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Index
1AC ............................................................................................................................................................. 4
Prisons spread disease (1/2).................................................................................................................... 18
Prisons breed disease (1/3) ..................................................................................................................... 20
Prison efforts fail now (1/3) .................................................................................................................... 23
Disease Spillover – Generic (1/3) ........................................................................................................... 26
Disease Spillover – HIV (1/1) ................................................................................................................. 29
Disease Spillover - Hepatitis (1/2) .......................................................................................................... 30
Disease Spillover – Tuberculosis (1/2) ................................................................................................... 32
Disease Spillover – STD’s ....................................................................................................................... 34
Impacts – Generic (1/2) .......................................................................................................................... 35
Impacts - AIDS ........................................................................................................................................ 37
Mental Health Fails in Prisons (1/4) ...................................................................................................... 38
Mental Health Impacts ........................................................................................................................... 42
Prison Rape.............................................................................................................................................. 43
Prison Rape – Impacts (1/2) ................................................................................................................... 44
Prison Rape – Moral Obligation............................................................................................................ 46
Probability Calculus (1/2)....................................................................................................................... 47
Racial Disparity in SQ Ext. .................................................................................................................... 49
2ac Dehumanization Add-on.................................................................................................................. 50
Moral Obligation Ext. (1/3) .................................................................................................................... 51
Prisoners need basic human rights (1/2) ............................................................................................... 54
Hepatitis add-on ...................................................................................................................................... 55
Solvency-Education reduces recidivism (1/3) ....................................................................................... 56
Solvency-Drug Education....................................................................................................................... 59
Solvency-Disease Education ................................................................................................................... 60
Solvency-Moral Obligation for Education............................................................................................ 61
Solvency-Risk Reduction ........................................................................................................................ 62
Solvency-Mental Health Care (1/2) ....................................................................................................... 63
Solvency-Disease Screening.................................................................................................................... 65
Recidivism Uniqueness ........................................................................................................................... 66
Poverty Recidivism ............................................................................................................................. 67
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Recidivism Reflects on the System ........................................................................................................ 68
Education solves recidivism (1/3) .......................................................................................................... 69
Recidivism Impact .................................................................................................................................. 72
Inherency – BOP Lacks Funding (1/3) ................................................................................................. 73
Inherency – Abstinence Only Approach ............................................................................................... 76
Courts Have The Authority ................................................................................................................... 77
Courts Solve Best .................................................................................................................................... 78
Ext #1 – Estelle v. Gamble ...................................................................................................................... 79
Ext #2 – Accountability .......................................................................................................................... 80
Courts Solve State Prisons ..................................................................................................................... 81
Courts Solve State Prisons ..................................................................................................................... 82
Courts Test Case – California (1/2) ....................................................................................................... 83
AT: State Courts CP ............................................................................................................................... 85
AT: Court Intervention  Prison Violence ......................................................................................... 86
2AC Death Row Wait Add-On .............................................................................................................. 87
Ext #1 – Court Intervention  Precedent ............................................................................................ 88
Ext #2 – Death Row Wait = Torture ..................................................................................................... 89
AT: Court Overrule ................................................................................................................................ 90
AT: Congress Rollback........................................................................................................................... 91
2AC Death Penalty Add-on 1/2.............................................................................................................. 92
Ext #3 – Impact ....................................................................................................................................... 94
Removing Death Penalty Solves Biopower ........................................................................................... 95
2AC AT: Solvency Takeouts (8th Specific)............................................................................................ 96
Racial Disparity in the Justice System .................................................................................................. 97
No current efforts to solve ...................................................................................................................... 98
Longer Sentences .................................................................................................................................... 99
Discrimination makes poverty inevitable ........................................................................................... 100
Black Hyper-Incarceration .................................................................................................................. 101
Torture ................................................................................................................................................... 102
The “Supermax” of Federal Prisons ................................................................................................... 103
Racism is unacceptable ......................................................................................................................... 104
The Solution........................................................................................................................................... 105
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States Fail (1/2) ...................................................................................................................................... 106
States Fail - Funding ............................................................................................................................. 108
States Fail – Funding Tradeoff ............................................................................................................ 109
Fed Key .................................................................................................................................................. 110
States Model Federal Action ................................................................................................................ 111
States Model Federal Action ................................................................................................................ 112
World Models US Action...................................................................................................................... 113
Politics-Plan Bipartisan (1/3) ............................................................................................................... 114
Politics-Webb......................................................................................................................................... 117
Plan Popular-State Reforms Prove ..................................................................................................... 118
Plan Popular-Republicans ................................................................................................................... 119
Plan Popular- Democrats ..................................................................................................................... 120
Politics-Obama Will Push .................................................................................................................... 121
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Advantage One- Disease
Current prison healthcare programs are failing, encouraging disease spread throughout greater
society
American Journal of Public Health Public Health Implications of Substandard Correctional Health Care
Zulficar Gregory Restum.. Washington: Oct 2005. Vol. 95, Iss. 10; pg. 1689, 3 pgs
http://proquest.umi.com/pqdweb?did=909247321&sid=2&Fmt=3&clientId=15023&RQT=309&VName=PQD
The alarming prevalence of communicable diseases like hepatitis C, TB, and HIV/AIDS among prisoners poses a
serious public health problem. Overcrowded conditions and poor health education in prisons, as well as weak community-based public
health programs for infected people, exacerbate the problem. Also, since condoms and bleach are illegal in prisons, many inmates who are victims
of rape or engage in consensual sex are at risk of transmitting diseases in prison and after they are released back to their communities. Even
those with short-term sentences can become infected in prison with a communicable disease, which can mean a
virtual death sentence. The links between intravenous drug use, hepatitis C and HIV/AIDS, and incarceration help explain the rise in
infectious diseases in our nation's prisons.7 Hepatitis C The Association of State and Territorial Health Officials reported in 2000 that "an
estimated 1.4 million HepC [hepatitis C]-infected people pass through the US correctional system each year."8 Today, 20% to 40% of prison
inmates are infected with hepatitis C, a rate due in large part to the prevalence of injected drugs in prison. Released prisoners spread the infection in
the community through sex, blood transfusions, needle sharing, and street fighting.8 As Phyllis Beck, director of the Hepatitis C Awareness Project
and cofounder of the Hepatitis C Prison Coalition, reports, "all of the risk factors [of hepatitis C] multiply exponentially when they are confined to a
small space with crowded conditions such as a prison." She adds, "In essence, our state prisons have become a state-sponsored
incubator for HepC, by default."7 Tuberculosis TB has seen a rapid rise in recent years in state and federal prisons, owing in part
to inadequate screening on admission and poor treatment if TB is diagnosed. Because TB is an airborne disease, it thrives among people who live in
dose quarters with poor ventilation. Prisons offer the optimum environment for the growth of TB. Controlling TB requires a
joint effort on the part of health care professionals to diagnose the disease, isolate infected individuals, give proper medical treatment, track
reactivation of the disease, and educate both prisoners and the general population.
TB spreads from prisons to the outside community through releases, prison transfers, and regular contact between
prisoners and prison staff and visitors. The impact on the community can be considerable.12 For example, in one
Arkansas community, 800 males aged 16 to 61 years were diagnosed with TB between 1972 and 1977; 9.6% had spent time in prison.13 The
incidence in Arkansas today has increased considerably. HIV/AIDS When me HIV/AIDS epidemic peaked in the 1980s, there was an explosion of
cases in US prisons. The prison health care system reacted slowly, but it eventually developed treatment programs for HIV-infected inmates. The
problem now, however, is inconsistency in administering these programs and in helping prisoners overcome the
stigma attached to HIV. To receive medications, prisoners must wait in long lines. Medications for treating
HIV are uniquely packaged, allowing other prisoners to identify them and their recipients. These conditions
make many prisoners reluctant to request diagnostic tests and receive needed treatment.4 Public Health
Concerns Prison screening programs and treatment initiatives are inadequate and inconsistent. Prisoners are
sometimes not notified that they have an infection. When they are released, they become free carriers of the
infection. Because prisoners constantly come in contact with other prisoners, staff, guards, health care
professionals, and the general public through visits, the rampant spread of communicable diseases throughout
the nation's prisons affects society as a whole. PRISON HEALTH CARE DELIVERY Many of the problems in prison health care
delivery stem from myths about prisoner patients. Concern about violent behavior may cause health care professionals to use excessive force, such
as shackling hospitalized prisoners to beds. Such activity perpetuates the notion that all prisoners are violent. In an attempt to remedy the delivery
of health care, many states have retained private health care providers or correctional health maintenance organizations (HMOs), such as
Correctional Medical Services (CMS), purportedly to save the state money. While CMS is the nation's largest provider of prison medicine, it is also
the cheapest Unlike conventional HMOs, however, which risk malpractice suits, CMS and similar companies have little reason to protect
themselves because juries are reluctant to decide on behalf of convicts or award them damages. Health Care Professionals The husband of
Josephine Williams has been incarcerated in an Indiana prison for 33 years. He currently suffers from a number of serious medical problems. In an
interview with the author, Mrs Williams described the shoddy treatment given to her husband and to other inmates at the prison. In one episode, a
friend of her husband suffered chest pains while on the job. He went to the infirmary and, after waiting a long time, was given an aspirin and told to
return to work. A while later, weakened by progressively greater chest pains, he was assisted to the infirmary by another inmate. He was told to get
on a gurney and wait. He waited for an hour, until he died, completely unattended. The primary barrier to health care that prisoners face is being
seen by a prison physician. They must fill out a form and then wait for approval. Even then they cannot be assured of seeing a physician. Some
states require that a prisoner must be able to afford the copayment portion of the care received. If a prisoner arrives at the clinic after it closes, he or
[Continued no text deleted]
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1AC
she must wait for another appointment. A long wait to see a doctor could mean time lost from work; in some state prison systems, every missed day of
work adds another day to the prisoner's sentence. Prison nurses in Illinois have voiced concerns over a variety of problems in 19 correctional facilities,
including deteriorating care, lack of medical supplies, and weak accountability from state officials and contractors. In short, the health of Illinois prison
inmates has been sacrificed to boost the profits of private companies administering health care.4 Ethical and Legal Questions
Doctors and nurses working in jails and prisons face ethical conflicts that are unfamiliar in a community context. Prisons are designed primarily to
carry out court instructions and protect society from those who have committed crimes. Reformation is secondary to detention. Although prisons are
not normal health care settings, prisoners undeniably have health care needs that must be addressed. Although Skubel v Fuoroli, as detailed by
Wing,14 pertained to home nursing services, he states that there is a "consensus among health care professionals that community access is not only
possible but desirable for disabled individuals." Prisoners, by virtue of their incarceration and high risk for contracting infectious diseases, should
be considered disabled and therefore have access to health care, just as do all members of society. SUMMARY Two million men and women are
incarcerated in US prisons. Many contract chronic, life-threatening contagious diseases while in prison. The impoverished
environments of prisons are breeding grounds for hepatitis C, TB, and HIV/AIDS; drug abuse; and violence. If these
diseases go undetected in prison, people emerge infected. The "diseases" flourish and spread in the outside
communities, becoming epidemics affecting the general population. Society pays the price, in the high cost of both private
health care providers-who often fail to deliver adequate care-and of public health care for released inmates receiving treatment and for their families
and friends who become infected and cannot afford private care. If society is to diminish the risk of contracting infectious diseases from prisoners,
it must insist on education, preventive measures, proper screening and treatment, continuity of care, and accountability on the part of those agencies
and officials in charge of prisoners in jails, state prisons, and federal correctional facilities.
Without federal action 1.5 million prisoners will be released with infectious diseases yearly
threatening public health
Gail C Christopher [vice president for health, women and families at the Joint Center for Political and Economic
Studies, and director of the Health Policy Institute] . New Pittsburgh Courier. (City Edition). Pittsburgh, Pa.: Jul 12-Jul
18, 2006. Vol. 97, Iss. 28; pg. A4, 1 pgs. “Prisoner health is society's concern
http://proquest.umi.com/pqdweb?did=1110487831&sid=5&Fmt=3&clientId=15023&RQT=309&VName=PQD
(NNPA)-The fight to end health disparities in the United States won't succeed unless local, state and federal leaders place
more emphasis on improving the healthcare available to inmates in the nation's jails and correctional facilities, according to a
new report by the Commission on Safety and Abuse in America's Prisons. The current situation is appalling. There are nearly
1 million African-Americans in jails and prisons today, comprising 44 percent of the 2.2 million prison population. The
inadequate healthcare that they receive while incarcerated contributes to the health disparities that are causing AfricanAmerican men, women and children around the country to be disproportionately diagnosed with a wide range of diseases.
How does the health of prisoners impact our communities? Data recently released by the Commission on Safety and Abuse
in America's Prisons shows that experts conservatively estimate that between 300,000 and 400,000 inmates across the
country suffer from some mental illness. They get little treatment while incarcerated, thus they are returned to their
communities with mental conditions that are likely to contribute to undesirable behavior. Moreover, the Commission's
report also found that 1.5 million prisoners are released each year with life threatening, infectious diseases. That means
people with HIV, tuberculosis, staph infections and Hepatitis are also returned to their communities where contagious
diseases are passed on. Clearly, our nation has turned its back on the healthcare of prisoners, failing to recognize that most
inmates eventually get released, and then bring their health issues back to their families and communities. There are a series
of policies in place that are a major hindrance to allowing prisoners to receive proper healthcare. For instance, it is
counterproductive for inmates to lose their Medicare and Medicaid benefits after they are incarcerated. A major hurdle for
prison wardens is that even if jails and prisons want to vastly improve healthcare services for prisoners, most lack the
resources to do so. The federal government exasperates the problem by taking away Medicare and Medicaid benefits,
reimbursements that could be used by jails and prisons to bolster their healthcare services. Furthermore, this is a shortsighted
policy by the government. In many instances, if prisoners received treatment for some of these diseases while they are
incarcerated, it would actually reduce the costs associated with their health once they are released. Take Hepatitis C, for
instance. Many prisoners don't receive any treatments for this disease. Years later when they are back in their communities,
they may need liver transplants, which will cost the government far more than the treatments.
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Health care in state run prisons fail due to a lack of strong leadership
The Lancet “cruel and unusual” February 28, 2009 - March 6, 2009. Lexis
Prisons are run by the state. They house people who have been convicted of a crime and are serving terms that could last for years, sometimes for
the rest of their lives. As such, a prison must be able to handle not only whatever acute problems afflict the residents, but also the chronic diseases associated
with ageing. Substandard prison health care is deemed a violation of the Eighth Amendment to the Constitution that prohibits cruel and unusual punishment,
making prisoners the only group of Americans who are guaranteed medical care. In reality, the care that prisoners receive varies widely,
depending on each state's policies and resources. Some states, like California, run their own prison health facilities, so the doctors and nurses who work there
are state employees. Others, like New York, contract with outside companies to provide prison care. Either way, this means that the care prisoners actually
receive reflects each state's politics, budget, leadership, and the will of the voters. Overall, health systems in US prisons have undergone "a
dramatic improvement in accessibility, quality, and timeliness" over the past few decades, says Ronald M Shansky, an internist and specialist in correctional
health care, who has testified in many court cases involving prison medical systems. California missed this trend in part because the state "never had the
strong leadership necessary to design and implement a good health-care system". One glaring problem was that "any
doctor with a license could be hired to give primary care. You might have pathologists or anesthesiologists seeing patients with diabetes".
Understaffing was another serious drawback: some prisons had only two or three doctors to care for 5000 inmates.
Failure of prison health care will soon result in drug resistant strains of HIV
US news and world report “Most HIV-Infected Prisoners Go Untreated After Release And that can pose a big public
health threat, researchers warn Posted February 24, 2009
http://health.usnews.com/articles/health/healthday/2009/02/24/most-hiv-infected-prisoners-go-untreated-after_print.htm
Following their release from Texas prisons, only 5 percent of ex-inmates with HIV
fill a prescription for medicine to treat their condition within the necessary 10 days, a new study finds. "Those who discontinue
ART [antiretroviral therapy] at this time are at increased risk of developing a higher viral burden, resulting in greater
infectiousness and higher levels of drug resistance, potentially creating reservoirs of drug-resistant HIV in the
general community," the University of Texas Medical Branch in Galveston researchers wrote in the Feb. 25 issue of the Journal of the
American Medical Association. The findings, which cover a recent four-year period, spark great concern about former prisoners'
TUESDAY, Feb. 24 (HealthDay News) --
health and whether the state needs to intervene to prevent a public health crisis, the study's authors said in a news release from the journal's
publisher. "Greater coordination between state and local agencies, health-care institutions, and community-based organizations is needed to reduce
this high rate of treatment interruption among newly released inmates," the researchers wrote. Of the more than 2,100 HIV-infected former inmates
released between 2004 and 2008, less than 18 percent filled their prescription for antiretroviral medication within 30 days of discharge, the
researchers noted. That rate increased to only 30 percent within 60 days. When breaking down the data, the authors found at least 90
percent of the former inmates experienced a treatment interruption, and many of these breaks lasted beyond 30 and even
60 days. Those ex-inmates with a detectable viral load, as well as those on parole or receiving help through an AIDS Drug Assistance Program
were more likely to fill their prescriptions than their counterparts. Most former inmates lack health insurance for some time following prison
release, so accessing antiretroviral therapy for HIV can be challenging without government help, the authors noted.
Failure of prison health care system leads to drug resistant TB which threatens the general
population
The Health Lawyer [editor Michele Westhoff.] “AN EXAMINATION OF PRISONERS' CONSTITUTIONAL
RIGHT TO HEALTHCARE: THEORY AND PRACTICE” Chicago: Aug 2008. Vol. 20, Iss. 6; pg. 1, 13 pgs. Proquest
Conditions common to prisons, including close quarters, overcrowding, and poor ventilation contribute to the spread
of TB.112 In addition, because prisons are notorious for failing to dispense medication as prescribed, many drugresistant strains of TB are common in correctional facilities.113 These factors create a particularly serious public
health risk for inmates and non-incarcerated citizens. First, prison conditions are ideal for facilitating explosive outbreaks of TB.114
A prison-wide epidemic could devastate the inmate population, but also easily be transmitted to the general public by
prison employees who become infected at work and carry the bacteria outside the prison walls when they are off-duty.115 Second, if an epidemic is
spurred by a drug-resistant strain of TB, the disease could prove extremely difficult to treat and exact an enormous cost in
terms of government funds and loss of life.116
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Mutant strains are the most probable cause of human extinction
South China Morning Post, ‘96
(South China Morning Post, 1/4/96, “Leading the way to a cure for AIDS.” )
Despite the importance of the discovery of the "facilitating" cell, it is not what Dr Ben-Abraham wants to talk about.
There is a much more pressing medical crisis at hand - one he believes the world must be alerted to: the possibility of
a virus deadlier than HIV. If this makes Dr Ben-Abraham sound like a prophet of doom, then he makes no apology for
it. AIDS, the Ebola outbreak which killed more than 100 people in Africa last year, the flu epidemic that has now
affected 200,000 in the former Soviet Union - they are all, according to Dr Ben-Abraham, the "tip of the iceberg".
Two decades of intensive study and research in the field of virology have convinced him of one thing: in place
of natural and man-made disasters or nuclear warfare, humanity could face extinction because of a single
virus, deadlier than HIV."An airborne virus is a lively, complex and dangerous organism," he said. "It can
come from a rare animal or from anywhere and can mutate constantly. If there is no cure, it affects one person
and then there is a chain reaction and it is unstoppable. It is a tragedy waiting to happen."That may sound like a
far-fetched plot for a Hollywood film, but Dr Ben -Abraham said history has already proven his theory. Fifteen years
ago, few could have predicted the impact of AIDS on the world. Ebola has had sporadic outbreaks over the past 20
years and the only way the deadly virus - which turns internal organs into liquid - could be contained was
because it was killed before it had a chance to spread. Imagine, he says, if it was closer to home: an outbreak of
that scale in London, New York or Hong Kong. It could happen anytime in the next 20 years - theoretically, it
could happen tomorrow. The shock of the AIDS epidemic has prompted virus experts to admit "that something
new is indeed happening and that the threat of a deadly viral outbreak is imminent", said Joshua Lederberg of
the Rockefeller University in New York, at a recent conference. He added that the problem was "very serious and is
getting worse". Dr Ben-Abraham said: "Nature isn't benign. The survival of the human species is not a
preordained evolutionary programme. Abundant sources of genetic variation exist for viruses to learn how to
mutate and evade the immune system."He cites the 1968 Hong Kong flu outbreak as an example of how viruses
have outsmarted human intelligence. And as new "mega-cities" are being developed in the Third World and
rainforests are destroyed, disease-carrying animals and insects are forced into areas of human habitation. "This raises
the very real possibility that lethal, mysterious viruses would, for the first time, infect humanity at a large scale
and imperil the survival of the human race," he said.
Preventative measures would save the government billions of dollars
Milken, 2k7
(The Milken Institute, October 2007, “An Unhealthy America: The Economic Burden of Chronic Disease”)
www.milkeninstitute.org/pdf/ES_ResearchFindings.pdf
In a groundbreaking study released today by the Milken Institute, the annual economic impact on the U.S. economy of the
most common chronic diseases is calculated to be more than $1 trillion, which could balloon to nearly $6 trillion by the
middle of the century. Yet the news is not entirely grim because much of this cost is avoidable.“An Unhealthy America:
The Economic Burden of Chronic Disease” brings to light for the first time what is often overlooked in the discussion of
the impact of chronic disease — the economic loss associated with preventable illness and the cost to the nation’s Gross
Domestic Product (GDP) and American businesses in lost growth.“In every community in our country, people are
suffering from preventable chronic diseases. Not only does that suffering affect our nation’s overall health — but also our
nation’s economic productivity,” said Richard H. Carmona, M.D., M.P.H., FACS. “With this new data from the Milken Institute,
we now know the cost burden of chronic disease in our nation, and it’s truly staggering. If we are unable to reduce the rate
of chronic disease, the potential economic damage to our nation could be devastating. For both the physical and economic health
of our country, we must bring together all sectors to find new, innovative, and cost-effective ways to prevent chronic disease. Any funding that we
spend to prevent chronic disease today will actually be a valuable investment — with long-term dividends.” Dr. Carmona is Chairperson of the
Partnership to Fight Chronic Disease (PFCD), 17th U.S. Surgeon General (2002-2006), and President of Canyon Ranch Institute. According to the
study, seven chronic diseases – cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions and mental illness – have a total impact on
the economy of $1.3 trillion annually. Of this amount, $1.1 trillion represents the cost of lost productivity.
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Advantage Two- Repugnant Practices
Lack of health and resources makes U.S. prisons the new gulag
Lendman 06
(Stephen Lendman; received a BA from Harvard University in 1956 and an MBA from the Wharton School at the University
of PA in 1960 following 2 years of obligatory military service in the US Army, March 16, 2006, “The US Gulag Prison
System”, http://www.globalresearch.ca/index.php?context=va&aid=2113)
THE PROFITABLE BUSINESS OF RUNNING A GULAG The for-profit side of running a gulag began to explode
during the Reagan years when incarceration rates began increasing dramatically. Along with a growing private prisons
industry (a small slice of the prison pie still largely a public enterprise), a vast array of private businesses wanted a piece of
the action and got it. These include architectural and construction companies; food service contractors; all sorts of equipment,
hardware and other suppliers of steel doors, razor wire, communications systems, and health care and medical supplies.
