ignorant or to remain
uneducated
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“State has a sufficient interest in eliminating
illiteracy among its convicts to justify”
requiring attendance in classes designed to
bring inmates up to at least the fourth grade
level
If the inmate refused, he could be disciplined
Inmate Suicides
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One appeals court has stated that a
psychological or psychiatric condition can
be as serious as any physical pathology or
injury, especially when it results in suicidal
tendencies and
Failure of staff to take any steps to save a
suicidal detainee from self-injury may
constitute a due process violation under
Bell v. Wolfish
Inmate Suicides: cont’d
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Government liability requires a finding of
deliberate indifference to the suicidal
tendencies of the inmate in the circumstances
of each case
In Freedman v. City of Allentown (1988) the
Third Circuit Court of Appeals recognized that
jail officials can’t guarantee the safety of the
persons confined
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That inmates truly intent on killing themselves
will probably be able to do so at some point
Inmate Suicides: cont’d
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In Matje v. Leis (1983), the district
court found that liability will occur
when action isn’t taken in the face of
a strong likelihood, as opposed to a
mere possibility, that failure to
provide care would result in harm to
the inmate
Inmate Suicides: cont’d
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In Heflin v. Stewart County (1992), the
court upheld a jury award to the family
of an inmate who had hung himself
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Deputy Sheriff had ordered that the body
be left hanging until a doctor or emergency
medical staff arrived
When medical staff had not arrived (after
some 20 minutes), inmate was cut down,
but died soon after that
Inmate Suicides: cont’d
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The trial and appeals courts found that
the Deputy Sheriff should have
immediately cut the inmate down and
begun CPR (was trained to do this)
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The lower courts found negligence on the
part of the deputy, plus an apparent
deliberate indifference toward the
condition of the inmate
Inmate Suicides: cont’d
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Similar facts, different result in Reed v.
Woodruff County (1993)
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Trustee inmate found hanging in shower
stall, where it was determined that he had
died of “auto-erotic asphyxiation”
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Death was apparently unintentional
Staff did not find inmate until after death
had occurred
Inmate Suicides: cont’d
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Inmate’s family claimed prison officials
were negligent, that there was a
constitutional violation
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Claimed the jailer (trained as an
emergency medical technician) should
have tried to resuscitate
Failure to do so was deliberate
indifference
Inmate Suicides: cont’d
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Federal appeals court held there was
no obligation to try to revive the
inmate when the trained jailer
determined death had already
occurred
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There was no evidence that an
attempt to resuscitate could have
succeeded
Inmate Suicides: cont’d
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In Myers v. Lake County (1994), a
16 year old was unsuccessful in
his try to hang himself in a county
facility, but he did suffer
permanent brain damage
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He was awarded $600,000 in a suit
alleging negligence against county
officials
Inmate Suicides: cont’d
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Applying state law, a jury found
detention facility negligent in not taking
adequate precautions against suicide
attempts
Federal appeals court upheld judgment
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The court recognized not all suicides
could be prevented
But that reasonable measures to prevent
them were required
Inmate Suicides: cont’d
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The court rejected the county’s defense
of being severely “starved” for funds and
being shorthanded
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While this might mean no staff were
negligent
The lack of funds could not defend against
a claim that the facility had failed to
perform its legally required functions
Inmate Suicides: cont’d
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Lower courts have held for the
government when finding circumstances
were insufficient to show deliberate
indifference because there was
insufficient evidence to make officials
aware of the suicidal risks
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For instance, Freedman v. City of Allentown
(1988), where officers did not realize the
scars on the inmate’s wrists and neck were
from prior suicide attempts
Logue v. United States (1973)
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U.S. Marshals arrested inmate Logue and
placed him in the county jail to await trial
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Jail had contract with federal government to
hold inmates
Inmate committed suicide in the jail by
hanging himself
His parents sued the United States for
wrongful death under the Federal Torts
Claims Act
Logue v. United States: cont’d
