Prison Healthcare and Human Rights: Addressing Medical Neglect in the U.S. Penal System

The U.S. prison system can house about 1.9 million people, making it the world’s largest incarcerated population [1]. However, despite the mandate under the Eighth Amendment prohibiting cruel and unusual punishment, incarcerated individuals frequently experience inadequate healthcare. This issue has raised significant ethical concerns regarding human rights and systemic disparities in access to care. Prisoners, regardless of their crimes, have the right to proper medical treatment. However, a combination of underfunding, staff shortages, and systemic barriers often leads to substandard care.

The Ethical Foundations of Prison Healthcare

Medical ethics is grounded in four key principles: Autonomy, Beneficence, Nonmaleficence, and Justice [2]. While incarcerated individuals inherently have limited personal freedoms, these principles are crucial in the ethics of prison healthcare. Autonomy, in a medical context, refers to a patient’s right to make informed decisions about their own care. However, prisoners often have little to no control over when they receive medical attention, frequently experiencing long wait times for physician visits, dental treatments, and specialist care. Justice means that prisoners, like all individuals, should receive equal access to healthcare. However, the systemic disparities in healthcare between the general and prison populations fail to uphold this ethical standard. Regarding beneficence and nonmaleficence, medical professionals have a duty to act in the best interests of their patients and avoid causing harm. Yet in prison, there are daily reports of delayed treatments, inadequate chronic disease management, and preventable deaths [3].

Medical Neglect in U.S. Prisons: Case Studies and Systemic Barriers

Where should we point the blame? Despite the legal requirement to provide healthcare, there is widespread neglect due to systemic deficiencies. Many prisons operate with limited medical staff, which can lead to delays in treating conditions. Prisons also house a disproportionately high number of individuals with chronic conditions such as diabetes, hypertension, and HIV, which can exacerbate health disparities [4]. Another factor is mental health. Over 40% of incarcerated individuals suffer from mental health disorders [5]. Punishments like solitary confinement have been linked to worsening psychiatric symptoms, raising ethical concerns regarding inhumane treatment.

Role of Private Healthcare Providers in Prisons

Many prisons attempt to contract private healthcare companies to provide medical services [6]. While privatization is intended to cut costs, many argue that for-profit companies have incentives to minimize care, reducing expenses at the cost of prisoner health. As a consequence, prisons may fail to provide necessary treatments, delay access to life-saving medications, and refuse specialist referrals due to cost concerns.

International Standards & U.S. Shortcomings

International human rights frameworks support the right to healthcare for incarcerated individuals. The United Nations Standard Minimum Rules for the Treatment of Prisoners state that prisoners must receive the same medical care available to the general population [7]. However, the U.S. has consistently fallen short of these standards, with reports of neglect, medical rationing, and underfunding being common across state prison systems.

Medical neglect in U.S. prisons represents an ethical failure that undermines the principles of justice and human dignity. Although incarcerated individuals have lost certain freedoms, their right to healthcare remains protected under both legal and ethical frameworks. In order to address prison healthcare disparities, we must recognize that access to care is a fundamental human right.

Edited By: Makayla Gorski

Designed By: Eugene Cho

References

[1] Wagner, Wendy Sawyer and Peter. “Mass Incarceration: The Whole Pie 2024.” Prison Policy Initiative, 14 Mar. 2024, www.prisonpolicy.org/reports/pie2024.html. 

[2] - Beauchamp, T., & Childress, J. (2019). Principles of Biomedical Ethics: Marking Its Fortieth Anniversary. The American Journal of Bioethics, 19(11), 9–12. https://doi.org/10.1080/15265161.2019.1665402

[3] - Maruschak, Laura M. “Medical problems of jail inmates.” PsycEXTRA Dataset, Nov. 2006, https://doi.org/10.1037/e500022007-001. 

[4] “The health status of soon-to-be-released inmates: A report to Congress, volume 2.” PsycEXTRA Dataset, Mar. 2002, https://doi.org/10.1037/e514682006-001. 

[5] - James, Doris J., and Lauren E. Glaze. “Mental health problems of prison and jail inmates.” PsycEXTRA Dataset, June 2017, https://doi.org/10.1037/e557002006-001. 

[6] Noga Shalev, “From Public to Private Care The Historical Trajectory of Medical Services in a New York City Jail”, American Journal of Public Health 99, no. 6 (June 1, 2009): pp. 988-995. https://doi.org/10.2105/AJPH.2007.123265

[7] - The United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), 26 Mar. 2016, https://doi.org/10.18356/9789213589427.