There's also a big need for uniforms and assorted weapons including dangerous products to restrain like chemical sprays
that can injure, cause severe pain, second degree burns, temporary blindness or worse and taser electro-shock guns that emit
50,000 volts of electricity (enough to flatten an all-pro NFL lineman in peak form) that can and have killed as many as 167
victims from it's use through January, 2006. And there's loads more. The (mal) care and feeding of a couple of million
humans takes a lot of supplying to keep the system going. Add it all up and it's big business, and it gets bigger with every
new prison and the inmates to fill them. Not to worry. Unlike oil, there's no chance of running out bodies. The big players
in this growing industry are the private companies that run the hellholes. And the ones they run are even more hellish than the
public ones. Private, publicly owned corporations with shareholders and Wall Street to please always need a growing revenue
and profit stream and strict cost control to maximize the bottom line part of it. That means understaffing, low pay for
poorly trained staff, poor and unsafe conditions, little or no life-enhancing or self-help programs like educational
opportunities or counseling services to rehabilitate those in need like ilicit drug users, and even worse medical care
than the third world kind in the publicly run system. Why bother, they all cost money, reduce profits and constrain
shareholder equity. Private contractors can also exploit prisoners as de facto chattel. They're not obliged to pay wages or
benefits and can take full advantage of all those bodies free of charge. Why would they ever pass that up. It's one more
revenue and profit stream. The private side of running prisons is still a small part of the total. But it's growing, and as it does,
it's darker side may just get darker. Unlike most businesses, quality control is not one of their concerns. If humans suffer
to enhance the bottom line, who will care. In running a gulag, you just gotta keep 'em under control
locked in cages, and if you use, abuse and lose some along the way, there's plenty more supply to fill
the available beds. That's how it works in a nation that commodifies its masses and exploits them. It's what happens in
this modern era when social conditions deteriorate enough to produce what Franklin Roosevelt spoke about in the Great
Depression years of the 1930s when he said "I see one-third of a nation ill-housed, ill-clad, ill-nourished." It's not that bad
yet, but we're heading in that direction. As discussed above, it produces a restive population the state chooses to lock up in
lieu of providing vital social services to satisfy essential needs. The result is the US gulag, the shame of the nation. Future
historians and others will judge us by the character of our social conscience, especially how we treat our least advantaged and
most needy. They'll also judge us by our system of justice and the prisons within it which reflect that conscience. The honest
ones won't be kind. The great Russian 19th century novelist, Fyodor Dostoevsky, once remarked that he measured the quality
of a society by the quality of its prisons. He might have added by its quantity as well.
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The nature of incarceration requires a fundamental societal obligation to preserve the health
prisoners
Paris 08
(Joseph E. Paris, PhD, MD, is a chemist turned medical doctor. He entered correctional medicine through the Florida Department of Corrections in 1985 and
was the first Florida correctional physician to prescribe AZT to an inmate. Dr. Paris retired from Department of Corrections work at the end of 2005 and
began part-time public health work with HIV patients. He is a founding member and past president of the Society of Correctional Physicians, past president
of the Florida chapter of the American Correctional Health Services Association, and a board member of the Certified Correctional Healthcare Professionals
and the Correctional Medical Institute, February 2008, Volume 10, Number 2: 113-115., “Why Prisoners Deserve Health Care,” http://virtualmentor.amaassn.org/2008/02/msoc1-0802.html)
Proponents of the state's being the single payer of medical care reimbursement for U.S. residents often quip that prisoners are assured necessary care while
law-abiding citizens are not. They make the argument that such a dichotomy is morally intolerable and that all U.S. residents (citizens and non-citizens alike)
should also be assured health care. The challenges of providing health care to all U.S. residents are complex and continue to be debated nationwide. A few
states have legislation that approaches universal coverage, but implementation requires political will and an agreement on the part of the public to finance the
care of large groups of residents—including noncitizens—with low or moderate incomes. There are legal, ethical, social, and public
health reasons why prisoners, as wards of the state, must be supplied with health care. The legal
reasons for providing health care to prisoners were stipulated in the 1976 Supreme Court Estelle v. Gamble decision,
in which the Court held that deprivation of health care constituted cruel and unusual punishment [1], a violation of
the Eighth Amendment to the Constitution. This interpretation created a de facto right to health care for all persons in custody, whether
convicted (prisoners) or not (pretrial detainees). The decision also brought forth the concept of "deliberate indifference," a legal definition that prohibits
ignoring the plight of prisoners who need care and translates into a mandate to provide all persons in custody with access to medical care and a professional
medical opinion. Correctional authorities and health care professionals who infringe this right do so at their peril and may be prosecuted in federal or state
courts [1]. Beyond the legal mandate, there are fundamental ethical reasons why prisoners should be given medical care. Free
persons may or may not have health insurance, based, at least in part, on their decisions about how to prioritize the use of their money. Some who decide
against buying insurance have the option to pay cash for the health services they seek . The very poor, the aged, and the disabled are
generally provided with assistance in the form of federal and state Medicare and Medicaid programs. Even the so-called
"working poor," loosely defined as those who earn too much to qualify for assistance and too little to afford to pay for health care, have the option to use or
borrow cash when they need medical treatment. Moreover, federal law requires that hospitals provide medically necessary
emergency health services regardless of a patient's health insurance status or ability to pay. My point is not that all U.S.
residents have the resources they need to cover their medical care; certainly many do not. My point is that prisoners have none of the choices
just enumerated. If the correctional institution's staff denied care, the inmate would have no alternatives. In the past two
decades, a substantial number of prisons and jails have decreed that prisoners must pay at least part of the bill for their medical services [2]. These policies
always include the provision that indigent prisoners will receive medically necessary, urgent care regardless of their financial status. It is evident that
society has embraced the concept that, when incarcerated, a person cannot see to his or her own
medical needs, and, therefore, society must do so. Health care is given to prisoners for social reasons too. The
vast majority of inmates will return to society within a few years. Proper care helps to preserve their physical function, which makes
it possible for ex-inmates reintegrating into society to embark on productive activities and avoid becoming a burden
to all. For example, hypertension and diabetes treatment are known to prevent strokes, heart attacks, and other sequelae that would burden society with
long-term care of disabled persons. It is in society's best interest that recently released prisoners be free of disabling diseases. Public health reasons for
providing care to prisoners are so strong that many view correctional medicine and public health medicine as essentially two approaches to the same problem
[3]. As a class, prisoners include a larger share of risk-taking individuals than a similar sampling of free persons, and
statistics show that they have a larger proportion of the health problems associated with risk taking—hepatitis B and
C, HIV, TB, and syphilis, to name a few [4-6]. If any of these diseases is to be eradicated, or even contained, it makes sense that public health
officers would develop prevention strategies in the prisons and jails, where large numbers of infected subjects reside. Disease prevention education,
vaccination where appropriate, and disease surveillance are basic public health tools that can be used in the
correctional setting with public health goals in mind. I have shown that it makes sense from a legal, ethical, social, and public health point
of view to provide health care to prisoners, but doing so creates the perceived injustice that those who behave badly are rewarded with free medical care,
while those who soldier on working for low pay and resist the temptation to resort to crime are punished by not receiving free care. Why is it, we ask,
that the health of prisoners seems moreimportant to the state than the health of other U.S. residents? I have no
solution to the apparent paradox. And the inequity does not even stop there. Under U.S. law, prisoners have the right to food, clothing, shelter,
and so on. None of these rights applies to free persons. Prisoners are expensive to maintain. The average prisoner in a southern state institution costs about
$34,000 a year. Of note, about 16 percent of that sum is allocated to health care. Why, then, is this relatively small amount of a prison system's budget a
lightning rod? I believe that the public's desire for affordable or free health insurance as part of a societal package for all is deep-seated and leads us to envy
for the prisoner's status, if only because of medical care coverage. Civilized, highly developed countries such as England, Canada, Germany, and the Scandinavian countries have long endowed all their
residents with medical care coverage. The fact that the U.S. lags behind riles a number of people, and especially those who understand how universal coverage applies to all U.S. prisoners. This dilemma will
persist until health insurance is available to all U.S. residents. Meanwhile, coverage of all U.S. prisoners continues and it is a good thing.
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The federal government has an ethical obligation to protect prisoners
Michael Levy, Visiting fellow a a National Centre for Epidemiology and Population Health, Australian National University, Canberra
2000, Australia. [Prison Health Services.]
http://www.bmj.com/cgi/content/full/315/7120/1394?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1039795129697_
9158&stored_search=&FIRSTINDEX=0&volume=315&firstpage=1394&resourcetype=1,2,3,4,10
Incarceration means that personal freedoms are denied to the prisoner—loss of choice over sanitation, diet, recreation, and
cell mates to name a few. Moreover, overcrowding provides ideal circumstances for stress related disorders and transmission
of diseases such as tuberculosis and HIV, as illustrated in this issue by Reyes and Coninx (p 1447).2 The more prisoners'
freedoms are limited, and the worse the general prison conditions, the greater the responsibility of the state to protect
prisoners: this leads to a misunderstood principle that prisoners actually acquire rights while in custody, principally protection
from harm and access to services, including health services.3
Prison rights area a prerequisite for societal flourishing
Donelly 85
(Jack Donelly, College of the Holy Cross, The Concept of Holy Rights, 1985, pg 55-58)
Basic moral and political rights are not just weighing factors in utilitarian calculations that deal with an
undifferentiated 'happiness'. Rather, they are demands and constraints of a different order, grounded in an essentially
substantive judgment of the conditions necessary for human development and flourishing. They also provide means –
rights – for realizing human potentials. The neutrality of utilitarianism, its efforts to assure that everyone counts
'equally', results in no-one counting as a person; as Robert E. Goodin puts it, people drop out of utilitarian calculations,
which are instead about disembodied preferences (1981:95; compare Dworkin 1977:94-100, 232-8, 274 ff.). In
Aristotelian terms, utilitarianism errs in basing its judgments on 'numerical' rather than 'proportional' equality. For our
purposes, such differences should be highlighted. Therefore, let us consider utilitarianism, whether act or rule, as an
alternative to rights in general, and thus human rights as well. In particular, we can consider utility and human rights as
competing strategies for limiting the range of legitimate state action. Once again, Bentham provides a useful focus for our
discussion. While Bentham insists on the importance of limiting the range of legitimate state action (1838:11, 495, VIII, 557
ff.), he also insists that (natural) rights do not set those limits. In fact, he argues that construed as limits on the state, natural
rights 'must ever be, - the rights of anarchy', justifying insurrection whenever a single right is violated (1838:11, 522, 496,
501, 506) For Bentham, natural rights are absolute rights, and thus inappropriate to the real world of political action. In fact,
though, no major human rights theorist argues that they are absolute. For example, Locke holds that the right to revolution is
reserved by society, not the individual (1967: para. 243). Therefore, individual violations of human rights per se do not
justify revolution. Furthermore, Locke supports revolution only in cases of gross, persistent and systematic violations of
natural rights (1967: paras 204, 207, 225), as does Paine. The very idea of absolute rights is absurd-from a human rights
perspective, since logically there can be at most one absolute right, unless we (unreasonably) assume that rights never come
into conflict. A more modest claim would be that human rights are 'absolute' in the sense that they override all principles and
practices except other human rights. Even this doctrine, however, is rejected by most if not all major human rights theorists
and documents. For example, Article 1 of the French-Declaration of the Rights of Man, after declaring that "men are born,
[Continued no text deleted]
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and always continue, free and equal in respect of their rights', adds that 'civil distinctions, therefore, can be founded only on
public utility', thus recognizing restrictions on the continued complete equality of rights. Similarly, the Universal Declaration
of Human Rights (Aricle 29) permits. such limitations as are determined by law solely for the purpose of securing due
recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order
and the general welfare in a democratic society. The International Covenant on Civil and Political Rights includes a similar
general limiting proviso (Article 4) as well as particular limitations on most of the enumerated rights. Rights ordinarily
'trump' other considerations, but the mere presence of a right - even a basic human right - does not absolutely and
automatically determine the proper, course of action, all things considered. In certain exceptional circumstances, needs,
utility, interests or righteousness may override rights. The duties correlative to rights, and even the trumping force of rights,
are prima facie only. But other principles also have prima facie moral force. Sometimes this will be sufficient to overcome
even the special entrenched priority of rights. The obligations arising from such rights therefore ought not to be discharged,
all things considered. In such cases, we can speak of the right being 'infringed', since the (prima facie) obligation correlative
to the right --is-not-discharged, but it would be seriously misleading to say that it had been 'violated' (Thomson 1976, 1977).
But if even basic human rights can be justifiably infringed, aren't rights ultimately subservient to utility? If recalcitrant
political realities sometimes requiresubordinating natural rights, aren't we simply suggesting that human rights are merely
utopian aspirations inappropriate to a world in which dirty hands are often a requirement of political action - and thus where
utility is the only reasonable guide? Such a response misconstrues the relationship between rights and utility and the ways in
which rights are overridden. Consider a very simple case, involving minor rights that on their face would seem to be easily
overridden. If A promises to drive B and C to the movies but later changes his mind, in deciding whether to keep his promise
(and discharge his rights-based obligations) A must consider more than the relative utilities of both courses of action for all
the parties affected; in most cases, he ought to drive them to the movies even if that would reduce overall utility. At the very
least he must ask them to excuse him from his obligation, this requirement (as well as the power to excuse) being a reflection of the right-holder's control over the rights relationship. Utility alone usually will not override even minor rights;
we require more than a simple calculation of utility to justify infringing rights. The special priority of rights/titles, as we have
seen, implies that the quality, not just the quantity, of the countervailing forces (utilities) must be taken into consideration.
For example, if, when the promised time comes, A wants instead to go get drunk with some other friends, simply not
showing up to drive B and C to the movies will not be justifiable even if that would maximise utility; the desire for a drunken
binge is not a consideration that ordinarily will justifiably override rights. But if A accompanies an accident victim to the
hospital, even if A is only one of several passers-by who stopped to offer help, and his action proves to be of no real benefit
to the victim, usually this will be a sufficient excuse, even if utility would be maximised by A going to the movies. Therefore,
even recasting rights as weighted interests (which would seem to be the obvious utilitarian 'fix' to capture the special priority
of rights) still misses the point, because it remains essentially quantitative. Rights even tend to override an accumulation of
comparable or parallel interests. Suppose that sacrificing a single innocent person with a rare blood factor could completely
and permanently cure ten equally innocent victims of a disease that produces a sure, slow and agonising death. Each of the
eleven has the 'same' right to life. Circumstances require, however, that a decision be made as to who will live and who will
die. The natural rights theorist would almost certainly choose to protect the rights of the one individual - and such a
conclusion, when faced with the scapegoat problem, is one of the greatest virtues of a natural rights doctrine to its advocates.
This conclusion rests on a qualitative judgement that establishes the right, combined with the further judgement that it is not
society's role to-infringe such rights simply to foster utility, a judgement arising from the special moral priority of rights.
Politically, such considerations are clearest in the case of extremely unpopular minorities. For example, plausible
arguments can be made that considerations of utility would justify persecution of selected religious minorities (e.g. Jews for
centuries in the West, Mormons in nineteenth-century America, Jehovah's Witnesses in contemporary Malawi), even giving
special weight to the interests- of members of these minorities and 'considering the precedents set liy such persecutions. None
the less, human rights demand that an essentially qualitative judgement be made that such persecutions are incompatible with
a truly human life and cannot be allowed and such judgements go a long way to explaining the relative appeal of human
rights theories. But suppose that the sacrifice of one innocent person would save not ten but a thousand, or a hundred
thousand, or a million people. All things considered, trading one innocent life for a million, even if the victim resists most
forcefully, would seem to be not merely justifiable but demanded. Exactly how do we balance rights (in the sense of 'having a
right'), wrongs (in the sense of 'what is right') and interests? Do the numbers count? If so, why, and in what way? If not, why
not? Ultimately the defender of human rights is forced back to human nature, the source of natural or human rights. For a
natural rights theorist there are certain attributes, potentialities and holdings that are essential to the maintenance of a
life worthy of a human being. These are given the special protection of natural rights; any 'utility' that might be served by
their infringement or violation would be indefensible, literally inhuman - except in genuinely extraordinary
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circumstances, the possibility of which cannot be denied, but the probability of which should not
be overestimated. Extraordinary circumstances do force us to admit that, at some point, however rare, the force of
utilitarian considerations builds up until quantity is transformed into quality. The human rights theorist, however, insists on
the extreme rarity of such cases. Furthermore, exotic cases should not be permitted to obscure the fundamental
difference in emphasis (and in the resulting judgements in virtually all cases) between utility and (human) rights. Nor
should they be allowed to obscure the fact that on balance the flaws in rights-based theories and practices seem less severe,
and without a doubt less numerous, than those of utility-based political strategies. Another way to read utilitarianism would
be as an objection to the priority human rights grant to the individual over society and the state. 1-low can we justifiably
require the state to protect the interests of the few, as expressed in rights, against the interests of the many or the whole, as
determined by utilitarian calculation? On what grounds can we say that individuals are to be protected in certain special ways
and, in their specially protected spheres, be given the liberty to exercise their rights so as to override virtually all other
considerations even, if necessary, stop the government dead in its tracks? Natural rights theorists must again go back to
'human nature', in the special sense that term has in the constructivist theory. Inherent and inviolable human dignity, which it
is the purpose of natural rights to protect, demands such special protection, even against society and the state (except in the
most extreme circumstances). To do anything less would be to treat people as less than fully human. Thus the state is viewed
as first an instrument to implement, protect and realise.(human) rights; pursuit of the common good is an-appropriate task for
the government only in so far as it does not interfere with securing the enjoyment of human rights. - The 'equality' at the core
of natural rights theories is a moral equality that rests on a substantive moral judgement of the type of life worthy of a human
being. For the natural rights theorist all men 'are equal', but not all things which men share with one another are equally
deserving of the protection of natural rights - particularly not their lower animal nature. The 'nature' that Bentham relies on is
largely physical and 'quantitative', while the 'nature' underlying human rights is essentially moral. Human rights represent the
moral limits of state action established by 'human nature', understood constructively. Not only can one never be justly
deprived of such rights, but even justifiable infringements are so severely restricted that for most purposes we can simply say
that they set down what the state cannot do. Bentham, however, takes special exception to precisely this claim. To denote
legal impossibility. . . ['cannot' is] without ambiguity or inconvenience. 'Such a magistrate cannot do so and so,' that is, he h
no power to do so and so. If he issue a command to such an effect, it is no more to be obeyed than if it issued from any
private person. But when the same expression is applied to the very power which is acknowledged to be supreme, and not
limited by any specific institution, clouds of ambiguity and confusion roll on in a torrent almost impossible to be withstood.
(1838:11, 495)
We must first evaluate the dignity of prisoners as opposed to survival claims
Daniel Callahan PhD in philosophy from Harvard, an MA from Georgetown University, and his BA from Yale an elected
member of the institute of Medicine, National Academy of Science; a former member of the Director’s Advisory Committee
Centers for Disease Control; and a former member of the Advisory Council, Office of Scientific Integrity, U.S. Department
of Health and Human Service. The Tyranny of Survival 1973
For all these reasons it is impossible to counterpoise over against the need for survival a “tyranny of survival”. There seems to be no imaginable
evil which some group is not willing to inflict on another for the sake of survival , no rights, liberties or dignities which it is not
ready to suppress. It is easy, of course, to recognize the danger when survival is falsely and manipulatively invoked. Dictators never talk about their
aggressions, but only about the need to defend the fatherland, to save it from destruction at the hands of its enemies. But my point goes deeper than that.
It is directed even at a legitimate concern for survival, when that concern is allowed to reach an intensity which would
ignore, suppress, or destroy other fundamental human rights and values. The potential tyranny of survival as a value is that
it is capable, if not treated sanely, of wiping out all other values, Survival can become an obsession and a disease, provoking
a destructive singlemindedness that will stop at nothing.We come here to the fundamental moral dilemma. If, both biologically and
psychologically, the need for survival is basic to man, and if survival is the precondition for any and all human achievements, and if
no other rights make much sense without the premise of a right to life- then how will it be possible to honor and act
upon the need for survival, without in the process, destroying everything in human beings which makes them worthy
of survival? To put it more strongly, if the price of survival is human degradation, then there is no moral reason why an effort should be made to ensure
that survival. It would be the Pyrrhic victory to end all Pyrrhic victories. Yet it would be the defeat of all defeats, if because human beings could not properly
manage their need to survive, they succeeded in not doing so. Either way, then, would represent a failure, and one can take one’s pick about
which failure would be worse, that of survival at the cost of everything decent in a man or outright extinction.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Resolved: The United States Supreme Court should mandate that The United States Congress
should fully fund federal and state prison health care reform by substantially increasing education,
health screening, risk reduction, disease treatment and vaccination services.
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Solvency
Courts are the best for prison healthcare- empirically they improve living conditions and ensure
compliance
SUSAN P. STURM (Associate Professor of Law, University of Pennsylvania) 1993: ARTICLE:
THE LEGACY AND FUTURE OF CORRECTIONS LITIGATION. Lexis
The case studies also show that court intervention generally has improved the living conditions and practices in the
facilities at issue. In some cases, the improvements linked to court-ordered change have been quite dramatic n135 and
have concerned virtually every [*671] aspect of inmate life. n136 Yet, in many systems improvements have been
limited to raising living conditions to minimal standards, and have failed to provide a systemic response to the
overcrowding problem plaguing most correctional institutions.
The most blatant abuses, such as Arkansas's Tucker telephone, Alabama's "doghouses," n137 and widespread use of
officially sanctioned violence, have been virtually eliminated, often in direct response to litigation. n138 The case
studies also show that in many instances, previous legislative and administrative efforts to eliminate these abuses had
been unsuccessful, and that litigation was a crucial factor in exposing and correcting these abuses. n139
The case studies suggest that litigation may be particularly successful in improving the quality of medical care and
physical conditions in targeted institutions. Even in cases where compliance has otherwise been uneven, litigation has
led to the development and maintenance of a vastly improved system of medical care. n140 [*672] This relative
success may be attributable to the independence and professionalism of medical care providers brought in to provide
services in response to litigation. In addition, the case studies directly link litigation to the appropriation of funds for
capital expenditures to renovate and expand correctional facilities. n141 The quality of the food and lighting in prisons
has improved markedly as the result of litigation. Several case studies suggest that corrections officials are less
resistant to court-ordered changes in physical facilities, and that these types of reforms are easier to achieve. n142
Litigation has virtually eliminated the use of inmates as trusties or building tenders. This system of governance, which
relied on inmates to manage other inmates and maintain order, prevailed in many Southern institutions and contributed
strongly to the arbitrary and violent environment that characterized prison life. Its elimination dramatically
transformed the structure of governance in Southern prisons and eliminated some of the worst abuses in those
systems. n143 In many jurisdictions, staffing ratios improved dramatically [*673] in response to court orders. n144 In
Alabama, once court-ordered reforms took hold, the rate of violence plummeted, and inmates reported that they felt
safe in dormitories that were described as a "jungle atmosphere" prior to the litigation. n145 Crouch and Marquart
report that the Texas Department of Corrections is a safer place as a result of the bureaucratic order instituted in
response to court intervention. n146
Plan resolves the five main areas required for meaningful healthcare in prisons
G. Niveau Department of Community Health and Medicine, Faculty of Medicine, IUML, Avenue de
Champel 9, 1211 Geneve 4, Switzerland Public Health Volume 120 January 2006
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B73H6-4H0BT2F1&_user=4257664&_coverDate=01/31/2006&_alid=941062985&_rdoc=10&_fmt=full&_orig=mlkt&_cdi=11546&_sort=v
&_st=17&_docanchor=&view=c&_ct=1049&_acct=C000022698&_version=1&_urlVersion=0&_userid=4257664&md5=4e
e5192b392f15084b3561ea1d35f27c#SECX10
The time spent in prison or jail provides an exceptional opportunity to come into contact with a population
that is generally difficult to access, especially with regard to preventive measures.17 Different international
recommendations encourage these actions for health promotion, but it is difficult to evaluate their
effectiveness.28,51, 52 and 74 Knowledge of the risk factors and the target diseases makes it possible to define
specific healthcare actions within the prison environment. Health promotion activities must be adapted to
local policies and to local incidence and prevalence of each disease. These possible preventive actions have been
[Continued no text deleted]
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grouped into five main themes: [include] information and education, screening, limiting harm from risk
behaviour (sexual behaviour and use of contaminated equipment), treatment and vaccinations.