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Supreme Court held that even
though Logue was placed in the jail
as a federal prisoner by a Deputy
U.S. Marshal, he was under the
control of the local sheriff and his
staff
Logue v. United States: cont’d
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For liability under Tort Claims Act ,
negligent act had to be done by a
“federal agency”
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Jail was contractor with federal
government
Act specifically excluded a contractor with
the U.S. from the definition of a federal
agency
U.S. not liable for the negligent acts or
omissions of the jail’s employees
Logue v. United States: cont’d
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Case did have a question as to whether the
deputy U.S. Marshal, knowing that Logue
had some suicidal tendencies
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Should have alerted the jail officials to that
problem and
Should have made sure there were
arrangements for Logue to be under constant
surveillance
Case sent back to lower courts to
determine whether federal employee was
negligent in this aspect of the inmate’s
death
HIV and AIDS
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Serious health threat in prisons and jails:
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At the end of 2001: 24,147 inmates in U.S.
HIV-positive
At the end of 2001: 2.0% of all males and
3.2% of all female state prison inmates HIVpositive
5,754 inmates in 2001 with confirmed AIDS –
this accounted for about 0.49% of the total
prison population; this rate is over three times
the rate of occurrence in the U.S. general
population (0.14%)
HIV and AIDS: cont’d
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Questions to be faced by administrators:
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Should the agency adopt a testing policy to
detect HIV-positive inmates
If yes, who should be tested and when
Should HIV-positive tested inmates be
segregated
If left in the general population, should they be
placed in the same work assignments and other
programs as other inmates
HIV and AIDS: cont’d
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Who should be notified of HIV test results
Should all corrections staff have a right to
know which inmates are HIV-positive
Once AIDS symptoms develop, where
should the inmates be placed
How should disciplinary cases be handled
HIV and AIDS: cont’d
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Are there special concerns for assaultive and
drug-using offenders
Should AIDS patients be returned to the
community early; should special efforts be
made to arrange for their care; should persons
in the community with whom they have contact
be notified of the inmate’s HIV status
The courts have ruled on few of these issues,
with those at the local level
HIV and AIDS: cont’d
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Two Supreme Court cases have had
some impact
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In Pennsylvania Department of Corrections
v. Yeskey (1998), Yeskey was denied
placement in a motivational boot camp
because of his hypertension; he sued
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Supreme Court ruled that the Americans with
Disabilities Act (ADA) applied to inmates in
state institutions
HIV and AIDS: cont’d
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Bragdon v. Abbott (1998) deals with a
private citizen, but its holding, which
interprets the ADA, gives guidance to
prison and jail officials
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In this case, a dentist in the community told
an HIV-infected patient that her cavity would
need to be filled at a hospital, at no added
fee for his services; but there would be a
hospital charge
HIV and AIDS: cont’d
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The Dr.’s policy was not to fill cavities of HIVinfected persons in the office
Patient Abbott sued, in part, under Section
302 of the ADA - section says no person
“shall be discriminated against on the basis
of disability in the full and equal enjoyment
of the goods, services . . .or accommodations
of any place of public accommodation by any
person . . . who operates a place of public
accommodation”
HIV and AIDS: cont’d
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Disability is defined in the statute as a
“physical or mental impairment that
substantially limits one or more of the major
life activities of such individual”
Supreme Court agreed with lower courts
that Abbott’s HIV infection satisfied the
definition of disability
Means the protections of the ADA apply to
persons with HIV infections
HIV and AIDS: cont’d
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Harris v. Thigpen (1991) involved a challenge
to Alabama’s program for mandatory testing
of all inmates and for segregating those
found to be HIV-positive
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The district court upheld the mandatory testing
policy, conducted for all inmates at admission,
stating it was a reasonable means of trying to
address the threat of AIDS to the prison
population
HIV and AIDS: cont’d
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Challenge was on basis of unreasonable
search and seizure, cruel and unusual
punishment, and due process violations
Both the district and appeals courts held
that the segregated placement of HIVpositive inmates was not cruel and unusual
punishment, and did not require due
process hearings prior to inmate placement
HIV and AIDS: cont’d
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Lower courts also denied a deliberate
indifference claim as to the provided