Training and education are the most easily accepted prevention methods and the most used in prisons.60 Health
education should include information concerning diseases, routes of transmission, risk factors, methods of
prevention, signs of disease outcomes, and possible treatments. An effective health policy requires voluntary
screening of the greatest possible number of prisoners.77 and 78 Due to the rapid turnover and the risk of
transmission, testing should be proposed as soon as possible when the inmate arrives.79 The screening of sick
inmates requires a medical interview and a physical check-up as soon as they enter jail or prison. Many prisoners
are unaware that they are seropositive for infectious diseases, and laboratory tests should be carried out in
order to make a diagnosis and encourage prisoners to change their behaviour.80
Continues…
As in the general population, the prevention of disease transmission during sexual relations consists of
encouraging the use of condoms.87 In correctional settings, however, there is a certain reticence concerning
condoms from both wardens and inmates.88 and 89 Anonymous distribution of condoms should therefore be
organized.90 If prisoners have sufficient access to condoms, the efficacy of preventive measures could be
comparable to that obtained in the general population. The main risk behaviour is use of contaminated syringes
and needles to inject illegal drugs. Prevention should therefore aim to reduce drug abuse and modify drugtaking behaviour. In order to fight against the use of injectable drugs, the prison health service can help
prisoners to gradually give up taking the substance, or can propose a substitution treatment for
opiates.91 The substances used in withdrawal and substitution programmes vary depending on the country, but
they never protect the inmates fully from the risk of taking illegal drugs by injection. The treatment of prisoners
with transmissible diseases, using means at least equivalent to those found in the community, is an essential
requirement for public health. Treatment must be started as early as possible, especially in jail, and should
be completed before the prisoner is released.73 When treatment cannot be completed in correctional facilities, it is
necessary to co-operate with the community health services to continue treatment after release.77 Prisoners may
have low compliance and compliance control may be necessary,85 taking into account the problems that prisoners
have when they get back into the community. The treatment of STDs and active tuberculosis is an obvious
priority. The treatment of active tuberculosis requires isolation of inmates with positive sputum smears. Contact
tracing must be undertaken to detect newly infected patients or unrecognized cases.98 Recently infected subjects
and inmates with latent tuberculosis and HIV co-infection must be given chemoprophylaxis and, if possible,
medical follow-up after release.The time spent in prison is an ideal opportunity to immunize a high-risk
population. Vaccination against hepatitis A can be limited to subjects at risk,19, 62 and 75but vaccination against
hepatitis B is recommended for all prisoners,19 and 65 except those already infected by the virus.100 Even if the
cost of vaccinating a large number of prisoners is high, it has been shown that the cost-effectiveness is
globally favourable to the community and the health service.33
Federal prisons provide the best way to target disease spread because the period of stay is longer
Drs. Peter M Ford and Wendy L Wobeser are with the Department of Medicine, Queen’s University,
Kingston, Ont 2000 http://www.cmaj.ca/cgi/reprint/162/5/664.pdf
Screening for disease and provision of adequate treatment programs in short-term detention facilities (i.e.,
provincial jails), which have high turnover rates, is difficult although possible, if these programs are integrated
with community services. Because periods of stay are longer in federal penitentiaries, these institutions
should be able to do better. Unfortunately, the same problems exist at the federal level.
Continues…
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Failure to provide adequate screening and failure to provide timely treatment may increase the burden of
ill health later on and may also increase the costs to the health care system. Transmissible diseases that
spread in prisons and that are left undetected or untreated will ultimately spread to the community.
HEALTHCARE EDUCATION IN PRISONS GREATLY REDUCES DISEASE INCIDENCE RATES
Reentry Policy Council ‘5 (Report of the Re-Entry Policy Council: Charting the Safe and Successful Return of
Prisoners to the Community. Council of State Governments. Reentry Policy Council. New York: Council of State
Governments. January 2005,
http://74.125.47.132/search?q=cache:wP7Q0CxfKnEJ:www.bard.edu/bpi/pdfs/crime_report.pdf+education+in+prisons&cd=
1&hl=en&ct=clnk&gl=us )
First, when treating a prisoner for a particular ailment, health care providers should make sure to educate him or her about
how to manage that illness. A patient with a communicable disease, for example, should receive information about
preventing transmission of the disease to other people. Research supports the notion that people in prison or jail are interested
in treatment and compliant with medical directives. For instance, patients treated for high "bad cholesterol" levels in the New
Hampshire Department of Corrections were found to have a 95 percent compliance rate with drug therapy, and 71 percent of
patients achieved clinical results consistent with national guidelines. [1] A Rhode Island study of treatment for chronic
hepatitis C infection among inmates also demonstrated patient compliance with treatment and clinical response rates
comparable to those in the community. [2] All state departments of corrections should have standardized clinical protocols
for the evaluation, treatment, and education of inmates with chronic diseases, some of which disproportionately affect prison
populations. In the absence of such protocols, it is impossible to measure and assure quality of care for persons suffering
from chronic illnesses. In addition, correctional health care programs should include instruction on general wellness issues.
Health care professionals or their partners from community-based organizations can teach inmates about the importance of
good nutrition, compliance with medication regimens, and protection from sexually transmitted diseases. Even in the absence
of system-wide protocols, informal counseling from physicians on health issues can have significant results. For example, a
number of community-based studies have shown that physician counseling can influence smokers to quit, a benefit that saves
both lives and money. According to one University of California Department of Medicine study, the cost-effectiveness of
brief, anti-smoking advice during routine office visits ranges from $705 to $988 per year of life saved for men and from
$1,204 to $2,058 for women. [3] Among prisoners, who smoke at a rate more than three times the national average, the
opportunity for such savings is dramatic. Given the likely benefits of such education, communities are wise to invest in
providers who can seize the public health opportunity of educating incarcerated patients about health, well-being, and any
diagnosed illness. Significantly, however, such education need not come only from doctors. Departments of corrections can
partner with other government agencies (including public health departments) or community-based organizations to educate
inmates about a range of health issues.
Health screenings are prerequisites to effective mental health treatment
Natasha H Williams, PhD, JD, MPH “Community Voices: Healthcare for the Underserved” 2006
http://www.communityvoices.org/Uploads/TiesThatBind_00108_00150.pdf
Screening techniques that are effective, culturally sensitive, and accurate must be developed to correctly detect and
diagnose mental health problems, especially among African Americans and Hispanics (Borowsky et al, 2000; Baker and
Bell, 1999). While incarcerated, those with mental health conditions need treatment regimes that provide for
assessment to determine proper treatment modality, extensive case management, and discharge planning upon release.
Once they reenter the community, they also need facilitated access to social services, medical services, housing,
transportation and employment and linkages to ongoing treatment programs (Welsh and Ogloff, 1998).
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Disease screening and treatment is imperative in prisons to improve health and cut costs
John J Gibbons and Nicholas de B Katzenbach, co-chairs of the federal Commission on Safety and
Abuse in America’s Prisons “Confronting Confinement” June 2006
http://www.prisoncommission.org/pdfs/Confronting_Confinement.pdf
Screen, test, and treat for infectious disease. Every U.S. prison and jail should screen, test, and treat for infectious
diseases under the oversight of public health authorities and in compliance with national guidelines and ensure continuity
of care upon release.
Continues…
The NCCHC report demonstrates that proper screening and treatment of infectious diseases in prisons and jails would
improve public health (NCCHC 2002). While some public health agencies already work with correctional systems to
manage infectious disease, too many county and state public health departments have not shouldered this responsibility.
There are potentially devastating results when corrections departments do not have the help and resources to control
disease. Conversely, well-designed systems of disease control can enormously benefit public health and result in
tremendous cost savings down the road. For example, in New York City in the 1980s and early 1990s there was an
epidemic rise in tuberculosis, including a dangerous jump in the incidence of multi-drug resistant tuberculosis. The rise in
drug-resistant cases, in particular, was believed by many to be largely the result of poor treatment in prisons and jails.
Research shows a correlation between time spent in jail and tuberculosis infection (Bellin et al. 1993). With support from the
Centers for Disease Control and Prevention, the city and state’s coordinated response included establishing a Communicable
Disease Unit in the jails at Rikers Island. The effort was a success. Between 1992 and 1998 tuberculosis cases declined 59
percent citywide, and the number of drug-resistant cases declined 91 percent (Shalala 2000).
Addressing risky behavior such as drug use among prisoners is critical to public health
Report of the Re-Entry Policy Council: Charting the Safe and Successful Return of Prisoners to the
Community. Council of State Governments. Reentry Policy Council. New York: Council of State
Governments. January 2005. http://reentrypolicy.org/Report/PartII/ChapterII-B/PolicyStatement12
Because a history of using drugs and/or alcohol is common to so many people in prisons and jails - both generally and
in connection with particular criminal offenses - it is especially key that addictions issues be addressed during the period
of incarceration. Failing to capitalize on this opportunity to treat addiction poses risks to successful prisoner
reintegration, public safety, and public health. Utilizing programs proven to be effective, prioritizing resources for those
nearing release, and encouraging community-based aftercare will ensure better outcomes for re-entering prisoners and
the communities to which they return
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Prisons spread disease (1/2)
Inadequate health care in prisons spreads life threatening diseases
G.Patrick Callahan Jan/ Feb 2001 [Co-Founder of the November Coalition, which fights against the War on Drugs and
for the rights of the prisoners incarcerated as the effect of that war] “TB or not TB: Another good reason to reduce prison
populations” http://www.november.org/razorwire/rzold/22/22019.html
"TB (tuberculosis) poses a unique challenge today in correctional environments as inmate populations increase and
overcrowding makes an outbreak of TB a serious threat." -Controlling TB In Correctional Facilities, Center for Disease Control
(CDC), 1999 I watched with a sense of outrage and dismay as the test site turned an angry red. By the next day there was a large knot on the
underside of my forearm. After ten years in prison, dodging untold microbiological bullets, I was hit; I tested positive for Mycobacterium
tuberculosis: TB. Several of us were infected because we were jammed in close proximity for four months to a Vietnamese
immigrant who had somehow slipped through the system and become an active TB carrier. What we thought was only a
persistent smoker's hack was, in fact, a virulent case of infectious TB. "Poor ventilation and overcrowding in prisons may promote
the transmission of infection from persons with undiagnosed TB to inmates, staff and visitors. Frequent transfers, both
within and between prisons, also contribute to the spread of TB within the prison system." From Cohen, F. Durham, JD,
Tuberculosis: A Sourcebook For Nursing Practice, 1995. State and Federal prisons are bursting at the seams. As of this writing there are
146,000 men and women in federal custody and two million people imprisoned overall in the United States. This is chiefly due to our country's
nearly fanatical adherence to a failed drug war policy - the federal prison system grows at the rate of one thousand prisoners each month. Every
federal lockup is running over its rated capacity; the federal system is averaging 146% over rated capacity. (Bureau of Justice
research, 1999) In 1990 one in every seven state correctional facilities was under state or federal court jurisdiction (or consent decree) for specific
conditions relating to overcrowding. To date no federal judge has had the guts to order any federal prison to comport to its rated capacity. As we
consider infectious disease, prisoners are, therefore, similar to hapless sitting ducks in a game of government sponsored
Russian roulette. "Hospitals, correctional facilities and other institutional settings have been the focus of outbreaks of MDR-TB. The extent of
MDR-TB transmission in the community has not been well studied." - Problem 2, CDC National Action Plan To Combat Multidrug-Resistant TB
When someone is moved from one prison to another, it is standard practice to be assigned to a former dayroom turned barracks, rooms crammed
wall to wall with bunks, often poorly ventilated, always filthy, often filled with immigrants from major high-risk populations in Latin America,
Asia and Africa. "A group at high risk for TB in the United States is composed of those persons born in countries with a prevalence of TB. In the
United States, persons from six countries accounted for 63% of foreign born TB cases. These were China, Haiti, Mexico, the Philippines, South
America and Vietnam." - Jacobs, R.F./Starke, J.R. "Tuberculosis in Children" Were it not enough to be infected with M. tuberculosis, those of us
exposed were subsequently told that it was a drug resistant type, that apparently the strain of TB the carrier had was resistant to INH, the most
commonly used and most efficient medication for tuberculosis. Sometimes bacteria become resistant to more than one drug. This is called
Multidrug resistant TB, or MDR-TB, a very serious problem. People with MDR-TB disease must be treated with special drugs. These drugs are not
as good as the usual drugs for TB, and they may cause more side effects. (Bureau of Tuberculosis Control, New York City Department of Health,
2000) The primary medications we take each day are rifampin and pyrazinamide. Side effects can be numerous, including nausea, vomiting,
flushing, rash, jaundice, liver damage and hepatitis. Flu-like symptoms are common, as are headaches and malaise. As of now, the benefits of this
medication are hypothetical in nature since the particular resistance to them is unknown, but assuming their efficaciousness, they must be taken
every day throughout the regimen - it is non-adherence to the regimen that promotes drug resistant TB. The problems inherent with detection and
monitoring this disease are staggering; they can and often do overwhelm prison medical staff, and the situation is becoming worse. In one
analysis, Bloom and Murray (1992) estimate that about one quarter of the recent rise in tuberculosis incidence in the
United States is due to active transmission in hospitals, homeless shelters and prisons. (Bloom, B.R. 'Tuberculosis: Pathogenesis,
Protection and Control', ASM 1994) In every study to date it has been demonstrated that - in the drug war analysis especially - longer sentences
have little or no deterrent value and have had no impact whatsoever on the drug trade which thrives on massive noncompliance with unrealistic,
badly considered legislation. Long prison sentences do, however, contribute to the spread of a variety of diseases, with TB
among the most dangerous. Recent outbreaks in prisons and an increase in both cases and resistance rates in many areas of the United States
have created an urgent need for system wide improvement in correctional facilities' efforts to control tuberculosis. The TB threat calls for
innovative approaches by legislators who can mandate necessary interventions and provide adequate funding for their implementation. It also calls
for strong support from state and local health departments, public agencies ultimately responsible for TB control within their jurisdictions. Indeed,
effective TB control in correctional facilities is necessary for the reduction of TB rates throughout the country and the eventual elimination of TB
disease from the United States. US drug war policy is a national failure of immense proportion. The drug war is waged in the name of public
health; yet due to the prohibition on needle exchanges, 25,000 otherwise preventable cases of HIV occur in intravenous drug users. HIV infection
has become a major source for the spread of tuberculosis. "Poverty and drug addictions are not 'gender neutral'. Women and families comprise an
increasing proportion of congregate living populations, as in shelters or prisons. The United States has the world's highest known rate of
incarceration, with 426 prisoners per 100,000. Women made up about 3% of the U.S. prison population in 1981; in a little over a decade that
proportion has doubled. One objective of the National Action Plan to Combat MDR-TB is to analyze the incidence and prevalence of tuberculosis
in HIV infected women because little data is now available. Women are among the fastest growing group of persons with HIV disease." - Cohen, F.
/Durham, J.D. Tuberculosis: A Sourcebook For Nursing Practice, 1993 In any one regimen of TB medication there is a small percentage of failure
wherein the infected individual progresses into the full blown disease. TB is often called the 'White Death', killing 3 million people worldwide each
[Continued no text deleted…]
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Prisons spread disease (2/2)
year. It is still 'tops' among the most lethal of diseases, even for those patients who have successfully completed a medicinal regimen. The dormant
disease can break out if they become immune-suppressed. A car accident or a case of pneumonia can cause recurrence of TB. TB among the
elderly is higher than any other population group, accounting for 26 percent of TB cases in the U.S. It can always be there, in other words, waiting
to 'take one down'. Was I sentenced to be infected with TB as part of my punishment? Was anyone? Is that part of your punishment? I have yet to
read this element anywhere in the U.S. Sentencing Guidelines; yet exposure to TB and MDR-TB has become common. The longer the prison
term, the greater one's chances of becoming infected. Any sentence can, therefore, be a potential death sentence.
Legislators can and should intervene and realize that one of the most effective ways to reduce the incidence of TB infection is to reduce the prison
population: for the public's health.
Plagued by scandals the prison system in the SQ spreads viral diseases
American Journal of Public Health. The Health and Health Care of US Prisoners: Results of a Nationwide Survey
Andrew P Wilper, Steffie Woolhandler, J Wesley Boyd, Karen E Lasser, et al. Washington: Apr 2009. Vol. 99, Iss. 4; pg.
666, 7 pgs http://proquest.umi.com/pqdweb?did=1668847201&sid=1&Fmt=3&clientId=15023&RQT=309&VName=PQD
Currently,
nearly 2.3 million US inmates (about 1% of US adults) must rely on their jailers for health care.2 Although
prisoners have a constitutional right to health care through the Eighth Amendment's prohibition of "cruel and unusual" punishment,3
periodic scandals, as well as previous studies, indicate that prisoners' access to health care and the quality of that care
are often deficient.4,5 Indeed, citing deplorable conditions in California's prison system, a federal judge recently removed prison health care
from the state's control.6 However, there is little nationally representative data on the health and health care of America's prisoners. Inmates
have high rates of chronic medical conditions, especially viral infections. In addition, substance abuse and mental illness are
common among inmates.7,8 We are not aware of any study analyzing the prevalence of common chronic conditions or of access to medical and
psychiatric care among the incarcerated population as a whole. Therefore, we sought to determine the prevalence of select chronic diseases, access
to health services, and pre- and postincarceration psychiatric treatment among the US inmate population.
Prisoners receive no education or help in re-adjusting to their communities leading to the spread of
disease among the general population
Justice Matters [Staff writer Julia Lutsky] Fall 2002 “Justice matters”
http://www.westernprisonproject.org/info/nation/story/521
When prisoners return to their communities, they are, for the most part, left to navigate the system on their own. They may
find medical benefits with the help of non-profit organizations, but most often they must find it with nothing more than their own ingenuity and
resourcefulness. Many public health benefits are available only after a waiting period that may be as long as 45 days.
This can be catastrophic for an individual who needs continued care. Though public assistance is often expedited for those released
prisoners suffering from AIDS, according to Deborah Santana, with the Osborne Society in the Bronx, New York, those with other diseases like
tuberculosis, hepatitis or STDs must wait, sometimes months, for the help they need. In the interim their diseases fester and are passed to those
around them.
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Prisons are hotbeds for infectious disease
The Health Lawyer [editor Michele Westhoff.] “AN EXAMINATION OF PRISONERS' CONSTITUTIONAL
RIGHT TO HEALTHCARE: THEORY AND PRACTICE” Chicago: Aug 2008. Vol. 20, Iss. 6; pg. 1, 13 pgs. Proquest
Prisons are hotbeds for infectious diseases, both due to the fact that entering inmates tend to have higher rates of communicable
because prison conditions and high-risk behaviors common among incarcerated prisoners facilitate
rapid transmission. For example, the incidence of HIV and AIDS in prison populations is many times higher than in
the general population. In 1989, there were 202 cases of HIV/AIDS per 100,000 U.S. inmates, compared to 14-7 cases per 100,000 nondisease upon arrival in prison, and
incarcerated Americans.98 The majority of prisoners in the United States are young African American and Latino men, many of whom are undereducated and engage in high-risk behaviors prior to incarceration, such as unprotected sexual intercourse and drug and alcohol abuse.99
Furthermore, there is evidence that high-risk behavior continues during imprisonment.100 Lamentably, the number of Latino and African-American
men infected with HIV exceeds the number of Latino and African-American men enrolled in colleges and universities.101 Prolonged confinement
of these individuals in correctional facilities, combined with ever-present poor sanitation, violence, consensual and non-consensual sex, and
intravenous drug use, puts uninfected prisoners at high risk for contracting HIV while incarcerated.102 Compounding the problem is the
fact that prisons provide very few HIV prevention services to inmates.103 Corrections officials point to a lack of funding as a
major impediment, but also admit that there is institutional resistance to establishing programs that promote safe sexual practices and advocate the
use of sterile syringes when anal sex and drug use are against prison policy.104 In fact, only two state prison systems and five city/county jail
systems make condoms available to their male prisoners.105 Also, there continues to be stigma associated with discussing HIV, and many inmates
avoid educational programs related to the disease because they fear that showing an interest in learning about HIV will lead other inmates and staff
to believe they are HIV positive and result in negative treatment.106 Another common communicable disease in prisons is
Tuberculosis ("TB"). TB is a highly contagious bacterial disease that most often affects the lungs and causes sepsis, high fevers, night sweats,
and emaciation.107 If left untreated, TB produces profound symptoms of toxemia and is rapidly fatal.108 Although the incidence of TB in the
general population is less than ten cases per 100,000 individuals, rates as high as ten times the national average have been reported
in some prisons.109 Studies revealing a positive correlation between length of incarceration and positive tuberculin skin tests suggest that most
inmates contract TB inside correctional facilities.110 This is especially significant in light of the high incidence of HIV infection in prisons, since
HIV weakens the immune system and greatly increases the likelihood that a patient will contract TB.111
Prisons act as breeding grounds for disease
American Journal of Public Health Public Health Implications of Substandard Correctional Health Care
Zulficar Gregory Restum.. Washington: Oct 2005. Vol. 95, Iss. 10; pg. 1689, 3 pgs
http://proquest.umi.com/pqdweb?did=909247321&sid=2&Fmt=3&clientId=15023&RQT=309&VName=PQD
In 2000, the United States incarcerated 2071 686 individuals, or 478 per 100 000 US residents.5 The number of male inmates has increased by 77%
since 1990, and the number of female inmates has increased by 108% during the same time. Most alarming is the fact that nearly 600 000
inmates are released each year, many with communicable diseases.5 Eighty-four percent of new prison admissions in 2000 were
for nonviolent crimes, typically for drug abuse.4 Contrary to the common public perception, most inmates are not hardened criminals.
They come from the underbelly of society, where drug and alcohol abase runs rampant. These nonviolent prisoners lack direction and, given the
chance, could become productive citizens instead of wasting space in prison. According to Bureau of Justice statistics, 24 000
inmates nationwide were HIV positive in 1996, but more recent studies suggest the number is as high as 47 000, a rate 10 times
higher than among nonprisoners.6 One in 4 inmates is infected with tuberculosis (TB), compared with less than 1 per
10 000 in the general population; hepatitis C infects more than 41% of California inmates alone, compared with less
than 2% of the state's general population.6 Living Conditions Since the end of 2000, state and federal prisons have operated at
full capacity or significantly above capacity. Crowded or overcrowded state prisons can be optimum breeding grounds for
infectious diseases. The practice of "double celling"-doubling the standard number of inmates to a cell-puts inmates at risk through the use of
shared razor blades for shaving. One of the greatest threats to good health comes through consensual and nonconsensual sex, including anal sex,
which is common in prisons.7
20
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Prisons breed disease (2/3)
The head of the CDC reports that the lack of health care in prisons has turned them into reservoirs
of disease
Justice Matters [Staff writer Julia Lutsky] Fall 2002 “Justice matters”
http://www.westernprisonproject.org/info/nation/story/521
Testing for and treating the above mentioned diseases could significantly decrease contagion in prisons and could keep the diseases from spreading
to the general public upon the release of prisoners. The Centers for Disease Control (CDC) in Atlanta points to the some 600,000
prisoners released each year as carriers of potentially dangerous diseases. In March of this year, CDC director John Miles
told prison doctors and nurses that prisons were “the nation’s reservoirs of disease.”
Lack of adequate health care means prisoners are disproportionally affected with every type of
disease both in jail
John V Jacobi [professor of law at Seton Hall University] 200 5 “Prison Health, Public Health: Obligations and
Opportunities American Journal of Law and Medicine”.Vol. 31, Iss. 4; pg. 447, 32 pgs
http://proquest.umi.com/pqdweb?did=969303231&sid=1&Fmt=4&clientId=15023&RQT=309&VName=PQD
The two million adult prisoners in the U.S. do not reflect a cross-section of America; they are poorer, less well-educated, and
much more likely to be members of racial minorities.25 In addition, however, they are sicker: The prevalence of chronic illness,
commundicable diseases, and severe mental disorders among people in jail and prison is far greater than among other
people of comparable ages. Significant illnesses afflicting corrections populations include coronary artery disease, hypertension, diabetes,
asthma, chronic lung disease, HIV infection, hepatitis B and C, other sexually transmitted diseases, tuberculosis, chronic renal failure, physical
disabilities, and many types of cancer.26 They are sicker going in, and they are also sicker when they are released.27 Four
categories of prisoners' conditions are worthy of particular attention: communicable diseases such as HIV disease and tuberculosis ("TB"); sexually
transmitted diseases ("STDs") such as syphilis and Chlamydia; chronic conditions such as asthma and diabetes; and serious mental illness such as
schizophrenia and bipolar disorder.28 1. Communicable Diseases. Communicable diseases are spread from person to person, easily (as with TB,
which is transmissible by air) or with more difficulty (as with hepatitis, which is transmissible with direct contact between persons' bodily
fluids).29 The rate of infection with communicable diseases among prisoners is startlingly high. They are
disproportionately infected when they arrive in prison.30 Compared to the general population, it has been estimated that
"rates of human immunodeficiency virus (HIV) infection . . . are 8 to 10 times higher, rates of hepatitis C are 9 [to] 10 times
higher, and rates of tuberculosis are 4 [to] 7 times higher."31 Prisoners are also disproportionately infected when they
are released from incarceration. In 1996, released prisoners accounted for 35% of all people in the United States with tuberculosis, 29% of
those with hepatitis C, 12% of those with hepatitis B, and 13% of those with HIV infection.32 2. Sexually Transmitted Diseases. Sexually
transmitted diseases (STDs) are a subset of communicable diseases (that is, they are transmissible from person to person) that are also
over-represented in prisons and jails. Approximately 2.6 to 4.3% of prisoners are infected with syphilis, 2.4% with Chlamydia, and 1%
with gonorrhea.33 The incidence of STDs in jails, in particular, is very high. Studies of women in jails in the United States have found that "35% of
the women had syphilis, 27% had Chlamydia, and 8% had gonorrhea."34 A study of syphilis in New York City jails found that women with
multiple incarcerations had an incidence of syphilis infection that exceeded the rate of women in the general New York City population "by more
than a thousandfold."35 A 1999 study of early syphilis in Chicago found that "almost one third of all incident cases . . . were diagnosed at Cook
County Jail."36 3. Chronic Illness. A large number of prisoners have serious chronic illnesses. The asthma rate in United States prisons and jails in
1995 was 8.%; diabetes, 4.8%; and hypertension, 18.3%.37 The asthma rate was higher than that of the general population.38 The rates for diabetes
and hypertension were lower than the general population.39 However, the relative youth of the prison population and the fact that both diabetes and
hypertension are more likely to arise in older persons, suggests prison populations are disproportionately affected by these conditions as well.40 4.
Mental Illness. America's prisons and jails have-with the sharp reduction in the census in mental hospital-become the "new asylums."41 The
simultaneous surge in imprisonment of people with mental illness and decrease in institutionalization in mental hospitals has been referred to as
"transinstitutionalization."42 This phenomenon is caused by the failure of the community mental health system to provide services to those cleared
from psychiatric hospitals in the process of deinstitutionalization, and changes in criminal sentencing processes that increased penalties for "quality
of life" and drug offenses while reducing the exculpatory or sentence-reducing effects of mental illness.43 "The nation's largest mental health
facilities are now found in urban jails in Los Angeles, New York, Chicago, and other big cities."44 About 16% of people in state prisons and jails
have a mental illness.45 About 700,000 people with mental illness are placed in American jails each year,46 about threequarters of which also have substance abuse disorders.47 The incidence of mental illness, particularly major mental illness, is substantially higher is
prisons and jails than in the free world.48 The incidence of schizophrenia in state prisons is three to five times higher than in the general
population,49 and two to three times higher in jails than in the general population.50
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HIV spreads 4 times as fast in federal prison compared to the general population
Criminology & Public Policy INMATE FACTORS ASSOCIATED WITH HIV TRANSMISSION IN PRISON*
Christopher
P
Krebs..
Columbus:
Feb
2006.
Vol.
5,
Iss.
1;
pg.
113,
23
pgs
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The prevalence of AIDS infection is approximately four times higher in state and Federal prisons than among the
general U.S. population. It is also apparent that high-risk HIV transmission behaviors occur inside prison; however, data
that validly document cases of HIV transmission in prison are rare. This study uses data from a large sample of state prison inmates and logistic
regression to determine what inmate characteristics are associated with contracting HIV inside prison. Findings indicate that inmates who are
nonwhite and younger and who have been convicted of sexual crimes and have served longer sentences are more likely to contract HIV inside
prison. Documenting that HIV is transmitted inside prisons justifies the need for additional research and effective prevention strategies. Modeling
what types of inmates might be at risk for contracting HIV inside prison can help public and correctional health researchers and officials improve
their current prevention practices and ultimately reduce or prevent HIV transmission both inside and outside prison.
HIV spreads at twice the national rate in prisons and 40 % of federal prisoners have chronic
medical conditions
American Journal of Public Health. The Health and Health Care of US Prisoners: Results of a Nationwide Survey
Andrew P Wilper, Steffie Woolhandler, J Wesley Boyd, Karen E Lasser, et al. Washington: Apr 2009. Vol. 99, Iss. 4; pg.
666, 7 pgs http://proquest.umi.com/pqdweb?did=1668847201&sid=1&Fmt=3&clientId=15023&RQT=309&VName=PQD
Based on our analysis, US federal prisons held 129196 inmates and state prisons 1225680 in 2004. In 2002, local jails held 631241 inmates. The
overwhelming majority of inmates were male, were younger than 35 years, and were disproportionately Black or Hispanic. About 200000 (10%)
were military veterans. The majority were parents of minor children at the time of incarceration or at the time of the survey. Nonresponse to
individual items was uncommon. Among federal inmates, 2.1% were missing data on prescription medications at admission
and 2.8% on prior diagnosis of PTSD; 6.0% were missing data for HIV testing and 15.8% for duration of incarceration. No data
were provided for sexual assault or gunshot wounds in federal prisons. Among state inmates, 1.2% were missing data on prescription medications at
admission and 1.7% on prior diagnosis of PTSD; 4.0% were missing data regarding HIV testing and 6.3% for duration of incarceration. Among jail
inmates, 0.5% were missing data on the duration of incarceration and 2.2% on prior diagnosis of PTSD; 5.2% were missing data on HIV testing.
Chronic Medical Problems Chronic conditions were common among inmates; 49702 federal inmates (38.5% [SE=2.2%]),
524116 state inmates (42.8% [SE=1.1%]), and 244336 local jail inmates (38.7% [SE=0.7%]) had at least 1 chronic medical condition
(Table 1). Inmates had rates of diabetes, hypertension, prior myocardial infarction, and persistent asthma comparable to those of the US
noninstitutionalized, nonelderly population. However, following age standardization to the 2000 US census , the prevalence of these
conditions appeared to be higher for inmates than for the general population, except for prior myocardial infarction among jail
inmates (Table 2; see also the appendix to Table 1, available as a supplement to the online version of this article at http://www.ajph.org). More than
20000 inmates reported testing positive for HIV, including 1023 federal inmates (1.0% [SE=3.1%]), 15115 state inmates (1.6%
[SE=1.6%]), and 4245 local jail inmates (1.2% [SE=0.2%]); this prevalence was double that of the noninstitutionalized 2003-2004
NHANES population. These percentages did not substantially change when only inmates aged 18-49 years (the age group that underwent HIV
testing in the NHANES sample) were included.
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Prison efforts fail now (1/3)
New screening guidelines in prisons fail because nothing is done with the information
Justice Matters [Staff writer Julia Lutsky] Fall 2002 “Justice matters”
http://www.westernprisonproject.org/info/nation/story/521
Despite new screening guidelines prisons fail because they don’t act on the information placing the public at risk According to a report by
the Department of Justice approximately 11.5 million people cycle in and out of prisons and jails each year; the majority of them
will spend only a short time in jail. Many of those millions are infected with communicable diseases such as hepatitis B and/or C,
HIV/AIDS, tuberculosis, sexually transmitted diseases (STDs) - such as syphilis, gonorrhea, chlamydia - and other highly contagious diseases like
scabies. According to the Nation Magazine, (The Shame of Prison Health, by Sasha Abramsky, 7/1/02),
“experts estimate that for
[such] diseases, the infection rates (the number of cases per 100,000) among prisoners are upward of ten times those
found in the American population as a whole.” The high level of disease among prisoners when they enter the correctional system
presents the authorities with two clear options: intervene to treat those who are ill and to arrange for treatment to continue when the person leaves
prison - or let the infections fester and spread. The overwhelming reality is that corrections systems take the second option. Even when there is
initial screening for infection, nothing is done with the information obtained that would benefit either the prisoner
or the general public when he or she is eventually released. When a sick person enters the system his or her illness stands a good
chance of being spread by proximity to other prisoners (particularly the case with tuberculosis), by the widespread but officially ignored presence of
prison rape, and by the unacknowledged presence and use of injectable drugs. Both rape and needle-sharing propagate hepatitis B and C, HIV/AIDS
and, in the case of rape, the STDs.
Problems with prison health care mean prisoners regularly lose access to medicine and cannot see
doctors
American Journal of Public Health. The Health and Health Care of US Prisoners: Results of a Nationwide Survey
Andrew P Wilper, Steffie Woolhandler, J Wesley Boyd, Karen E Lasser, et al. Washington: Apr 2009. Vol. 99, Iss. 4; pg.
666, 7 pgs http://proquest.umi.com/pqdweb?did=1668847201&sid=1&Fmt=3&clientId=15023&RQT=309&VName=PQD
Access to Medical Services Among inmates with a persistent medical problem, 13.9% of federal inmates, 20.1% of state inmates, and
68.4% of local jail inmates had received no medical examination since incarceration. More than 1 in 5 inmates were taking
a prescription medication for some reason when they entered prison or jail; of these, 7232 federal inmates (26.3%),
80971 state inmates (28.9%), and 58991 local jail inmates (41.8%) stopped the medication following incarceration. Prior to
incarceration, slightly more than 1 in 7 inmates were taking a prescription medication for an active medical problem routinely requiring medication
(as defined in the Methods section). Of these, 3314 federal (20.9% [SE= 6.7%]), 43679 state (24.3% [SE=3.3%]), and 28473 local jail inmates
(36.5% [SE=1.7%]) stopped the medication following incarceration. Only a small portion of prison inmates (3.9% [SE=6.5%] of federal and 6.4%
[SE=3.2%] of state inmates) with an active medical problem for which laboratory monitoring is routinely indicated had not undergone at least 1
blood test since incarceration. However, most local jail inmates with such a condition (60.1% [SE=1.8%]) had not undergone a blood test.
Following serious injury, 650 federal inmates (7.7%), 12997 state inmates (12.0%), and 3183 local jail inmates (24.7%) were not seen
by medical personnel (Table 3).
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800,000 prisoners are infected in the United States yet receive no health care
Chicago Citizen [Julie Steenhuysen, editor] Jan 21, 2009 “Many inmates sick, access to care poor
.. Chicago, Ill.:. Vol. 43, Iss. 43; pg. 7, 1 pgs”
http://www.cha.harvard.edu/news/press_releases_09/090115_Wilper_Prisoners_study.shtml
in U.S. prisons and jails have rates of serious illness that far exceed those of the general
population and many lack access to healthcare, researchers said on Thursday. They found that 800,000 inmates - about 40
percent of the U.S. prison population - have a chronic medical problem such as diabetes, asthma or heart or kidney problems.
And more than 20 percent of sick inmates in state prisons and 13.9 percent in federal prisons had not seen a doctor or a nurse since
their incarceration began. "A substantial percentage of inmates have serious medical needs. Yet many of them don't
get even minimal care medical care," said Dr. Andrew Wilper of the University of Washington School of Medicine in Seattle, whose
CHICAGO (Reuters) - Inmates
study appears in the American Journal of Public Health. Wilper did the research while at the Cambridge Health Alliance and Harvard Medical
School in Massachusetts. He and colleagues analyzed data from a 2002 survey of inmates in local jails and a 2004 survey of prison inmates. They
found a far higher incidence of chronic disease among inmates. Compared to other Americans of the same age, state prison
inmates were 31 percent more likely to have asthma, 55 percent more likely to have diabetes, and 90 percent more likely to have
suffered a heart attack. Access to care was worst in local jails and best in federal prisons. One-quarter of jail inmates who had suffered severe
injuries had received no medical attention, versus 12 percent in state prisons and 8 percent in federal prisons. The researchers also looked at mental
illness. While about a quarter of inmates had a history of chronic mental illness like schizophrenia, bipolar disorder, depression or anxiety, twothirds of them were off treatment at the time of their arrest Only after their imprisonment did most of these inmates receive treatment. A study
this week in the Journal of the American Medical Association found inmates with drug problems are not getting
adequate treatment. The study by researchers at the National Institute on Drug Abuse, part of the National Institutes of Health, found about
half of all prisoners - including some guilty of non-drug offenses ~ are dependent on drugs. Yet less than 20 percent of inmates suffering from drug
abuse or dependence get formal treatment. They said the criminal justice system was in a position to encourage drug abusers to enter and remain in
treatment, disrupting the cycle of drug use and crime.
Prisoners are the most at risk for infection but have the least access to health care
The Health Lawyer [editor Michele Westhoff.] “AN EXAMINATION OF PRISONERS' CONSTITUTIONAL
RIGHT TO HEALTHCARE: THEORY AND PRACTICE” Chicago: Aug 2008. Vol. 20, Iss. 6; pg. 1, 13 pgs. Proquest
Many Americans are somewhat incredulous that prisoners have a constitutionally protected guarantee to adequate medical care
and treatment. Why, they argue, should convicted criminals enjoy an invaluable benefit that the government has declined to provide to lawabiding citizens?84 Though the public's indignation is understandable and perhaps even justified, in truth healthcare in the nation's prisons has not
improved significantly since 1976. Unfortunately, the present condition of prison health systems could potentially silence
even the most strident opponents of government-sponsored medical care for inmates. Despite the legal mandate to
provide inmates with medical care "commensurate with modern medical science and of a quality acceptable within prudent professional standards,"
many correctional facilities do not have adequate resources.85 This deficiency is even more serious in light of the fact
that prisoners have a higher rate of disease and disability than the non-incarcerated population.86 For example, in one study
of a large county jail in Ohio, upon admission to the facility 32 percent of inmates reported symptoms consistent with infectious diseases, 47
percent reported using drugs and/or alcohol often enough to necessitate a substance abuse assessment, 19 percent reported symptoms of
schizophrenia, 16 percent reported symptoms of bipolar disorder, 32 percent reported symptoms of depression, 38 percent reported high-risk sexual
behaviors or previously diagnosed sexually transmitted diseases, and 50 percent reported a risk factor for HIV infection.87 This study highlights the
extreme need for diligent provision of access to specialized medical screening and treatment in prisons. Unfortunately, much work remains to be
done in order to meet this goal. Lack of Physicians Willing to Work in Prisons
24
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Prison efforts fail now (3/3)
Lack of education in prison means that prisoners are 13 times more likely to die once they leave
compared to members of the general population
Boston Globe [ Linda Johnson, staff writer] “Newly released inmates face high risk of death, study finds
Drug overdose, heart disease are among top killers” January 11 2007
http://www.boston.com/news/nation/articles/2007/01/11/newly_released_inmates_face_high_risk_of_death_study_finds/
Prison life may be dangerous, but getting out can be deadly, too. Newly released inmates were almost
13 times more likely than the general public to die during their first two weeks of freedom, a study in Washington state
TRENTON, NJ --
found. Drug overdoses were the top killer, with former convicts 129 times more likely to die that way within two weeks of their release than the
general population. That cause of death was followed by heart disease, homicide, and suicide, according to the study, the first major look at the
issue. Over an average of two years, the study found the former inmates were 3 1/2 times more likely than other state residents and nearly four
times more likely than current inmates to die. "The differences are more striking for women then they are for men," said lead researcher Dr. Ingrid
Binswanger, a public health researcher and assistant professor at University of Colorado at Denver. While 87 percent of former prisoners in the
study were men, the risk of death for the women was 5 1/2 times higher than for other women in the state. Specialists said the rest of the country
probably has a similar, or even worse, situation than Washington state, although the specific drugs causing overdoses might vary by region.
Binswanger, who did her research with colleagues while at the University of Washington, noted that studies in Europe and Australia found similarly
high death rates, particularly right after release from prison. The new findings show the need for more programs to help former inmates with a
history of addiction and poor health cope with the stress of finding housing, a job, healthcare, and other necessities and stay clean, said Christy
Visher of the Justice Policy Center at the Urban Institute. Other specialists said the results don't surprise them, because inmates
have far more physical and mental health problems than other citizens, often get inadequate treatment behind bars, and
get little help making the huge transition to society after a highly structured life. "People need much more than a job and a
place to put their heads," said Nancy Wolff, who heads Rutgers University's Center for Mental Health and Criminal Justice Research and is
developing a curriculum for prisons to train inmates before release. Dr. Scott Allen, co director of the Center for Prisoner Health and Human Rights
at Brown University and a former prison medical director, said that without help, released offenders probably "will reassociate with the group of
people they got in trouble with in the first place." "We see this every day," said Allen, whose study in Rhode Island in the 1990s found one in 10
former inmates died within seven years, mostly because of substance abuse. Binswanger's study is reported in today's New England Journal of
Medicine.
25
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover – Generic (1/3)
12 million inmates are released each year. Solving disease in prison is key to community health
American Journal of Public Health. The Health and Health Care of US Prisoners: Results of a Nationwide Survey
Andrew P Wilper, Steffie Woolhandler, J Wesley Boyd, Karen E Lasser, et al. Washington: Apr 2009. Vol. 99, Iss. 4; pg.
666, 7 pgs http://proquest.umi.com/pqdweb?did=1668847201&sid=1&Fmt=3&clientId=15023&RQT=309&VName=PQD
Mass incarceration as part of the war on drugs has created a burgeoning inmate population in the United States. Earlier studies
of inmates have been based on extrapolations from noninstitutionalized Americans, single institutions, or data from either federal or state prisons
alone or jail systems alone. Our study adds to the existing literature by analyzing a large, nationally representative sample of the entire US inmate
population. More than 800000 inmates report having 1 or more chronic medical condition, and their access to medical care appears to be
poor, particularly in jails. Our data also demonstrate that prisons are holding and treating many mentally ill people who were off treatment at
the time of arrest. Our age-standardized prevalence estimates for rates of hypertension and diabetes were higher than estimates from earlier
populationbased projection models (18.3% and 4.8%, respectively).13 Although the rates of asthma in our study were similar to the rates in the
earlier study (8.5%),13 our figures include only those with active asthma, whereas the earlier estimates included any prior diagnosis. Furthermore,
the earlier projections were based on models that used data from NHANES III that included laboratory testing (diabetes) and physical examination
(hypertension) as part of diagnostic criteria; including these measurements as part of the diagnostic criteria among inmates would have increased
our prevalence estimates.13 Improved management of chronic conditions in prisons and jails may have important
implications for community health and in reducing health care disparities, because the vast majority of inmates are
eventually released. Approximately 12 million inmates are released annually (William J. Sabol, PhD, chief, Corrections
Statistics, Bureau of Justice Statistics, oral communication, April 2008). This high turnover of a population with elevated rates of
treatable conditions offers a substantial public health opportunity. Indeed, in response to a congressional request, the National
Commission on Correctional Health Care issued an extensive report in 2002 titled The Health Status of Soon-To-Be-Released Inmates8; although it
included recommendations of specific strategies to improve inmates ' health, no congressional action has ensued (R. Scott Chavez, PhD, MPA, vice
president, National Commission on Correctional Health Care, oral communication, July 2008). Nonetheless, minimizing inmates' physical and
mental disability is an important step in reintegrating them into family and employment roles. The prevalence of HIV in prisons is
higher than in the noninstitutionalized population, although it is declining.14,15 A high incidence of blood-borne illnesses among
inmates has also been documented.16,17 Limited privacy in prison may make prisoners reluctant to comply with treatment of HIV, and sexual
coercion and bartering may facilitate transmission. Similarly, untreated bleeding injuries (as documented in our data) pose an obvious transmission
risk. Hence, poorly managed HIV may lead prisons to function as "amplifiers" of this and other infectious illnesses and
add to the burden of untreated and advanced disease borne by inmates, families, and communities following inmates'
release.
Most prisoners are released and serve to infect the general population with life threatening disease
The Health Lawyer [editor Michele Westhoff.] “AN EXAMINATION OF PRISONERS' CONSTITUTIONAL
RIGHT TO HEALTHCARE: THEORY AND PRACTICE” Chicago: Aug 2008. Vol. 20, Iss. 6; pg. 1, 13 pgs. Proquest
The majority of prisoners do not remain incarcerated for life.162 After serving their sentences, inmates are released back into
society and are free to engage in all of the activities in which free citizens partake. Once they leave prison, inmates who have contracted
tuberculosis, an airborne pathogen, can transmit the disease to any number of unsuspecting citizens if the disease
becomes active.163 Prisoners infected with HIV, Hepatitis C, or other sexually transmitted diseases can pass these viruses on to sexual partners in
the general population.164 Moreover, because HIV and Hepatitis C are blood-borne, if an infected ex-prisoner engages in I.V. drug abuse, he
or she may transmit these diseases to anyone with whom a needle is shared.165 Notwithstanding Americans' personal feelings about
whether inmates deserve state-of-the-art medical treatment, the effect of poor prison Healthcare on the public health should
not be disregarded.