medical care
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In part, inmates claimed the AZT drug was not
used for treating HIV-positive inmates to the
extent recommended in the outside
community
The courts found no constitutional violations
and that failure to provide the AZT treatment
was permissible (justifying its conclusion in
part on the high cost of the drug treatments)
HIV and AIDS: cont’d
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HIV-positive inmates objected to being
ineligible for prison programs that would
help them upon release
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The courts held the inmates were not entitled
to such programs as a matter of law
Program involvement decisions were for
prison officials to make based on their
informed correctional judgment
HIV and AIDS: cont’d
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Appeals court did send the case back for
further fact-finding by the district court on
whether segregated HIV-positive inmates
were excluded from programs available to
other inmates and whether this was a
violation of the Rehabilitation Act of 1973
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Of particular concern was a claimed denial of
access to the law library materials, and thus
equal access rights to the courts
HIV and AIDS: cont’d
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In 1999, the Eleventh Circuit Court of Appeals
issued its opinion, in Onishea v. Hopper on
whether Alabama’s policies were in violation
of Section 504 of the Rehabilitation Act
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HIV-positive inmates had sued under the Act to
force the mixing of HIV-positive and HIVnegative inmates in prison recreational,
religious, and educational programs
HIV and AIDS: cont’d
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The lower courts denied relief, finding that
sexual conduct, intravenous drug use, and
bloodshed were always a possibility in
prison when staff are not watching
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Held that prison life is unpredictable
That since HIV is transmitted by the above
actions
HIV transmission in prison is more than a
“theoretical possibility”
HIV and AIDS: cont’d
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Fact that prisons have violence,
intravenous drug use, and sexual conduct
and that these acts may cause blood-toblood contact, providing opportunity for
transmission of the virus, was sufficient to
find significant risk
This risk removed inmates from the
protective benefits of the Rehabilitative Act
HIV and AIDS: cont’d
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In Gates v. Rowland (1994), an appeals court
held that California prison officials did not
have to place HIV-infected inmates into work
assignments in food services
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Recognizing there was little risk of transmission
through the work, the appeals court upheld the
government’s position that other inmates would
perceive it as a threat
And that it was particularly important in a prison
setting that inmates have positive attitudes
about the safety and sanitation of their food
HIV and AIDS: cont’d
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Privacy concerns are being litigated in
the lower courts
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For example, does the inmate have a
privacy interest over who should have
access to his health status
Are there instances where the prison has
a legitimate interest in disclosing the
information
HIV and AIDS: cont’d
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Two potential areas of staff interest
in knowing who is HIV-infected in
the general prison population
1.
So staff can take appropriate safety
precautions
HIV and AIDS: cont’d
2.
And where staff is assaulted by an inmate
in which there may be exposure to blood
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Should the staff member be notified the
inmate is HIV positive; what about inmate
privacy concerns
One approach is to offer the employee
periodic testing, with pretest and posttest
counseling, with costs absorbed by the
agency
HIV and AIDS: cont’d
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Important to know state and local
requirements on reporting HIV/AIDS
cases to the local authorities
As to providing medical care for an HIVinfected inmate and the AIDS patient,
staff should apply the same standards
in adopting policy and procedures that
they would use for other health care:
HIV and AIDS: cont’d
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Must not be deliberately indifferent
Must stay informed about the current level
of accepted care and precautionary
treatments that are followed in the
community, and
Must try to follow those guidelines to the
extent possible
Tuberculosis in Prison:
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Tuberculosis (TB) in prisons a special
concern
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Close living environment can facilitate the
spreading of TB
Second concern is the interaction between
TB and HIV infection – the presence of
immunosuppressions in a person (for
example, presence of HIV) may cause the
person not to be reactive to a TB skin test
Tuberculosis in Prison: cont’d
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Besides testing and interviewing of
inmates at admission, periodic retesting
of inmates is recommended
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Isolation of those testing positive is
recommended
When inmates with TB are scheduled for
release, referral to local health
departments should be made
Tuberculosis in Prison: cont’d