26
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover – Generic (2/3)
Failures in prison health care mean that when prisoners are released they place an enormous strain
on their communities in addition to spreading disease
John V Jacobi [professor of law at Seton Hall University] 2005 “Prison Health, Public Health: Obligations and
Opportunities American Journal of Law and Medicine”.Vol. 31, Iss. 4; pg. 447, 32 pgs
http://proquest.umi.com/pqdweb?did=969303231&sid=1&Fmt=4&clientId=15023&RQT=309&VName=PQD
In the last fifty years, reformers shifted to individual rights arguments based on prisoners' constitutional rights.7 Substantial progress in the early
years of that era has given way to reaction from courts and legislatures, throwing this strategy of prison reform into doubt . The harm that flows
from mismanagement of chronic conditions and mental illness comprises severe strain on community health facilities,
harm to the communities flowing from the inability of sick ex-prisoners to reintegrate into society, and the costs of
recidivism when failure to reintegrate contributes to ex-prisoners' return to crime. Almost all of the two million prisoners
now in prisons and jails will return to their communities one day.8 If, due to poor prison health care, they return with uncontrolled
syphilis, tuberculosis, HIV, and other infectious conditions, they will likely infect many around them. Positive state
constitutional rights obviously reach situations where federal constitutional protections do not.291 These positive rights may be argued to extend to
the community's right of protection from the state's mismanagement of prison health causing avoidable public health injuries to poor communities
and communities of color. Instead, it is "merely" a political argument, much like that made by reformers such as Cobb Wines and Theodore Dwight
in 1867, when they argued that brutal conditions in prisons were both inhumane and contrary to social interests in reforming prisoners, permitting
them to return with dignity to a useful role in society.292 Similarly, the political argument here is that poor prison health care is both inhumane and
contrary to social interests in achieving prisoner reentry maximizing ex-prisoner integration and minimizing the public health threats to their
communities. Prisons' and jails' failure to provide adequate treatment to a wide variety of chronic conditions, mental illnesses, sexually
transmitted diseases, and communicable diseases threaten those communities with physical and financial harm, infection,
and illness. Public health arguments, drawn in part from the emerging reentry movement, have the potential to move society to pay the costs for
decent prison health care out of clear self-interest, where it has been unwilling to do so as a matter of justice and morality.
Inmates pose an enormous health risk to the general population
The Taipei Times [Taiwan] June 23, 2004 “US Prisons Nurture Violence, Disease”
http://www.november.org/stayinfo/breaking2/Taiwan.html
The prison health problem registered in Congress, which in 1997 held hearings and instructed the Justice Department to perform the
country's first nationwide study of the health environment of jails and prisons. The study, a groundbreaking work entitled "The Health Status of
Soon-to-Be-Released Inmates," was completed in 2000. Critics of the government say that the report was shelved for two years before being made
public - without the imprimatur of the Justice Department, which had worked on the project. Once released, the study sank so swiftly from view
that even members of Congress seemed unaware that it existed. "The Health Status of Soon-to-Be Released Inmates" is available on the web site of
the National Commission on Correctional Health Care, which worked with the government on the project. It offers a sobering view of the
corrections system, which has clearly become a major conduit for infectious disease. The rate of transmission for sexually transmittable disease
behind bars is roughly 10 times that in the world outside. In any given year, 17 percent of people with AIDS, 35 percent of
people with tuberculosis and nearly a third of those with hepatitis C pass through the corrections system. This system
represents a gaping hole in the public health network, thanks in part to the fact that prisoners become ineligible for Medicaid
assistance while they're behind bars. Inmates who have the misfortune of being housed in jails and prisons without serious
medical programs often have no choice but to cease treatment, which means that they get sicker and continue to pose
an infection risk to others.
27
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover – Generic (3/3)
Substandard prisons served to spread the swine flue
The Miami Herald “South Miami-Dade prison confirms 13 swine flu cases” 6/27/2009
An outbreak of swine flu at a South Miami-Dade women's prison has infected 13 inmates and hospitalized one, health officials
said Friday. Homestead Correctional Institution has suspended visits and stopped accepting or releasing prisoners. The development came as
federal officials on Friday talked about plans for a possible fall vaccination campaign that could involve an unprecedented 600 million doses of
vaccine. ''The flu is not going away,'' said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases of the
U.S. Centers for Disease Control and Prevention. She said the official U.S. count of 27,717 cases of H1N1 flu is ''really just the tip of the iceberg,''
and the true count may be as high as one million cases. In a Friday news briefing, Schuchat urged local communities to start planning now to
vaccinate their most vulnerable residents -- those under 25, pregnant women and those with underlying health conditions -- next fall, if federal
health officials decide it's necessary. Still, Schuchat said the swine flu remains mild so far. The cases at Homestead Correctional Institution were
confirmed between June 19 and Thursday, said Dr. Fermin Leguen, epidemiologist for the Miami-Dade Health Department. Most of the cases are
mild, he said. VISITS ON HOLD Social visits have been suspended, and confirmed cases from all five dormitories are being housed in
one area separate from other inmates, according to Jo Ellyn Rackleff, spokeswoman for the Florida Department of Corrections. The facility is
not receiving or releasing inmates, she said. The facility was built in 1976 or house minimum- and medium-security male inmates, but
turned into a female facility in 1999. Inmates are serving terms for such felonies as grand theft, credit card fraud, aggravated battery, second-degree
murder and cocaine sale. Maximum capacity is listed on its website as 668; it lists the current population as 678.
28
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover – HIV (1/1)
145,000 HIV positive inmates have been released since 1997
NCCHC (National Commission On Correctional Health Care) “The Health Status of Soon-to-be-Released Inmates
A Report to Congress. Volume 1” March 2002 http://www.ncchc.org/pubs/pubs_stbr.vol1.html
HIV/AIDS. The study estimates that 35,000 to 47,000 inmates in 1997 were infected with HIV. These included 28,000 to 36,300 prison
inmates and 6,800 to 10,200 jail inmates. An estimated 98,000 to 145,000 HIV-positive inmates were released from prisons and
jails in 1996, including about 11,600 to 15,000 released from Federal and State prisons and about 87,000 to 130,400 released from jails. The
estimated rates for these communicable diseases are much higher for releasees than for current inmates largely because of the rapid turnover and
short lengths of stay in jails. Among HIV-infected inmates, an estimated 8,900 inmates had AIDS in 1997: 6,000 in State and Federal prison and
2,800 in jails. 3 An estimated 39,000 inmates with HIV were released from prisons and jails in 1996, about 2,500 from prisons and 36,000 from
jails.
The prison system releases 2,100 HIV positive inmates each year
The Nation's Health [wriater Donya Currie] May 2009 “Inmates with HIV lack treatment after release”
Vol. 39, Iss. 4; pg. 13, 1 pgs.
http://proquest.umi.com/pqdweb?did=1708352121&sid=2&Fmt=3&clientId=15023&RQT=309&VName=PQD
Once released from prison, most inmates with HIV do not receive adequate medical care, at least when it comes to
prescription medication .A study in the Feb. 25 Journal of the American Medical Association found that of approximately 2,100 HIVpositive inmates released between January 2004 and December 2007 from the Texas Department of Criminal Justice
prison system, a little more than 5 percent of those inmates filled a initial prescription for antiretroviral medication
within 10 days of release. By 30 days, only about 18 percent of the former inmates had filled their prescriptions, and the number climbed to 30
percent within 60 days of release.The study found that inmates released on parole had higher rates of filling an antiretroviral prescription at 30 days
and 60 days than those with a standard, unsupervised release. Black and Hispanic former inmates were less likely to have filled a prescription at 10
days and 30 days after release, a finding that "is consistent with previous community-based research indicating that minority populations may
experience more socioeconomic barriers to health care than their non-minority counterparts," the study's authors noted.
29
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover - Hepatitis (1/2)
The spread of Hep C starts in prisons and unless checked will kill 30,000 Americans a year
ACLU [ American Civil Liberties Union] 1/21/2003 Prison Officials' Failure to Contain Hepatitis C Brings Epidemic
Outside Prison Walls, MI ACLU Charges http://www.aclu.org/prison/medical/14694prs20030121.html
DETROIT - In a class-action lawsuit that may impact thousands,
the American Civil Liberties Union of Michigan today charged state
prison officials with allowing an infectious disease to reach epidemic proportions by failing to adequately test and
treat inmates with the Hepatitis C Virus (HCV). The class action lawsuit was filed today in federal district court. "This is a
very serious problem for everyone in Michigan," said Kary Moss, Executive Director of the ACLU of Michigan. "Unless the prisons
begin to follow appropriate protocols for testing and treating Hepatitis C among inmates, HCV will continue to spread
well beyond the prison walls. And unless the disease is treated in the early stages, the cost of treatment will
undoubtedly rise dramatically." HCV is a blood-borne virus that causes liver disease and other life-threatening problems.
It is spread primarily through contact with the blood of an infected person by, for example, sharing of intravenous or tattoo needles or the sharing of
bodily fluids, including during sex. It may also be spread through the sharing razors and toothbrushes. According to the ACLU lawsuit, not only
does the Michigan Department of Corrections' protocol for testing and treating inmates for HCV "fall far short of nationally
accepted medical standards," corrections officials also fail to follow their own inadequate standards. Some inmates are
not even notified that they have Hepatitis C or educated about how to prevent the transmission of the disease, the ACLU charged. "Not
only does the Department of Corrections' approach to HCV constitute cruel and unusual punishment, but it is also extremely short-sighted," said
Michael J. Steinberg, Legal Director of the Michigan ACLU. "Inmates with Hepatitis C will eventually be released from prison.
If
they are not diagnosed or told that they are infected, they will unknowingly spread this deadly disease throughout
society." The Surgeon General has declared the disease to be a national epidemic. It now causes between 8,000 and
10,000 deaths each year in the U.S., a death rate that is expected to triple in the next two decades. The nation's prisons
are a focal point for Hepatitis C infection and transmission, the ACLU said in legal papers, with an estimated 15 to 40
percent infection rate, compared to an infection rate of two percent for those outside prison. At the end of 2002, Michigan's inmate population
exceeded 49,000. National and other state estimates suggest that between 7,350 -19,600 of these inmates (15 to 40 percent) may be infected with
HCV, and many more are likely to have elevated risk factors for HCV infection that indicate HCV testing would be appropriate. In addition to
Moss and Steinberg, ACLU Cooperating Attorney Daniel Manville will be working on the case, as well as student attorneys from the University of
Michigan Clinical Law Program supervised by Professor David Santacroce.
30
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover - Hepatitis (2/2)
Each year prisons release 1.3 million inmates with untreated hepatitis
The Health Lawyer [editor Michele Westhoff.] “AN EXAMINATION OF PRISONERS' CONSTITUTIONAL
RIGHT TO HEALTHCARE: THEORY AND PRACTICE” Chicago: Aug 2008. Vol. 20, Iss. 6; pg. 1, 13 pgs. Proquest
Viral hepatitis is also a disturbing problem in correctional facilities. Viral hepatitis is an inflammatory disorder of the liver that
produces symptoms of jaundice and malaise.117 Chronic viral hepatitis, caused by strains B and C of the Hepatitis virus, can ultimately lead
to cirrhosis, liver failure, liver cancer, and death.118 Rates of Hepatitis B and C infection are nine to ten times higher in prisoners
than in the non-incarcerated population.119 In 1993, 1.3 million American inmates were Hepatitis C positive upon
release from prison, and 155,000 were Hepatitis B positive.120 These numbers stand in stark contrast to the incidence and prevalence of
hepatitis in the general population: Approximately 35,000 new cases of Hepatitis C, and 140,000 cases of Hepatitis B, are reported in the general
U.S. population annually.121 Because Hepatitis B and C are transmitted through the same behaviors and practices that facilitate transmission of
HIV, such as unprotected sex and intravenous drug use, and because the behaviors are common among prisoners during incarceration, uninfected
inmates run a similarly high risk of contracting hepatitis during their detention.122 Also like HIV, there is no cure for Hepatitis B or C.123
Therefore, inmates who contract viral hepatitis while in prison are saddled with a debilitating, potentially fatal chronic illness which requires careful
medical management and treatment, and which can constitute a public health risk upon the inmate's release from prison.124
More ev
NCCHC (National Commission On Correctional Health Care) “The Health Status of Soon-to-be-Released Inmates
A Report to Congress. Volume 1” March 2002 http://www.ncchc.org/pubs/pubs_stbr.vol1.html
Hepatitis B and C. More than 36,000 prison and jail inmates in 1997 and 155,000 releasees in 1996— an estimated 2 percent of prison and jail
inmates and releasees—had current or chronic hepatitis B infection. At least 303,000–332,000 prison and jail inmates were infected with hepatitis C
in 1997. Between 1.3 and 1.4 million inmates released from prison or jail in 1996 were infected with hepatitis C. 5
31
Prison Aff
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover – Tuberculosis (1/2)
TB starts in prisons and quickly spreads to communities
Corrections Today. Improving Communication Between Public Health and Corrections: The Tuberculosis Case
Ellen R Murray. Lanham: Apr 2009. Vol. 71, Iss. 2; pg. 26. Proquest
Tuberculosis (TB) is an airborne disease that does not need permission to infect someone. This disease is especially
challenging in jails and prisons because of recirculated air and crowded cells, which are two risk factors for TB
infections. Because inmates are more likely to be immunosuppressed, HIV infected and substance abusers, they are at
a higher risk for progressing to active TB once infected.1 Symptoms of active TB include fever, cough, weight loss,
loss of appetite and fatigue. It is easily spread by coughing, making correctional facilities an ideal venue for this
disease to infect a large number of people. Screening for tuberculosis is not always easy in correctional facilities;
inmates may not have their own best interests at heart and some try to manipulate the system to their own end.2
Because inmates move around and are not always seen by the same staff member, TB can go unrecognized for several
weeks or months in correctional facilities.3 It is no surprise that risk factors for tuberculosis are higher among
inmates,4 and with rapid turnover of inmates and staff, TB becomes something that is not always identified quickly.
Careful monitoring of latent TB infection in inmates and staff is necessary to monitor a potential outbreak.5 To be
proactive in fighting tuberculosis, it is necessary for health departments and corrections to begin building relationships
to combat this disease. One way to do this is through the use of corrections liaisons, specially trained individuals
knowledgeable not only in TB and public health, but also in the everyday challenges that exist in the corrections
setting. The Centers for Disease Control and Prevention's (CDC) 2006 updated guidelines for corrections state that
"Correctional facilities and health departments should each designate liaisons for TB-associated efforts. Liaisons
should serve as a familiar and accessible communication link between collaborating entities."6 Why Improve
Communication? Improving communication between corrections and health department staff continues to be an
ongoing challenge. Definitions for words such as safety, screening, isolation and monitoring, may differ in corrections
and public health settings. "Safety" to a custody staff member might mean the absence of weapons and the presence of
order, while "safety" to a public health staff person might mean the control of infectious diseases. While "isolation" to
many correctional custody staff means placing in a single room away from others, to medical personnel who are
discussing TB, a negative airborne infection isolation room comes to mind.7 CDC reports TB cases diagnosed in
correctional facilities; however, statistics do not include cases of suspected TB or cases that travel through
correctional facilities and are not diagnosed until they reach the community.8 These statistics lead authorities to
believe that TB may be underreported in correctional facilities. For instance, it may be difficult to convince
corrections staff that they need to improve their TB programs when only one TB case is diagnosed. However, when it
is identified that 25 percent of TB cases in the community were housed in a correctional facility undiagnosed, the
numbers become very real and the awareness of the need for improved screening heightened. The rapid movement
and discharge of inmates in short-term correctional facilities plays an important role in the potential for
underrecognizing suspected cases, which leads to under-reported cases. Although tuberculosis has been present in
correctional facilities for many years, the breadth of the problem confounds opportunities for change.9 In correctional
facilities, medical staff may spend only 20 minutes in routine encounters with inmates. To pick up on symptoms of
TB, such as a cough that just will not go away, more than 20 minutes is needed. Mandatory screening and testing
becomes a critical component of a facility's TB Infection Control Plan. Also, training and education on the
symptoms of active TB become very important as officers and staff transport inmates to and from medical and
other areas. Inmates may spend 24 hours a day, seven days a week with each other. Thus, inmate education plays an
important role in the corrections TB control process. Once inmates are educated on the symptoms of TB, that
information is taken with them wherever they go, including to other facilities, or out into the community, where they
can educate their families and acquaintances. When TB goes unrecognized in correctional facilities, it can result in
one person spreading the disease to a large number of people - from inmate to staff,10 staff to inmates, and inmate to
inmates." TB is then spread into the community when inmates are released.12 This sequence from corrections
to community and back into corrections will continue until the cycle is broken.
32
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover – Tuberculosis (2/2)
566,000 prisoners are released each year with TB
NCCHC (National Commission On Correctional Health Care) “The Health Status of Soon-to-be-Released Inmates
A Report to Congress. Volume 1” March 2002 http://www.ncchc.org/pubs/pubs_stbr.vol1.html
Tuberculosis infection and disease. An estimated 131,000 inmates tested positive for latent TB infec- tion in 1997—more than 90,000 prison
inmates and more than 41,000 jail inmates. An estimated 566,000 inmates with latent TB infection were released in 1996,
including more than 37,000 inmates from prisons and nearly 529,000 inmates from jails. In 1996, an estimated 1,400 inmates had active TB disease,
including nearly 500 from pris- ons and over 950 from jails. About 12,000 persons released from a correctional facility during 1996 had TB disease
during that year. 6
Empirically proven: Prisoners were responsible for the drug resistant tuberculoses epidemic of the
1990’s
The Taipei Times [Taiwan] June 23, 2004 “US Prisons Nurture Violence, Disease”
http://www.november.org/stayinfo/breaking2/Taiwan.html
The diseases that incubate behind bars don't just stay there. They come rushing back to the general population -and to the overburdened public health system -- with the nearly 12 million inmates who are released each year. Some
states have responded to the danger of prison epidemics by gearing up to test, treat and counsel inmates. But most of the system is not so forward
looking. Faced with tight budgets, many jails and prisons have backed away from testing inmates for fear that they will be required to pay for
treatment. This approach was shown to be penny wise but pound foolish when the country experienced an epidemic of drug-resistant
tuberculosis -- driven mainly by former prison inmates -- during the 1990s. Though expensive, testing and treatment for TB
cases behind bars are more efficient and cost-effective than mounting a full-scale assault on the disease once it hits the streets. A similar
pattern has emerged with AIDS as infected inmates leave prison and infect people outside, who then turn to the
public health system.
33
Prison Aff
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Disease Spillover – STD’s
200,000 STD positive inmates are released into the community each year
NCCHC (National Commission On Correctional Health Care) “The Health Status of Soon-to-be-Released Inmates
A Report to Congress. Volume 1” March 2002 http://www.ncchc.org/pubs/pubs_stbr.vol1.html
Sexually transmitted diseases: syphilis, gonorrhea, and chlamydia. The total number of inmates or releasees infected with any one STD cannot be
deter- mined because an inmate could have more than one infection. It is safe to conclude, however, that in 1997 the Nation’s prisons
and jails held, or released into the community, at least 200,000 individuals with an STD. There were an estimated 107,000
to 137,000 cases of STDs among inmates and between 465,000 and 595,000 STD cases among releasees in 1997. As shown in table 3–1, most of
these inmates and releasees were infected with syphilis. 4
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Impacts – Generic (1/2)
Disease leads to extinction.
Corey S. Powell [Senior Editor and Executive web editor at Discover magazine] October 2001 “20 Ways the World Could
End” www.corey-powell.com/20Ends.html
task. Germs and people have always coexisted, but occasionally
the balance gets out of whack. The Black Plague killed one European in four during the 14th century; influenza took at least 20
million lives between 1918 and 1919; the AIDS epidemic has produced a similar death toll and is still going strong. From
1980 to 1992, reports the Centers for Disease Control and Prevention, mortality from infectious disease in the United States rose 58 percent. Old
diseases such as cholera and measles have developed new resistance to antibiotics. Intensive agriculture and land development
is bringing humans closer to animal pathogens. International travel means diseases can spread faster than ever. Michael Osterholm, an
infectious disease expert who recently left the Minnesota Department of Health, described the situation as "like trying to swim
against the current of a raging river." The grimmest possibility would be the emergence of a strain that spreads so fast
we are caught off guard or that resists all chemical means of control, perhaps as a result of our stirring of the
ecological pot. About 12,000 years ago, a sudden wave of mammal extinctions swept through the Americas. Ross
MacPhee of the American Museum of Natural History argues the culprit was extremely virulent disease, which humans helped
If Earth doesn't do us in, our fellow organisms might be up to the
transport as they migrated into the New World.
Disease outweighs terrorism and WMD’s
Fareed Zakaria, Editor of Newsweek International, October 2005, “A threat worse than terror”
www.fareedzakaria.com/ARTICLES/newsweek/103105.html
A flu pandemic is the most dangerous threat the United States faces today," says Richard Falkenrath, who until recently
served in the Bush administration as deputy Homeland Security adviser. "It's a bigger threat than terrorism. In fact it's bigger than
anything I dealt with when I was in government." One makes a threat assessment on the basis of two factors: the probability of the event, and the
loss of life if it happened. On both counts, a pandemic ranks higher than a major terror attack, even one involving weapons
of mass destruction. A crude nuclear device would probably kill hundreds of thousands. A flu pandemic could easily
kill millions.
Disease tanks military readiness.
Suburban Emergency Management Project, July 25, 2007, Disease Outbreak Readiness Update, U.S. Department of
Defense www.semp.us/publications/biot_reader.php?BiotID=449
An infectious disease pandemic could impair the military’s readiness, jeopardize ongoing military operations abroad,
and threaten the day-to-day functioning of the Department of Defense (DOD) because of up to 40% of personnel reporting sick or
being absent during a pandemic, according to a recent GAO report (June 2007).
Congressman Tom Davis, ranking member of the Committee on Oversight and Government Reform in the U.S. House of Representatives,
requested the GAO investigation. (1) The 40% number (above) comes from the Homeland Security Council’s estimate that 40% of the U.S.
workforce might not be at work due to illness, the need to care for family members who are sick, or fear of becoming infected. (2) DOD military
and civilian personnel and contractors would face a similar absentee rate, according to the GAO writers.
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Impacts – Generic (2/2)
Disease hurts the U.S. economy
The Milken Institute, October 2007, “An Unhealthy America: The Economic Burden of Chronic Disease
www.milkeninstitute.org/pdf/ES_ResearchFindings.pdf
More than half of Americans suffer from one or more chronic diseases. Each year millions of people are diagnosed
with chronic disease, and millions more die from their condition. By our calculations, the most common
chronic diseases are costing the economy more than $1 trillion annually —and that figure threatens to reach $6
trillion by the middle of the century. Yet much of this cost is avoidable. This failure to contain the containable is undermining
prospects for extending health insurance coverage and for coping with the medical costs of an aging population. The
rising rate of chronic disease is a crucial but frequently ignored contributor to growth in medical expenditures.
Of course, the personal and financial consequences of avoidable illness are greatest for those who become ill and their families. In this research,
however, we focused on the narrower, more tangible costs of chronic illness: the medical
resources used to treat avoidable illness; the impact on labor supply (primarily through lower productivity), and thus GDP; and the drag on longterm economic growth. Specifically, we analyzed the impact of seven of the most common chronic diseases—cancer (broken into several types),
diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental disorders—and estimated the economic costs that could be avoided
through more effective prevention and treatment. Even before considering the suffering of those with these diseases, the magnitude of these
potential economic benefits would justify increased investment in preventive health measures.
Disease leads to extinction.
South China Morning Post, 1/4/96, “Leading the way to a cure for AIDS”
Despite the importance of the discovery of the "facilitating" cell, it is not what Dr Ben-Abraham wants to talk about. There is a much more
pressing medical crisis at hand - one he believes the world must be alerted to: the possibility of a virus deadlier than HIV. If this
makes Dr Ben-Abraham sound like a prophet of doom, then he makes no apology for it . AIDS, the Ebola outbreak which killed more than 100
people in Africa last year, the flu epidemic that has now affected 200,000 in the former Soviet Union - they are all, according to Dr BenAbraham, the "tip of the iceberg". Two decades of intensive study and research in the field of virology have convinced him
of one thing: in place of natural and man-made disasters or nuclear warfare, humanity could face extinction because of a single
virus, deadlier than HIV."An airborne virus is a lively, complex and dangerous organism," he said. "It can come from a rare animal or from
anywhere and can mutate constantly. If there is no cure, it affects one person and then there is a chain reaction and it is unstoppable. It is a tragedy
waiting to happen."That may sound like a far-fetched plot for a Hollywood film, but Dr Ben -Abraham said history has already proven his theory.
Fifteen years ago, few could have predicted the impact of AIDS on the world. Ebola has had sporadic outbreaks over the past 20 years and the only
way the deadly virus - which turns internal organs into liquid - could be contained was because it was killed before it had a chance to spread.
Imagine, he says, if it was closer to home: an outbreak of that scale in London, New York or Hong Kong. It could happen anytime in the next 20
years - theoretically, it could happen tomorrow. The shock of the AIDS epidemic has prompted virus experts to admit "that something new
is indeed happening and that the threat of a deadly viral outbreak is imminent", said Joshua Lederberg of the Rockefeller University in New York,
at a recent conference. He added that the problem was "very serious and is getting worse". Dr Ben-Abraham said: "Nature isn't benign. The survival
of the human species is not a preordained evolutionary programme. Abundant sources of genetic variation exist for viruses to learn how to mutate
and evade the immune system."He cites the 1968 Hong Kong flu outbreak as an example of how viruses have outsmarted human
intelligence. And as new "mega-cities" are being developed in the Third World and rainforests are destroyed, disease-carrying animals and
insects are forced into areas of human habitation. "This raises the very real possibility that lethal, mysterious viruses would, for
the first time, infect humanity at a large scale and imperil the survival of the human race," he said.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Impacts - AIDS
Absent the plan the economy will collapse due to disease in three decades
Bell, Devarajan and Gersbach [Clive Bell, Shantayanan Devarajan and Hans Gersbach] May 2001 “The Longrun Economic Costs of AIDS: Theory and an Application to South Africa”
http://info.worldbank.org/etools/bspan/PresentationView.asp?PID=825&EID=414)
Most existing estimates of the macroeconomic costs of AIDS, as measured by the reduction in the growth rate of GDP, are modest.
For Africa – the continent where the epidemic has hit the hardest – they range between 0.3 and 1.5 per cent annually. The reason is that these
estimates are based on an underlying assumption that the main
effect of increased mortality is to relieve pressure on existing land and physical capital so that output per head is little affected. We argue that this
emphasis is misplaced and that, with a more plausible view of how the economy functions over the long run, the economic costs of AIDS
are almost certain to be much higher. Not only does AIDS destroy existing human capital, but by killing mostly young
adults, it also weakens the mechanism through which knowledge and abilities are transmitted from one generation to
the next; for the children of AIDS victims will be left without one or both parents to love, raise and educate them. To
analyze this problem, we use an overlapping generations (OLG) model, in which parents have preferences over current consumption and the
(expected) human capital attained by their children. Two family structures are analyzed: ‘nuclear’ and ‘pooling’, whereby under the latter all
children are cared for within an extended family. The decision about how much to invest in education is influenced by premature adult mortality in
two ways: first, the family’s lifetime income depends on the adults’ health status, and second, the expected pay-off depends on the level of
premature mortality among the children when they attain adulthood. Furthermore, if one or both parents die while their offspring are still children,
the transmission of knowledge across generations is weakened. The outbreak of AIDS leads to an increase in premature adult mortality, and if the
prevalence of the disease becomes sufficiently high, there may be a progressive collapse of human capital and productivity. The policy problem,
therefore, is to avoid such a collapse. The instruments available for this purpose are (i) spending on measures to contain the disease and treat the
infected, (ii) aiding orphans, in the form of either income-support or subsidies contingent on school attendance, and (iii) taxes to finance these
expenditures. When calibrated to South Africa, the model yields the following results. In the absence of AIDS, the counterfactual benchmark, there
is modest growth, with universal and complete education attained within three generations . If nothing is done to combat the epidemic,
however, a complete economic collapse will occur within three generations. With optimal spending on combating the disease,
and if there is pooling, growth is maintained, albeit at a somewhat slower rate than in the benchmark case in the ab- sence of AIDS. If pooling
breaks down, and is replaced by nuclear families, growth will be slower still. Indeed, if school-attendance subsidies are not possible, growth will be
distinctly sluggish. In all three cases, the additional fiscal burden of intervention will be large, which reinforces the gravity of the findings.
Sensitivity analysis suggests that these findings are robust to changes in a variety of key assumptions and parameter values concerning mortality,
the efficiency of measures taken to combat it, and the formation of expectations. A delay in responding to the outbreak of the epidemic, however,
can lead to a collapse.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Mental Health Fails in Prisons (1/4)
Mental health problems are seen more in prisoners.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
Prisoners are particularly vulnerable to developing mental health problems. Histories of abuse, deprivation,
homelessness, unemployment and substance misuse are common. Many prisoners have numeracy and literacy
problems and most prisoners have a lower than average IQ (Her Majesty’s Inspectorate of Prisons, 1997b, 2000a;
Singleton et al, 1998).
Prisoners are ignored when it comes to healthcare.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
The point-prevalence studies conducted by the Institute of Psychiatry (Gunn et al, 1991; Maden et al, 1995) reveal a
significant level of unmet mental health treatment needs among prisoners, especially those held on remand
(Tables 4 and 5 ). The results relating to male prisoners suggest that, at the time these surveys were conducted, the
prison population held in excess of 1000 men with psychosis and nearly 2000 male prisoners in need of
immediate transfer to psychiatric hospitals for treatment.
Lack of mental health services increases the stress levels of prisoner mothers.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
Prisoners may lead an institutional life behind bars, but this does not mean that what goes on in the outside
world ceases to have an effect on their well-being – far from it. Women prisoners, in particular, worry about their
family, especially their children. Up to two-thirds of women in prison are mothers and nearly half of all women
who are sent to prison have a dependent child living with them when they are imprisoned. Less than one-quarter
of women in this position have a current or ex-partner available to care for their children while they are in prison (Her
Majesty’s Inspectorate of Prisons, 1997a).
Strict security and movement among prisons leads to untreated stress in prisoners.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
Being remanded into custody while awaiting trial can be a very stressful time. Those who find themselves in this
position not only have to cope with prison life, but also have to deal with ongoing court proceedings and may
face considerable uncertainty about their future. Being able to stay in touch with friends and family while in
prison is important, whatever your circumstances. Because local prisons serve local courts and the older ones, in
particular, tend to be situated in or near town or city centres, visiting is not usually too difficult. On the other hand,
newer prisons tend to be located in more remote places which are less well-served by public transport; furthermore,
category A prisons, with their tight security arrangements, are less visitor-friendly. Distance may also be a
barrier to visits. Those serving longer sentences may start off at a local prison, but they are usually dispersed to a
training prison and may be moved within the prison system several more times before they are released.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Mental Health Fails in Prisons (2/4)
Prisoners with mental health problems are discriminated against rather than helped.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
The behaviour of inmates towards each other and the culture that this creates can have a profound effect on the
mental health of prisoners. Bullying is particularly prevalent in women’s prisons and young offender
institutions, and sex offenders, especially those who have offended against children (referred to as ‘nonces’ by other
prisoners), are at particular risk of being victimised and assaulted. For this reason, sex offenders and certain
other vulnerable prisoners are usually housed separately in vulnerable-prisoner wings or units. They tend to be
moved when other prisoners are locked up and they have separate regimes to keep them segregated from other
prisoners. Prisoners from ethnic minorities may experience racial abuse, and problems can arise if cultural or
religious needs are overlooked by prison staff. Prisoners with mental health problems are also prone to
discrimination. The prejudice and ridicule levelled by prisoners and even prison officers at inmates with mental
health disorders is illustrated by the use of pejorative terms such as ‘being nutted off’ or ‘sent to Fraggle Rock’ to
refer to their transfer to the prison health care centre. It is not surprising, therefore, that prisoners with mental health
problems who retain some insight are wary of talking about their difficulties. Previous personal experience of
sub-standard prison health care, fear of being placed in unfurnished accommodation or having treatment
forced on them and suspicion of health care staff, who are seen as part of the establishment, are additional
reasons why some prisoners with mental health problems choose not to disclose information
PHS isn’t doing enough to provide mental healthcare for prisoners causing doctors to leave.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
The Prison Health Service, with its workforce of around 300 doctors (a combination of prison medical officers and
part-time doctors, most of whom are also general practitioners) supported by prison health care officers and NHStrained nurses, still constitutes the backbone of health care in prisons. It is fair to say that NHS mental health services
do not tend to go out of their way to involve themselves with people in prisons. Some diversion services
incorporate remand liaison schemes, but regular psychiatric input into prisons is usually provided by visiting
forensic psychiatrists. Few prisons receive what could be regarded as a proper multi-disciplinary service.
Prison Service standard 22, which deals with the provision of health services for prisoners, promotes the notion of
equivalence of care (Box 1 ). In reality, however, the quality of health care provided for mentally disordered
offenders varies considerably between prisons. Reed found that few prisons he inspected provided health care
broadly equivalent to NHS care: in many, health care was of low quality, some doctors were not adequately
trained to do the work they faced, and some care failed to meet proper standards of ethics (Reed & Lyne, 1997).
A report published by the British Medical Association (2001) claims that, because the NHS is ignoring the health
needs of prisoners and working conditions in prisons are so poor, large numbers of doctors and nurses are
leaving the Prison Health Service.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Mental Health Fails in Prisons (3/4)
Prisoners with mental health issues are denied services and treatment.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
Larger prisons with health care beds and 24-hour observation provide in-patient health care facilities for clusters
of nearby prisons that lack these facilities. Because these health care centres tend to be located in category A and B
prisons, in-patient care is associated with conditions of higher security and hence a more restrictive prison regime.
Although still often referred to as hospitals by prison staff, in-patient prison health care centres are quite unlike any
hospital in the NHS. They are designed and staffed to function as cottage hospitals and they are not recognised as
hospitals for the purposes of the Mental Health Act. This means that prisoners who require hospital treatment for
mental disorder need to be transferred to a suitably secure psychiatric hospital. However, pressure on secure
psychiatric hospital beds means that, compared with the level of need, relatively few hospital transfers take
place each year (Hotopf et al, 2000). As a result, prison health care centres across the country are overflowing
with people with mental illness who are in need of urgent treatment in a psychiatric hospital.
It is also fair to say that the problem goes beyond a lack of available beds. Mentally disordered offenders are not
popular as patients and they often fail to meet the criteria required for acceptance by community mental health
teams. Mentally disordered offenders with dual diagnosis, which constitute the majority, are particularly
vulnerable in this respect. They are often rejected by community or in-patient mental health teams because they have
a comorbid substance misuse problem, and are turned away by substance misuse services because of their
mental illness. Furthermore, low staffing levels and procedures for opening cells out of hours mean that it can
take over 10 minutes to gain access to a prisoner in the health care centre at night. For prisoners with mental
illnesses who are experiencing suicidal thoughts, this situation is quite unacceptable.
Prison mental healthcare is ineffective.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
Because prison reception health screening is ineffective and health care for prisoners tends to be based in the health
care centre, prisoners with mental disorder who are placed on ordinary prison location are liable to remain
undetected. Indeed, research suggests that there are plenty of mentally disordered offenders on prison wings
who are not identified as such and whose treatment needs therefore remain unmet (Birmingham et al, 1998;
Birmingham, 1999).
Mental Healthcare inadequacies in prisons exist now
Earthrowl, 2003 (M., British journal of psychiatry. Providing treatment to prisoners with meantal disorfers: development
of a policy Selective literature review and expert consultation exercise. Volume 182 Issue 4. Page 299.)
The standard of health care provided in prison has been a source of concern for many years (Smith, 1984).
Careful consideration must be given to the impact of implementing any policy that extends treatment provision within
a prison setting where health care inadequacies exist. There are undoubtedly inadequacies in mental health care
provision in prisons. A study of the in-patient care of people with mental illness in prison based on the inspection of
13 prisons with in-patient beds in England and Wales revealed that no doctor in charge of in-patients had completed
specialist psychiatric training, suitably trained nursing staff were in short supply, patients' lives were unacceptably
restricted and the availability of therapy was limited (Reed & Lyne, 2000). It is also recognised that there are
unacceptable delays in arranging the transfer of prisoners with mental illness to the NHS, and in some cases the
NHS does not give such patients the same priority as they would have if they were admitted from the
community (Department of Health & Prison Service, 2001).
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Mental Health Fails in Prisons (4/4)
Psychiatric morbidity is present in prisoners due to lack of adequate healthcare services.
Earthrowl, 2003 (M., British journal of psychiatry. Providing treatment to prisoners with meantal disorfers: development
of a policy Selective literature review and expert consultation exercise. Volume 182 Issue 4. Page 299.)
Psychiatric morbidity is prevalent among prisoners (Office for National Statistics, 1998). Because conditions in
prison are not conducive to good mental health, prisoners with mental illness are at risk of experiencing a
deterioration in their mental state. Evidence also suggests that outcomes for people with schizophrenia are worse
when they are not subject to ongoing treatment (Wyatt, 1991).
In reality many prisoners with mental disorders wait for long periods for a suitable bed, or are not accepted by
services (Reed & Lyne, 1997, 2000). For those who remain in prison the situation is exacerbated by the fact that the Care
Programme Approach is not widely implemented in prisons, and standards of health care are inferior to those
provided outside prison (Smith, 1999). This means that until adequate resources are provided by the NHS, enabling
those with serious mental illness to be quickly transferred to hospital, prison doctors and visiting psychiatrists
will continue to be confronted by considerable ethical and legal dilemmas posed by prisoners with serious
mental illness, on a frequent and regular basis.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Mental Health Impacts
Higher rate of morbidity in prisons due to the lack of mental health care provided.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
Mental health problems are the most significant cause of morbidity in prisons. Over 90% of prisoners have a
mental disorder. The prison environment and the rules and regimes governing daily life inside prison can be
seriously detrimental to mental health. Prisoners have received very poor health care.There are positive
developments but concerted and determined action is required to bring prison health care up to acceptable
standards.
Suicide rates in prisons increased due to the lack of mental health care services.
Birmingham, 2003 (Luke, The mental health of prisoners, Advances in Psychiatric Treatment,
http://apt.rcpsych.org/cgi/content/abstract/9/3/191 )
The suicide rate in prison more than doubled between 1982 and 1998, from 54 to 128 per 100 000 of the average
annual prison population. Self-inflicted deaths currently represent about half of all deaths in prison and local
prisons bear the brunt of prison suicides. The majority of self-inflicted deaths occur by hanging, and more than half
occur during the first 3 months of imprisonment. Remand prisoners, young offenders, and those with a history
of substance misuse and violent offences are at particular risk (Her Majesty’s Inspectorate of Prisons, 1997b,
1999a). A very high proportion of those interviewed during the 1997 national prison survey (Singleton et al, 1998)
said that at some point they had considered committing suicide. For example, 46% of male remand prisoners had
thought of suicide in their lifetime, 35% had had such thoughts in the past year and 12% had experienced suicidal
thoughts in the week prior to interview. The rates for female remand prisoners were even higher. Suicide attempts
were also common and, compared with their sentenced counterparts, prisoners on remand were more likely to
report having made attempts on their life: 27% of male and 44% of female remand prisoners said that they had tried
to commit suicide during their lifetime; 15% and 27%, respectively, said that they had attempted suicide in the past
year.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Prison Rape
Social services now fail to address the psychological effects of prison rape.
PCAR, 2k6 (Pennsylvania Coalition Against Rape, 2006, “Meeting the Needs of Prison Rape Victims”)
Prison rape has gone largely unaddressed by social service programs; correctional institutions; and until recently,
lawmakers in this country. When prison rape is mentioned in the media or general public, it is often in the form
of a joke or jest. Nothing about rape is funny, regardless of where or to whom it occurs. Victims of prison rape are at
high risk of becoming victims again, largely because they may be too fearful to reach out for help or when they do,
they find services specific to their needs are unavailable. They often fear experiencing further trauma and shame
if they come forward. If they do choose to tell someone, their cries are sometimes ignored or disregarded. When
victims of prison rape are released-as the majority of inmates are- and rejoin our communities, they often suffer a
complex interplay of biopsychosocial effects from their victimization.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Prison Rape – Impacts (1/2)
Prison rape contributes to the spread of HIV/AIDS.
Michell, 2k2
(Steve Mitchell, UPI Medical Correspondent, July 26, 2002, Prison rapes spreading deadly diseases, United Press
International )
Prison rape has become such a common occurrence in federal and state prisons across the United States that it
could have deadly consequences for the inmate population as well as the public at large, experts in the field told
United Press International.
Congress plans to take a closer look at the issue next week because prison rape has been associated with the spread of
potentially fatal diseases such as AIDS and tuberculosis.
"The AIDS incidence within prisons is alarmingly high," Pat Nolan, president of the non-profit group the Justice
Fellowship of Reston, Va., which works to reform the criminal justice system, told United Press International. He
noted 95 percent of people in prison will eventually be released back into society, so if they contract AIDS or
other diseases while incarcerated they will be a tremendous burden to society due to healthcare costs and the
threat they pose for spreading disease.
Lara Stemple, executive director of the non-profit human rights group Stop Prisoner Rape, told UPI, "Rape and HIV
in prison is eight to 10 times as high as in the general population." Her group views AIDS as an unadjudicated
death sentence because people who receive only a short sentence for their crime but contract AIDS while in prison
have essentially had their sentence extended to death.
She said the people most likely to be raped in prisons are nonviolent and first-time offenders and these are the
most likely to be released back into the general population, which ultimately poses a disease risk to society. In
addition to AIDS, herpes and other sexually transmitted diseases have been spread in prisons and hepatitis C is an
epidemic in certain prisons, Stemple said. Men as well as women run the risk of being raped while in prison, she said.
One in five men have been sexually assaulted while in prison and one in ten have been raped.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Prison Rape – Impacts (2/2)
Prison rapes are brutal to the point of violating human rights.
Gordan, 2k1
(Neve Gordon, Head of the Department of Politics and Government at Ben-Gurion University of the Negev
September 14, 2001, “Rape used as control in U.S. prisons”, National Catholic Reporter)
Many prisoners are targeted for sexual exploitation the minute they enter a penal facility; their age, looks,
sexual preference and other characteristics mark them as candidates for maltreatment. In a new groundbreaking
report, Human Rights Watch documents the widespread prisoner-on-prisoner rape in U.S. men’s prisons. The rights
group accuses state authorities of not taking measures to prevent and punish rape and, in many cases, for allowing this
cruel form of abuse to persist.
One reads that in extreme incidents prisoners find themselves the “slaves” of their rapists. Forced to satisfy
another man’s sexual appetites upon demand, they may also be responsible for washing his clothes, massaging
his back, cooking his food and cleaning his cell. They are frequently “rented out” for sex services, sold or even
auctioned off to other inmates.
One prisoner from Arkansas wrote to Human Rights Watch: “I had no choice but to submit to being Inmate B’s prison
wife. Out of fear for my life, I submitted to [him]. In all reality, I was his slave, as the Officials of the Arkansas
Department of Corrections … did absolutely nothing.”
“Rapes are unimaginably vicious and brutal,” writes Joanne Mariner, deputy director of the Americas division of
Human Rights Watch, and author of “No Escape: Male Rape in U.S. Prisons.” Gang assaults are not uncommon,
and victims may be left beaten, bloody and even dead; they almost always suffer from extreme psychological
stress, including nightmares, deep depression, shame and self-hatred, which may lead to suicide. There are also known
cases whereby the victim has contracted HIV.
No conclusive national data exists regarding the prevalence of this phenomenon, but the most recent statistical survey,
published in the Prison Journal, revealed that 21 percent of inmates in seven Midwestern prisons had experienced
at least one episode of pressured or forced sex since being incarcerated, and at least 7 percent had been raped
in their facility.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Prison Rape – Moral Obligation
The federal government has an ethical obligation to protect prisoners from rape and it is failing
now.
Williams and Stannow, 2k9
(Max Williams and Lovisa Stannow, Rape is Not Part of the Penalty, The Oregonian, June 21, 2009)
When the government removes someone’ s liberty, it takes on an absolute responsibility to keep that person
safe, including from sexual abuse. This is a difficult task and, unfortunately, in prisons nationwide the failure of
government agencies to uphold that responsibility is all too common.
Oregon is no exception. Sexual violence does occur in our prisons. What sets Oregon apart, however, is the
Department of Corrections’ effort over the last five years to end this type of abuse. The most recent initiative was
launched through a unique collaboration between Oregon corrections officials and national human rights advocates.
On Tuesday, the National Prison Rape Elimination Commission is due to release the first–ever binding national
standards aimed at preventing and addressing sexual abuse in U.S. prisons and jails. Mandated by the Prison Rape
Elimination Act of 2003, and developed with input from corrections officials, prisoner rape survivors, and advocates,
these standards have the potential to become the most important tool so far in the effort to end sexual abuse in
detention.
The national standards spell out requirements for prison housing decisions, staff training, inmate education,
and sexual assault investigations. The U.S. attorney general has one year to issue a rule codifying them.
Governors will then have another year to confirm that their states are in compliance with the standards. Those
who fail to do so risk losing 5 percent of their corrections-related federal funding. That is not, however, why the
Oregon DOC has made the bold decision to seek compliance with the standards even before it is required to do so.
The reason for that decision is simple: Sexual abuse in detention is wrong. It is an affront to our society's basic values.
It causes terrible harm to survivors and creates unsafe prisons for staff and inmates alike.