Lawsuits have focused on the alleged
failures to take adequate steps to
prevent the spread of the disease, thus
placing other inmates (and staff) at
increased risk

One appeals court held that an agency’s
failure to take adequate steps to detect
and fight the disease could show deliberate
indifference to the serious medical needs
of inmates (DeGidio v. Pung (1990) )
Tuberculosis in Prison: cont’d

A Wyoming district court held that
allegations on the failure to isolate
infectious TB cases showed only
differences of opinions on how TB cases
should be treated, and not indifference to
inmate’s medical needs (Blumhagen v.
Sabes (1993))
Tuberculosis in Prison: cont’d

These two cases point out the
standards that would be recommended
for prison officials

Prison officials should consult with health
officials about adoption of detection and
treatment programs according to current
guidelines (from Centers for Disease
Control and Prevention [CDC] and others)
Tuberculosis in Prison: cont’d
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Failure to do so could expose officials to
claims of deliberate indifference and thus to
personal liability under § 1983 actions
Even if programs are implemented, staff
should update them as needed and make
sure staff follow through with all
recommended testing and treatments to
avoid tort claims of medical malpractice
Tuberculosis in Prison: cont’d

A second legal issue involves
inmates’ objections to being tested
when there is a mandatory,
universal testing program
Tuberculosis in Prison: cont’d

The Massachusetts appeals court, in Langton
v. Commissioner of Corrections (1993),
upheld the state’s policy that inmates had to
be tested for TB


Because of the legitimate concerns for inmate
security and safety, the court said the policy for
mandatory testing was lawful and justified
And that the inmate could be disciplined for
refusing to take the TB test
Tuberculosis in Prison: cont’d

From a different perspective, in a New York
case, Jolly v. Coughlin (1995), a Rastafarian
inmate refused to take the TB screening test
based on his religious beliefs


Pursuant to the corrections department’s TB
control program, the inmate was placed in
“medical keeplock,” meaning cell restriction,
except to shower
Inmate was in this status for over 3.5 years
Tuberculosis in Prison: cont’d



Applying RFRA standards, the court found a
substantial burdening of the inmate’s exercise of
his religious beliefs, without a compelling
government justification
Prison officials failed to convince the court that
keeping the inmate in lockdown status was the
least restrictive approach to further their
interest in fighting the spread of TB
The court ordered the inmate released from
keeplock status and enjoined prison officials
from placing him there
An Aging Prison Population

Number of older inmates in prison
expected to increase



Based on number of elderly in general
population
And longer sentences
Management problems are presented

Health care
An Aging Prison Population:
cont’d




Depression appears to be more common in
this age group
Other mental health problems also develop
Nutrition needs are different, may require
consideration of different dietary
requirements
Physical ailments and general deteriorations
of energy levels and muscles produce
problems in the classification of elderly
inmates, regarding housing, job assignments,
and other programs
An Aging Prison Population:
cont’d


Another management problem: elderly
can become easier targets for other
inmates to prey on
Some activities – religious, watching
television, participating in organizations,
for example - may be more attractive to
elderly inmates
An Aging Prison Population:
cont’d

No set approach for handling this
population

Does require a coordinated response



Some agencies place the elderly in certain
institutions where staff members are trained
to look after their needs
Some house the elderly together
Some have jobs set aside for the elderly
An Aging Prison Population:
cont’d

Many of the elderly prefer separate,
quieter quarters

Find living with their own age group less
stressful
An Aging Prison Population:
cont’d

Legal problems for dealing with elderly
essentially the same as for dealing with
general prison population – prison
officials must not show deliberate
indifference to the serious medical
needs of the inmates, and in this case,
the increased medical needs of the
elderly inmate
An Aging Prison Population:
cont’d

As part of the broad concerns for wellbeing of elderly inmates, prison officials
should show sensitivity on making
decisions such as



Food service
Special accommodations for visiting and
other contacts with family and friends, and
Assignments to special housing or special
programs
An Aging Prison Population:
cont’d

Failure to do so could expose staff to
individual constitutional liability under
Section 1983