46
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Probability Calculus (1/2)
Probability should be evaluated before magnitude
Nicholas Rescher, University of Pittsburgh Professor of Philosophy, “Risk: A Philosophical
Introduction to the Theory of Risk Evaluation and Management” 1983
A probability is a number between zero and one. Now numbers between zero and one can get to be very small indeed: As N gets bigger, 1/N will
grow very, very small. What, then, is one to do about extremely small probabilities in the rational management of risks ? On this issue
there is a systemic disagreement between probabilists working in mathematics or natural science and decision theorists who work on issues relating
to human affairs. The former take the line that small numbers are small numbers and must be taken into account as such. The latter tend to take the
view that small probabilities represent extremely remote prospects and can be written off. (De minimis non curat lex, as
the old precept has it: there is no need to bother with trifles.) When something is about as probable as it is that a thousand fair dice
when tossed a thousand times will all come up sixes, then, so it is held, we can pretty well forget about it as worthy of concern.
The "worst possible case fixation" is one of the most damaging modes of unrealism in deliberations about risk in real-life
situations. Preoccupation about what might happen "if worst comes to worst" is counterproductive whenever we proceed without recognizing that,
often as not, these worst possible outcomes are wildly improbable (and sometimes do not deserve to be viewed as real
possibilities at all). The crux in risk deliberations is not the issue of loss "if worst comes to worst" but the potential acceptability of this
prospect within the wider framework of the risk situation, where we may well be prepared "to take our chances," considering the possible
advantages that beckon along this route. The worst threat is certainly something to be borne in mind and taken into account, but it is emphatically
not a satisfactory index of the overall seriousness or gravity of a situation of hazard .
Any action could potentially have devastating impacts, but we don’t evaluate them because of the
low probability
Jessica Stern, Fellow at the Council on Foreign Relations and former National Security Council
Member “The Ultimate Terrorists” 1999 http://www.hup.harvard.edu/features/steult/excerpt.html
Poisons have always been seen as unacceptably cruel. Livy called poisonings of enemies "secret crimes." Cicero referred to poisoning as "an
atrocity." But why do poisons evoke such dread? This question has long puzzled political scientists and historians. One answer is that people's
perceptions of risk often do not match reality: that what we dread most is often not what actually
threatens us most. When you got up this morning, you were exposed to serious risks at nearly every stage of your progression from bed to
the office. Even lying in bed exposed you to serious hazards: 1 in 400 Americans is injured each year
while doing nothing but lying in bed or sitting in a chair--because the headboard collapses, the frame gives way, or
another such failure occurs. Your risk of suffering a lethal accident in your bathtub or shower was one in a million. Your breakfast increased your
risk of cancer, heart attack, obesity, or malnutrition, depending on what you ate. Although both margarine and butter appear to contribute to heart
disease, a new theory suggests that low-fat diets make you fat. If you breakfasted on grains (even organic ones), you exposed yourself to dangerous
toxins: plants produce their own natural pesticides to fight off fungi and herbivores, and many of these are more harmful than synthetic pesticide
residues. Your cereal with milk may have been contaminated by mold toxins, including the deadly aflatoxin found in peanuts, corn, and milk. And
your eggs may have contained benzene, another known carcinogen. Your
cup of coffee included twenty-six compounds
known to be mutagenic: if coffee were synthesized in the laboratory, the FDA would probably ban it as a
cancer-causing substance. Most people are more worried about the risks of nuclear power plants than the risks of driving to work, and more
alarmed by the prospect of terrorists with chemical weapons than by swimming in a pool. Experts tend to focus on probabilities
and outcomes, but public perception of risk seems to depend on other variables: there is little correlation between
objective risk and public dread. Examining possible reasons for this discrepancy will help us understand why the thought of
terrorists with access to nuclear, chemical, and biological weapons fills us with dread. People tend to exaggerate the likelihood of
events that are easy to imagine or recall. Disasters and catastrophes stay disproportionately rooted in
the public consciousness, and evoke disproportionate fear. A picture of a mushroom cloud probably
stays long in viewers' consciousness as an image of fear.
47
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Probability Calculus (2/2)
Turn: catering to minute risks based on higher magnitude creates policy paralysis, making their
impacts inevitable
Nicholas Rescher, University of Pittsburgh Professor of Philosophy, “Risk: A Philosophical
Introduction to the Theory of Risk Evaluation and Management” 1983
The stakes are high, the potential benefits enormous. (And so are the costs - for instance cancer research and, in
particular, the multi-million dollar gamble on interferon.) But there is no turning back the clock. The processes at
issue are irreversible. Only through the shrewd deployment of science and technology can we resolve the problems
that science and technology themselves have brought upon us. America seems to have backed off from its traditional
entrepreneurial spirit and become a risk-aversive, slow investing economy whose (real-resource) support for
technological and scientific innovation has been declining for some time. In our yearning for the risk-free society
we may well create a social system that makes risk-taking innovation next to impossible. The critical thing is to
have a policy that strikes a proper balance between malfunctions and missed opportunities - a balance whose
"propriety" must be geared to a realistic appraisal of the hazards and opportunities at issue. Man is a creature
condemned to live in a twilight zone of risk and opportunity. And so we are led back to Aaron Wildavski's thesis that
flight from risk is the greatest risk of all, "because a total avoidance of risks means that society will become
paralyzed, depleting its resources in preventive action, and denying future generations opportunities and
technologies needed for improving the quality of life. By all means let us calculate our risks with painstaking care, and
by all means let us manage them with prudent conservatism. But in life as in warfare there is truth in H. H. Frost's
maxim that "every mistake in war is excusable except inactivity and refusal to take risks" (though, obviously, it is
needful to discriminate between a good risk and a bad one). The price of absolute security is absolute stultification.
48
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Racial Disparity in SQ Ext.
Massive racial disparity in the Justice system- empirical studies
John M. Hagedorn, editor of racialdisparity.org, 2009
It is important to understand the meaning of the term “racial disparity.” Racial disparity in the criminal justice system
exists whenever the proportion of a racial/ethnic group within the control of the system is greater than the proportion
of that group within the general population. For example, in 1999 African Americans represented 3.5% of
Minnesota’s population, but 35% of the adult male prison population. This is clear evidence of a racial disparity in
Minnesota’s prison population. However, it is not evidence in and of itself, that the disparity is the result of racial bias. The racial disparity in the justice
system can stem from a number of different causes including socioeconomic factors, difference in crime rates, cultural
norms, and racial bias. While a portion of the Council’s research was devoted to examining crime rates, it was
primarily focused on identifying what portion of the disparity, if any, could be attributed to racial bias within the
justice system. Racial bias can occur at either the individual or institutional level and can be intentional or unintentional.
The Council’s focus was on institutional bias which most often takes the form of a policy or practice that has greater
negative consequences for persons of color than for Whites.
49
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
2ac Dehumanization Add-on
Dehumanization occurs in prisons from bad healthcare
Jacobi 05
(John V Jacobi [professor of law at Seton Hall University] 2005 “Prison Health, Public Health: Obligations and Opportunities
American Journal of Law and Medicine”.Vol. 31, Iss. 4; pg. 447, 32 pgs
http://proquest.umi.com/pqdweb?did=969303231&sid=1&Fmt=4&clientId=15023&RQT=309&VName=PQD)
Prison conditions in America have been dismal since the founding of the Republic. Oppressive, brutal conditions
predominated with reformist zeal for improving the conditions leading to brief periods of improvement.39 Overcrowded,
brutal prisons are of course unhealthy, and prison reformers of course attempted to ameliorate those conditions.40 With the
rise in the 20th Century of curative medicine, access to or denial of decent health services became a significant issue in prison
reform. It is clear that prison health care was shockingly bad during much of the 20th Century, as vital, life-saving care was
delay, denied, or provided by untrained fellow prisoners.41 The quality of health care services in modern prisons varies from
prison to prison, and state to state. Reform efforts, including prisoners’ rights litigation, have increased funding and
oversight in some prison systems. For example, the Re-Entry Council’s recent report, drawing on a variety of federal and
state sources state and federal corrections sources, recently asserted that the “quality and availability of medical services for
the prisoner population has been enhanced by multiple federal judicial decisions and by initiatives of a host of professional
organizations.” 42 It is possible, however, to exaggerate the improvements. Too often prison care is abysmal and
dehumanizing. This is true even in the state highlighted as an example of improvement in the Re-Entry Council’s
Report: California.43 Shortly after the Re-Entry Council issued its report, a federal judge blasted California’s prison health
care, issuing an Order to Show Cause why management of health services in the California
Department of Corrections should not be taken away from the State and assigned to a court-appointed receiver.44 The text of
the order relates a hair-raising account of a “totally broken system”45 The court found that, [e]ven the most simple and
basic elements of a minimally adequate medical system were lacking.”46 In one of the California prisons toured by
the Judge, “the main medical examining room lacked any means of sanitation – there was no sink and no alcohol gel –
where roughly one hundred per day undergo medical screening, and the Court observed that the dentist neither
washed his hands nor changed his gloves after treating patients into whose mouths he had placed his hands.47 Expert
reports on this prison noted referral slips for health care unattended for over one month,48 and dirty, dangerous, and
antiquated facilities, unchanged by prior court orders due to the indifference of corrections officials.49 Remarkably, the
Department of Corrections apparently did not either disagree with the facts or object to the proposal to divest it of its
authority to manage prison health, and officials acknowledged that they were “unable to correct the problems on their own,
and that unconstitutional conditions will remain until an outside agency is hired to take over.”50
<INSERT DEHUMANIZATION IMPACT>
50
Prison Aff
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Moral Obligation Ext. (1/3)
Moral Obligation to provide healthcare to prisoners
Jacobi 05
(John V Jacobi [professor of law at Seton Hall University] 2005 “Prison Health, Public Health: Obligations and Opportunities
American Journal of Law and Medicine”.Vol. 31, Iss. 4; pg. 447, 32 pgs
http://proquest.umi.com/pqdweb?did=969303231&sid=1&Fmt=4&clientId=15023&RQT=309&VName=PQD)
Individual rights and humanitarian arguments, then, have failed to achieve remedies for substandard health care at
least in part for failure to engage the self-interest of broader society. This Part will set out a vision of prison reform that
seeks to unite the interests of prisoners with those of broader society. It links the personal health needs of prisoners with the
broader social goals of population health. It first describes the discipline of public health, which is devoted to the goal of
improving overall population health. It then describes a growing movement seeking the successful reentry of released
prisoners into their communities. It then relates the goals and methods of the reentry movement to the goals of public health,
and argues that the logic of sound reentry programs demands improvement in the personal health services provided to
prisoners. There is common ground between prisoners and the broader population. A marriage of convenience is
necessary and possible between the humanitarian or individual rights obligation to provide decent health care
for prisoners’ sake, and the public health opportunity to improve prison health care for the sake of the society to
which most prisoners one day return.
Humanitarian and Constitutional right to provide healthcare to prisoners
Jacobi 05
(John V Jacobi [professor of law at Seton Hall University] 2005 “Prison Health, Public Health: Obligations and Opportunities
American Journal of Law and Medicine”.Vol. 31, Iss. 4; pg. 447, 32 pgs
http://proquest.umi.com/pqdweb?did=969303231&sid=1&Fmt=4&clientId=15023&RQT=309&VName=PQD)
The motivation for writing this article should be clear: it is immoral, an injustice, to imprison two million Americans
and fail to provide them with minimally adequate health care services. And yet that is the state of the affairs for very
many prisoners, and for very many prisons and jails. Poor treatment, including poor health treatment has been the norm
rather than the exception during the history of American prisons.248 People objecting to the mistreatment of prisoners have
tried two categories of arguments to achieve reforms. First, they tried humanitarian arguments, combining appeals too fellowfeeling for prisoners with pragmatic arguments that the cost of reform was justified by the return that would be achieved by
restoring the offender to full and productive citizenship. These were political arguments, addressed to legislatures and
executive agencies. These arguments largely failed to achieve any lasting improvements in prison conditions.249 Second,
they tried arguments based on the individual constitutional rights of prisoners, appealing to judgments that the Bill of
Rights guarantees prisoners a certain, basic modicum of dignity and health treatment. These were legal arguments,
addressed to courts. These arguments continue to be made, and continue on occasion to succeed, particularly in extremely
egregious cases.250 This avenue of prison reform is, however, hampered by restrictions imposed by courts and
legislatures.251 This article is motivated by a desire to fashion a third vision of prison reform, one that might succeed where
the first two failed.
51
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Moral Obligation Ext. (2/3)
Moral obligation to provide healthcare to prisoners
Jacobi 05
(John V Jacobi [professor of law at Seton Hall University] 2005 “Prison Health, Public Health: Obligations and Opportunities
American Journal of Law and Medicine”.Vol. 31, Iss. 4; pg. 447, 32 pgs
http://proquest.umi.com/pqdweb?did=969303231&sid=1&Fmt=4&clientId=15023&RQT=309&VName=PQD)
Government acquires obligations when it locks up prisoners, even when it does so for good reason. And government
acquires significant obligations when it decides to imprison over two million Americans. One of those obligations is that of
providing decent treatment, including necessary medical care. That obligation has been based since the beginning of
the Republic on humanitarian impulses and pragmatic goals of social enhancement. It has been based in the last fifty
years on the constitutional rights of prisoners to imprisonment free from cruel and unusual treatment. It is an obligation that
government has largely ignored, notwithstanding constant arguments by prison reformers. Decent prison health treatment
should be advanced pursuant to a third vision of prison reform, one based on a confluence of selfless and selfish
interests. The selfless interest continues to be the normative commitment to humane treatment for prisoners. The selfish
motive is based on the potentially devastating population health effects flowing from poor prison care. Almost all of the two
million American incarcerated today will be released to their communities. Prisons’ and jails’ failure to provide adequate
treatment to a wide variety of chronic conditions, mental illnesses, sexually transmitted diseases, and communicable
diseases threaten those communities with physical and financial harm, with infection and illness. Public health
arguments, drawn in part from the emerging reentry movement, have the potential to move society to pay the costs for decent
prison health care out of clear self-interest, where it has been unwilling to do so as a matter of justice and morality.
Government’s responsibility to provide health care to prisoners
Beyrer and Pizer 07
(Chris Beyrer; MD and MPH Professor
Director, Johns Hopkins Fogarty AIDS International Training and Research Program; Director, Johns Hopkins Center for
Public Health & Human Rights; Senior Scientific Liaison, HIV Vaccine Trials Network; Associate Director, Center for
Global Health Hank Pizer; Health Care Strategies, Inc., Cambridge, MA, USA 2007, “Public health and Human Rights,”
http://books.google.com/books?id=nGBf6Big_W8C&pg=PA105&dq=%22Reducing+harm+in+prisons)
The health and safety of prisoners is the responsibility of the correctional systems and authorities that hold them in
custody. Worldwide prison conditions play an important role in transmitting infectious diseases such as HIM drugresistant tuberculosis, and hepatitis. Prisoners also are victims of violence and sexual assault that have harmful, often
disastrous, health consequences. It is both a health threat and an abuse of their human rights that, as a matter of law and
policy, incarcerated individuals are routinely denied proven disease-prevention and harm-reduction strategies and are
subject to inmate-on-inmate and guard-on-inmate violence. The consequence of this negligence is that prisons in many
settings, including in the United States, too often serve as incubators for the transmission of disease inside the facilities and
into the general public when Inmates are released. Although still controversial in many countries, an ever Increasing number
of correctional systems in diverse nations worldwide offer condoms and sale injection equipment to prevent or limit the
spread of infectious diseases. These approaches, generally grouped as harm reduction or harm minimization, have the
potential to meet both public health tests for efficacy and human rights goals of providing minimum standards of access to
health care. Nevertheless, they have been fraught with political and operational challenges. And while prevention services
have often been limited, access to basic health care has also been problematic. Most notably in jails and other shorterterm detention settings.
52
Prison Aff
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Moral Obligation Ext. (3/3)
Obligation to prisoners to provide all the mechanism of the aff
Beyrer and Pizer 07
(Chris Beyrer; MD and MPH Professor
Director, Johns Hopkins Fogarty AIDS International Training and Research Program; Director, Johns Hopkins Center for Public Health & Human Rights;
Senior Scientific Liaison, HIV Vaccine Trials Network; Associate Director, Center for Global Health Hank Pizer; Health Care Strategies, Inc., Cambridge,
MA, USA 2007, “Public health and Human Rights,”
http://books.google.com/books?id=nGBf6Big_W8C&pg=PA105&dq=%22Reducing+harm+in+prisons)
Many international human rights Instruments apply to prisoners. Some address specifically the right to health care, while others do so
less directly. Some agreements are binding on the states that ratify them, while others elaborate general principles that. although not obligatory, should be
accepted as the standard for government behavior (Lines et a!., 2004: Cornell Law School). Article S of the 1948 Universal Declaration of Human Rights
WIN [R). which some argue has reached the status of customary international law, states. "No one shall be subjected to torture or cruel, inhuman or
degrading treatment or punishment." Having signed on to the 1948 (Jl)hIR, states are required to protect persons in custody from rape and
other forms of violence and to take reasonable measures to maintain the highest attainable standard of physical and mental health. including the
provision of and equal access to preventive, curative, and palliative health services (International Covenant on Economic, Social and Cultural
Rights. 1976; Mariner, 2001: Lines et al,. 2004). Although the special circumstances of confinement do not always permit the same delivery of care as is
available on the outside, it is government's responsibility to make a concerted effort to provide free health services similar to
what is available to the general public lReyes. 2001a; WHO Europe. 2005). Reliance on a community standard does not condone the delivery of
inferior health services to prisoners even if health care in the community is poor (Penal Reform International. 2001). In specific. correctional authorities
have a duty to provide safe and healthy living quarters: protection from violence and coercion: adequate health
care services and medicines, as far as possible. free of charge: commencing and continuing medical treatments begun on the
outside, including those for drug users; information and education about preventive health measures and healthy lifestyles;
medical screening, including the detection. prevention, and treatment of s t
di s, including HIV/ADS.
exually
ransmitted
sease
There also should be specific protection for vulnerable prisoners, such as individuals who are HIS! positive, and adequate counseling should be made
available before and after 11W testing. And protective measures should be taken to prevent inmates from acquiring communicable diseases. such as
tuberculosis (TB), that are readily spread in confined settings (WHO Europe. 2001).
Legal and ethical obligation to provide prisoners with health care, risk prevention, and education
Beyrer and Pizer 07
(Chris Beyrer; MD and MPH Professor
Director, Johns Hopkins Fogarty AIDS International Training and Research Program; Director, Johns Hopkins Center for
Public Health & Human Rights; Senior Scientific Liaison, HIV Vaccine Trials Network; Associate Director, Center for
Global Health Hank Pizer; Health Care Strategies, Inc., Cambridge, MA, USA 2007, “Public health and Human Rights,”
http://books.google.com/books?id=nGBf6Big_W8C&pg=PA105&dq=%22Reducing+harm+in+prisons)
Because incarcerated Individuals are nearly completely dependent on the powers that confine them, those authorities
are legally and ethically responsible for their health and safely. Failure to meet that responsibility allows
millions to be exposed to disease. Injury. and premature death. Prisoners engage in sex and all too often are subject to
rape. They use drugs and are forced by others to use drugs. Most correctional systems do not have sufficient resources to
make prisons safe. That would include having and properly training enough staff members to monitor all inmates around the
clock. Facilities would have to be renovated to remove blind spaces and prisoners would be housed in single-occupant cells.
Everyone who enters and all prisoners would be consistently and thoroughly searched for contraband. There would have to
be sufficient resources to provide preventive and comprehensive health services including vaccination for diseases like
UB\ mental health. and drug treatment programs. Given that high-risk sex and intravenous drug use continue in prisons
and that complete elimination of these behaviors in the near future seems unrealistic, a prudent public health approach would
be to afford prisoners the opportunity to protect themselves through proven harm reduction measures like safe
injection equipment and condoms. Education on disease risk and preventive measures beyond abstinence would also
be farsighted (Council of Europe. 1993 p, Such measures could put into practice a practical self-help approach and thereby
offer inmates the opportunity-indeed the human right-not to contract disease. Even if not offered to the outside community.
self-help programs in prisons seem to be a prudent strategy in prisons where resources are limited.
53
Prison Aff
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Prisoners need basic human rights (1/2)
Prisoners do not surrender their basic human rights, despite public mentalities to the contrary
Restum 05
(Zulficar Gregory Restum Professor at the Saint Joseph’s College of Maine April 26, 2005
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1449420)
There is a general misconception that when a person commits a crime and goes to prison, he or she surrenders all
rights. In fact, while being held in custody, judged, and sentenced, the individual maintains certain rights—to be protected, to be
represented by legal counsel, and to have access to health care services.
The general public, including correctional staff and health care professionals, tend to view prisoners as subhuman, as
those who have surrendered their rights by being convicted of crimes. This mentality, fueled by political rhetoric, leads to the erection of
barriers that affect the delivery of health care to prisoners.9
Doctors, who take the Hippocratic Oath upon graduating from medical school, vow to use all measures required for the benefit of the sick. Those who take
the classical version of the oath repeat, “Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice.”10
The negative view of prisoners adopted by the public and by health care professionals ignores the spiritual laws of
compassion, forgiveness, reconciliation, and responsibility. The price of this attitude has been an endless recycling of
crime and violence, all stemming from hatred. Teens, especially, are affected by this attitude. The effects can be felt across the board—teen
murders have doubled and murders of children by children have increased. At the same time, the general population’s attitudes are also being skewed:
people of all ages have grown comfortable celebrating the executions of criminals.11
Incarceration doesn’t change the prisoners right to healthcare
Shakespeare 08(Clare Shakespeare fifth year medical student at the University of Oxford in the Student British Medical Journal, externally peer
reviewed 2008 http://archive.student.bmj.com/issues/08/10/life/345.php)
Losing your freedom shouldn’t mean losing your health.
Complete loss of freedom is the punishment intended when an offender is given a custodial sentence, but should
inadequate health care also be part of the sentence? Absolutely not. According to the United Nations, prisoners should have
access to equivalent health services available in the rest of a country without discrimination based on their legal
situation.1 If properly used, the prison system can provide a unique public health opportunity to target the most deprived sections of society, a group
often invisible to the wider healthcare system. Evidence shows that improving the health of prisoners by tackling problems such as mental health and drug
use can reduce reoffending and should therefore be of interest to those aiming to reduce crime and improve public health. A prison sentence should
signify a loss of freedom, not a loss of health. In the prisons that I visited, health care is striving to meet the glut of opportunities presented.
The staff I met were proud of the considerable progress that has been made in recent years, especially with the quality and availability of primary care and
the introduction of drugs services, yet prison health care still poses a fascinating challenge to doctors on both a personal and a national public health level.
As a personal challenge doctors face working with a diverse, interesting, and needy patient group that necessitates the development of exceptional personal
skills, and on a public health scale prisons present a unique opportunity to address the distinctive health needs of a
disadvantaged and hard to reach population.
Prisoners still have a right to healthcare that is currently being violated
PRI 09(PRI Penal Reform International a non-profit association dedicated to reform of correctional facilities 2009
http://www.penalreform.org/health-in-prisons.html)
Being sent to prison is the punishment; conditions of imprisonment should not constitute an additional punishment.
Any form of torture or cruel, inhuman or degrading treatment or punishment is illegal under international law, and usually under
domestic law, at all times and under all circumstances.1 Yet such ill-treatment regularly occurs in all regions of the
world.2People with mental health problems who have not committed a crime, or who have committed a minor offence, are often
imprisoned rather than given appropriate medical care. Prison conditions, including overcrowding, lack of privacy, enforced isolation
and violence may increase or cause mental health problems, including self-harm and suicide.The same prison conditions, particularly in relation to
overcrowding, are also injurious to physical health, particularly in the spread of infectious diseases including
tuberculosis, HIV/Aids and hepatitis, as well as skin infections and diseases, respiratory and intestinal disorders.
54
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Hepatitis add-on
Reducing sexual behavior in prisons key to stopping hepatitis
Beyrer and Pizer 07
(Chris Beyrer; MD and MPH Professor
Director, Johns Hopkins Fogarty AIDS International Training and Research Program; Director, Johns Hopkins Center for
Public Health & Human Rights; Senior Scientific Liaison, HIV Vaccine Trials Network; Associate Director, Center for
Global Health Hank Pizer; Health Care Strategies, Inc., Cambridge, MA, USA 2007, “Public health and Human Rights,”
http://books.google.com/books?id=nGBf6Big_W8C&pg=PA105&dq=%22Reducing+harm+in+prisons)
Reducing the frequency of high-risk sexual behavior in prison is the best strategy for limiting the risk of transmitting
all three hepatitis strains. 1-1W. and other STIs CDC, 2002b; Weinbaum et al., 2003). Unfortunately, most correctional
facilities treat condoms as contraband. Prisoners are not under constant surveillance by the correctional staff, which
affords opportunities to engage in prohibited behavior. Rape is all too common in men's prisons, as is unsafe
consensual sex. The reported prevalence of consensual sex among inmates varies but apparently is substantial (Koscheski et
al., 2002). One study of 150 male inmates in Ohio found that although 77 percent identified themselves as heterosexual.
nearly 20 percent reported homosexual activity with another inmate during the prior year; 8.5 percent engaged in sex at least
once a week and 7.4 percent admitted to a continuing relationship (Tewksbury0 1989: Koscheski et al., 2002 I. In a study of
Inmates in Oklahoma, 80 percent identified themselves as heterosexual, 1 3 percent as bisexual, and 8 percent as
homosexual: 24 percent said they had permitted another man to touch their penis or had touched another man's penis. 23
percent had performed or received oral sex, and 20 percent admitted to participating in anal sex with another inmate II
lensley, 2(X)!: Koscheski et al.. 2002). Two studies of homosexuality among female inmates in the United States found at
least onethird of women engaged in sexual activity with another inmate (Koscheski et al.. 2002). Because the imbalance of
power between an inmate and a staff member prevents actual consent. all sexual encounters between staff members and
inmates are considered assault.
<INSERT HEPATITIS IMPACT>
55
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Solvency-Education reduces recidivism (1/3)
Education in prison reduces recidivating.
M.D. Harer, ‘95
(Research Analyst, Federal Bureau of Prisons, 5/19)
Results of this analysis provide substantial evidence that prison education program participation reduces the
likelihood of recidivating irrespective of post-release employment. I interpret this result as support for the
normalization hypothesis, which posits that many policies, operations, and programs found in modern prisons
reduce prisonization and nurture prosocial norms supporting rule/law abiding behavior. Therefore, results
reported here for the education program and recidivism relationship may be generalized as showing that other
prison policies, operations, and programs (e.g., unit management, prison industries, furlough programs, female
corrections officers, due process in handling misconduct) that have normalization as a goal may also reduce
recidivism. Additional analysis suggests that the monetary savings from reduced recidivism, due to prison
education program participation, are substantial.
Education in prison reduces recidivating.
M.D. Harer, ‘95
(Research Analyst, Federal Bureau of Prisons, 5/19)
This study examined the prison behavior and postrelease recidivism of more than 14,000 inmates released from
Texas prisons in 1991 and 1992. Comparisons were made between participants and nonparticipants in prison
education programs on a variety of behavioral outcomes. The findings suggest that these programs may be most
effective when intensive efforts are focused on the most educationally disadvantaged prisoners. Implications for
correctional education policy and correctional program research are discussed.
Education and vocational training is effective in minorities to reduce recidivating.
Saylor and Gaes ‘99
William G. Saylor and Gerald G. Gaes
(Gerald G. Gaes and William G. Saylor, Research Analysts, Bureau of Prisons, September 8 1999, The Differential
Effect of Industries and Vocational Training on Post Release Outcome for Ethnic and Racial Groups)
Our objective in this research note was to determine whether some effects of job training programs might
depend on an inmates race or ethnic makeup. Specifically, we were interested in observing whether the
improvement in survival rates for program participants carried across racial and ethnic groups. To study this question
we first defined a high risk of recidivism group in the absence of any consideration of their race or ethnicity. Thus,
young, male, undereducated inmates recidivate at a high rate. Overlaying these characteristics, we looked to see if
being in an ethnic or racial minority had an effect. Indeed, being a member of a minority also increased the risk of
recidivism. Finally, we evaluated whether program participation had any differential effect on minorities compared
to non-minority inmates. Regardless of whether a minority was defined on the basis of race or ethnicity, and despite
their being at a higher risk of recidivism, minority groups benefitted more from vocational training and
industries participation than their lower risk non-minority counterparts. While the absolute differences may not
appear that large, the relative improvements indicate a much larger program effect for minority program
participants who are otherwise more likely to be recommitted to prison.
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Solvency-Education reduces recidivism (2/3)
Education and vocational training is effective in minorities to reduce recidivating, saving money
Gaes, 2k8
(Gerald G. Gaes , Research Analyst, Bureau of Prisons, February 8 2007, The Impact of Prison Education Programs
on Post-Release Outcomes)
Different analysts reading and reviewing essentially the same set of studies have come to different conclusions. The
skeptic’s view is that there are some promising results from high quality studies, but there are too many poorly designed
and executed studies to come to definitive conclusions about the impact of correctional education on reentry outcomes.
The optimist’s view is that taken as a whole the poorly designed and well designed studies point to the same conclusion.
Correctional education reduces recidivism and enhances post-release employment. One’s interpretation of cost- benefit
also hinges on where one lands on the skepticism-optimism scale. Economic assumptions aside, if you are unwilling to
accept the average effect sizes, discounts and all, the economic assumptions are meaningless. My reading of this
literature is that the strong observational studies support a conclusion that correctional education reduces
recidivism and enhances employment outcomes, but I have no way of estimating the true effect size. It could be 9
percent for VT programs, but it could also be higher or lower. If the WSIPP economic assumptions are valid, even small
effect sizes, can produce meaningful net benefits. Even from a taxpayer’s perspective, the marginal costs of education
pale in comparison to the marginal savings in criminal justice costs from reductions in arrests, convictions, or
recommitments. Consistent with this perspective is the evidence for education achievement returns for people in the
community even though there is some controversy on how much of this return is an ability bias (Becker, 1993;
Card, 1999; Willis and Rosen, 1979). As of yet, there are not enough high quality studies to indicate which types of
correctional education provide the highest post-release returns. There are no high quality studies of college coursework
and the average effects sizes for VT and GED training seem to be about the same within meta-analyses, even though they
are different across meta-analyses.
Education empirically successful in reducing rates of recidivism
Wade 2k7,
(Barbara Wade, Spring 2007, Adult Basic Education and Literacy Journal)
A different type of evaluation was undertaken by Messemer and Valentine (2004). Their assessment of an ABE program
examined inmates' learning gains as measured by the Tests of Adult Basic Education (TABE) through the use of
pre- and posttests. Results indicated that inmates who participated in ABE programs made significant learning
gains in reading, math, and language. The majority of participants in these studies had failed academically prior to
their incarceration. Messemer and Valentine showed that students who were previously considered at risk could become
successful in the classroom. This indicates that perhaps the reason they failed was because most offenders went to
schools in communities infested with crime and poverty. Adult learners achieved academic success for the first time in
their lives, because these educational programs were structured to meet their needs. Fabelo (2002) also examined inmates'
learning gains. Success was defined as progressing from one level to the next based on educational achievement (EA) scores.
Fabelo concluded that most inmates were successful in (Pallant, 2002). Koski (1998) reported that individuals who
were convicted of drug-related crimes had lower rates of recidivism than individuals who were convicted of different
offenses. However, the results of his analysis are questionable, because his correlation was very small; yet, it was declared
as having statistical significance, with only an r value being reported. A proper way to analyze the statistical significance of
a correlation coefficient is to convert the r value into a z value, and compare the observed z value to a critical z value, using a
chosen alpha level (Pallant, 2002). Further, Koski stated that the r value of —.119 was significant at .01, which might
suggest another test of significance that examines r prime. This test is designed to detect statistical significance of a Pearson
correlation coefficient in a sample to a population when p (rho) does not equal 0, or when comparing two correlation
coefficients to see if there is statistical significance, for example between two groups, males and females (Jaccard & Becker,
2002). Hence, the research lacks correct interpretation of statistical methodology, and omits other important information,
which could clarify the data analysis.
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Solvency-Education reduces recidivism (3/3)
Prison Education is key to preventing reincarceration
Karpowitz and Kenner ‘3 (‘Education as Crime Prevention: The Case for Reinstating Pell Grant Eligibility for the
Incarcerated’, 2003, Bard College. Bard Prison Initiative, Daniel Karpowitz is a Lecturing professor, University of
California, Berkeley, Department of Rhetoric and director of policy and academics, Bard Prison Initiative, Max Kenner is the
Bard Prison Initiative founder, http://reentrypolicy.org/Report/PartII/ChapterIIB/PolicyStatement10/Recommendation10-C )
Social, psychological, and demographic factors correlate powerfully with recidivism. Most persons are released from prison
into the community unskilled, undereducated, and highly likely to become involved in crime again. Rates of recidivism in the
United States are extraordinarily high, ranging from 41% to 71%. 3Prison-based education is the single most effective tool
for lowering recidivism. According to the National Institute of Justice Report to the U.S. Congress, prison education is far
more effective at reducing recidivism than boot camps, shock incarceration,5 or vocational training. 6 In 1997, The
Correctional Education Association conducted “The Three State Recidivism Study” for the United States Department of
Education. Over 3600 persons, released more than three years earlier, were involved in a longitudinal study in Maryland,
Minnesota and Ohio. Using education participation as the major variable, the study shows that “simply attending school
behind bars reduces the likelihood of reincarceration by 29%. Translated into savings, every dollar spent on education
returned more than two dollars to the citizens in reduced prison costs.”
Education reduces recidivism and creates a more humane environment
Vacca ‘4 (James S. Vacca is the Chair of Special Education and Literacy at C.W. Post College in Long Island, Journal of
Correctional Education, December 2004,
http://findarticles.com/p/articles/mi_qa4111/is_200412/ai_n9466371/?tag=content;col1)
Since 1990, the literature has shown that prisoners who attend educational programs while they are incarcerated are less
likely to return to prison following their release. Studies in several states have indicated that recidivism rates have declined
where inmates have received an appropriate education. Furthermore, the right kind of educational program leads to less
violence by inmates involved in the programs and a more positive prison environment. Effective Education Programs are
those that help prisoners with their social skills, artistic development and techniques and strategies to help them deal with
their emotions. In addition, these programs emphasize academic, vocational and social education. The inmates who
participate in these programs do so because they see clear opportunities to improve their capabilities for employment after
being released. Program success or failure is hampered, however, by the values and attitudes of those in the authority
position, over crowded prison population conditions and inadequate funding for teaching personnel, supplies and materials.
In addition, recent studies show that most inmates are males who have little or no employable skills. They are also frequently
school dropouts who have difficulties with reading and writing skills and poor self-concepts and negative attitudes toward
education. Literacy skills in learner-centered programs with meaningful contexts that recognize the different learning styles,
cultural backgrounds and learning needs of inmates are important to program success and inmate participation. Inmates need
education programs that not only teach them to read effectively but also provide them with the necessary reinforcement that
promote a positive transition to society when they are released. Efforts in this direction would help stimulate better
participation of inmates in all prison education programs and will go a long way to help the prisoner rehabilitation process.
Prisoners who attend education programs while they are incarcerated are less likely to return to prison following their release.
Since 1990, literature examining the return rates of prisoners, or recidivism, has shown that educated prisoners are less likely
to find themselves back in prison a second time if they complete an educational program and are taught skills to successfully
read and write. The "right kind" of education works to both lower recidivism and reduce the level of violence. Moreover,
appropriate education leads to a more humane and more tolerable prison environment in which to live and work, not only for
the inmates but also for the officers, staff and everyone else (Newman et al. 1993).
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Solvency-Drug Education
Drug education is statistically politically popular and proposed effective in prisons
Michels and Stöver,
(Coordinator of Drug Policy and Drug Work in the State of Bremen, and Executive Director of the Association
KOMMUNALE DROGENPOLITIK/VEREIN FÜR AKZEPTIERENDE DROGENARBEIT in Bremen, 1995,
Drugtext Web-Lab)
While a growing number of experts - mainly from a health point of view - is arguing in favour of an (at least
experimental) provision of sterile needles and syringes, most prison governors and the administration of justice in
the different states and on federal level argues against this - undoubtly most effective - measure.
Their argumentation is: Instead of the provision of syringes, more preventive efforts should be undertaken on the
educational level, emphasizing the personal-commucicative aspect. One of the recommendations beeing made
at the moment as an alternative to instrumental preventive measures is the strong emphasizing of
"counselling". This phenomenon is critically discussed in the following:
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Solvency-Disease Education
HIV/AIDS education is the best way to reduce transmission to the population at large
American Journal of Public Health ’96 (J Gaiter and L S Doll, Am J Public Health. 1996 September; 86(9): 1201–1203,
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1380577&blobtype=pdf)
Many more HIV prevention and education programs must be developed for jails, prisons, and youth correctional facilities.
High levels of knowledge about HIV transmission will not necessarily dispel inmates' misconceptions and misinterpretations
about how HIV prevention information applies to their own behavior. Specific information on how to avoid risky behaviors
and consistently available prevention education and counseling offer the best means of alerting inmates to the risks that they
may encounter during imprisonment and after they are released. Furthermore, the majority of inmates return to their home
communities, and they require community support to sustain difficult risk reduction. Indeed, prevention work with inmates
affords opportunities to address prevention in the larger community outside of prisons through the education of family
members and friends and through the subsequent of diffusion of messages. Pre- release counseling is a final critical
opportunity to reinforce and remind those about to be released of ways to reduce risk when they return to familiar, risky
environments. The provision of HIV prevention messages and behavioral interventions for inmates is an important mission
for correctional facilities. A vital adjunct is HIV education for correctional officers, other prison staff, and visitors.
Reducing sexual behavior in prisons key to stopping hepatitis
Beyrer and Pizer 07
(Chris Beyrer; MD and MPH Professor
Director, Johns Hopkins Fogarty AIDS International Training and Research Program; Director, Johns Hopkins Center for
Public Health & Human Rights; Senior Scientific Liaison, HIV Vaccine Trials Network; Associate Director, Center for
Global Health Hank Pizer; Health Care Strategies, Inc., Cambridge, MA, USA 2007, “Public health and Human Rights,”
http://books.google.com/books?id=nGBf6Big_W8C&pg=PA105&dq=%22Reducing+harm+in+prisons)
Reducing the frequency of high-risk sexual behavior in prison is the best strategy for limiting the risk of transmitting
all three hepatitis strains. 1-1W. and other STIs CDC, 2002b; Weinbaum et al., 2003). Unfortunately, most correctional
facilities treat condoms as contraband. Prisoners are not under constant surveillance by the correctional staff, which
affords opportunities to engage in prohibited behavior. Rape is all too common in men's prisons, as is unsafe
consensual sex. The reported prevalence of consensual sex among inmates varies but apparently is substantial (Koscheski et
al., 2002). One study of 150 male inmates in Ohio found that although 77 percent identified themselves as heterosexual.
nearly 20 percent reported homosexual activity with another inmate during the prior year; 8.5 percent engaged in sex at least
once a week and 7.4 percent admitted to a continuing relationship (Tewksbury0 1989: Koscheski et al., 2002 I. In a study of
Inmates in Oklahoma, 80 percent identified themselves as heterosexual, 1 3 percent as bisexual, and 8 percent as
homosexual: 24 percent said they had permitted another man to touch their penis or had touched another man's penis. 23
percent had performed or received oral sex, and 20 percent admitted to participating in anal sex with another inmate II
lensley, 2(X)!: Koscheski et al.. 2002). Two studies of homosexuality among female inmates in the United States found at
least onethird of women engaged in sexual activity with another inmate (Koscheski et al.. 2002). Because the imbalance of
power between an inmate and a staff member prevents actual consent. all sexual encounters between staff members and
inmates are considered assault.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Solvency-Moral Obligation for Education
There is a moral obligation to provide education to prisoners
House of Commons Education and Skills Committee ‘5 (House of Commons Education and Skills Committee Seventh
Report of Session 2004-05, Volume I, 2005)
It is essential that we are clear about the purpose of prison education. Prison education should be part of a wider approach to
reduce recidivism through the rehabilitation of prisoners. Although contributing to the reduction of recidivism is of key
importance, prison education is about more than just this. It is also important to deliver education in prisons because it is the
right thing to do. The breadth of the education curriculum is important and the wider benefits of learning should not be
sacrificed due to an overemphasis on employability skills. Education as part of a broader approach to rehabilitation must
consider the full range of needs of the prisoner and continue to support the prisoner on release. Prison education does not take
place in isolation, and its purpose cannot be understood in isolation from these wider issues.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Solvency-Risk Reduction
Addressing risky behavior such as drug use among prisoners is critical to public health
Report of the Re-Entry Policy Council: Charting the Safe and Successful Return of Prisoners to the
Community. Council of State Governments. Reentry Policy Council. New York: Council of State
Governments. January 2005. http://reentrypolicy.org/Report/PartII/ChapterII-B/PolicyStatement12
Because a history of using drugs and/or alcohol is common to so many people in prisons and jails - both generally and
in connection with particular criminal offenses - it is especially key that addictions issues be addressed during the period
of incarceration. Failing to capitalize on this opportunity to treat addiction poses risks to successful prisoner
reintegration, public safety, and public health. Utilizing programs proven to be effective, prioritizing resources for those
nearing release, and encouraging community-based aftercare will ensure better outcomes for re-entering prisoners and
the communities to which they return.
Limiting risky behavior such as contaminated needles and tattoo equipment is critical to solve
prison health
G. Niveau Department of Community Health and Medicine, Faculty of Medicine, IUML, Avenue de
Champel 9, 1211 Geneve 4, Switzerland Public Health Volume 120 January 2006
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B73H6-4H0BT2F1&_user=4257664&_coverDate=01/31/2006&_alid=941062985&_rdoc=10&_fmt=full&_orig=mlkt&_cdi=11546&_sort=v
&_st=17&_docanchor=&view=c&_ct=1049&_acct=C000022698&_version=1&_urlVersion=0&_userid=4257664&md5=4e
e5192b392f15084b3561ea1d35f27c#SECX10
The main risk behaviour is use of contaminated syringes and needles to inject illegal drugs. Prevention should
therefore aim to reduce drug abuse and modify drug-taking behaviour. In order to fight against the use of injectable
drugs, the prison health service can help prisoners to gradually give up taking the substance, or can propose a substitution
treatment for opiates.91 The substances used in withdrawal and substitution programmes vary depending on the country, but
they never protect the inmates fully from the risk of taking illegal drugs by injection.
When the risk of injecting drugs is obvious, the prison health service should encourage the prisoner to use clean
equipment.87 and 91 In 1991, the WHO Regional Office for Europe recommended the provision of sterile syringes in prisons as
part of a comprehensive HIV prevention strategy.92 The WHO Guidelines on HIV Infection and AIDS in Prisons, published
in 1993, recommend the equivalence of health care, including preventive measures: ‘In countries, where clean syringes and
needles are made available to injecting drug users in the community, consideration should be given to providing clean
injection equipment during detention and on release’. 28 The same principles are supported by the Joint United Nations
Programme on HIV/AIDS. UNAIDS. Guideline 4 of the International Guidelines on HIV/AIDS and Human Rights
specifically states that prison authorities should provide prisoners with means of HIV prevention, including ‘clean injection
equipment’.93Different methods have been used to implement prison needle exchange programmes.12 and 94 The most
widespread consists of giving new syringes to inmates in exchange for used ones. However, this method does not guarantee
that several prisoners will not use the same syringe, and it is preferable to give clean syringes to all inmates making the
request. In some prisons, syringes can be obtained from automatic distributors. 95
Tattoos can also be done with contaminated equipment and clean equipment should be provided when requested.96
However, there is a great deal of resistance from the prison services regarding the distribution of syringes to
inmates.52 and 89 Wardens are afraid that they may injure themselves with the syringes, or that prisoners could use them as
weapons.12 This form of prevention of the transmission of infectious diseases should therefore be organized in
conjunction with the prison or jail authorities.97The prevention of risk behaviour concerning the use of contaminated
equipment in prisons and jails needs to be addressed at several levels and is a complex issue to resolve. Its effectiveness
is never definitive since there is always clandestine equipment in correctional facilities. However, prevention is very
important as it concerns a particularly high risk of transmission.
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Solvency-Mental Health Care (1/2)
Mental healthcare must be provided to inmates as a part of prison health policy
Report of the Re-Entry Policy Council: Charting the Safe and Successful Return of Prisoners to the
Community. Council of State Governments. Reentry Policy Council. New York: Council of State
Governments. January 2005. http://reentrypolicy.org/Report/PartII/ChapterIIB/PolicyStatement11/ResearchHighlight11-3
People in prison who have a mental illness, in comparison to the general population, tend to have longer criminal
histories involving violent offenses and are more likely to have been using drugs or alcohol when they committed their
crime. [1] They are also more likely to have histories of homelessness and sexual and physical abuse. [2] Thus, meeting the
needs of people in prison or jail who have a mental illness often involves treating the various issues with which they
may be dealing, such as a history of physical and sexual abuse, often perpetrated by family members or intimate partners;
addiction to alcohol and/or drugs; and homelessness; as well as the problems every individual re-entering society after
incarceration must face. To promote public safety and increase the likelihood of successful re-entry for inmates with
mental illness, it is important to ensure that these individuals continue to receive treatment and that their treatment
services are coordinated and tailored to their needs on an individual basis.
Increased funding for personal will give prisoners greater access to the mental services they require
John J Gibbons and Nicholas de B Katzenbach, co-chairs of the federal Commission on Safety and
Abuse in America’s Prisons “Confronting Confinement” June 2006
http://www.prisoncommission.org/pdfs/Confronting_Confinement.pdf
The need for mental health care in our country’s prisons and jails is enormous. The most conservative estimate of
prevalence—16 percent— means that there are at least 350,000 mentally ill people in jail and prison on any given day
(Ditton 1999). Other estimates of prevalence have yielded much higher rates, even of “serious” mental disorders— as
high as 36.5 percent or 54 percent when anxiety disorders are included (NCCHC 2002, Pinta 1999, Teplin et al. 1997). These
prevalence rates are two to four times higher than rates among the general public (NCCHC 2002). They reflect what
many witnesses told the Commission: that prisons and jails have replaced state psychiatric hospitals as the institutions that
house and care for persons with mental illness. Reginald Wilkinson, who made care of mentally ill prisoners a priority of his
15-year tenure leading the Ohio Department of Rehabilitation and Correction, put it simply: “Detention facilities have, in
fact, become the new asylums.” The result is not only needless suffering by the individuals who are undertreated but safety
problems those prisoners cause staff and other prisoners.
Continues…
Intermediate-level care is also lacking. “There need to be more step-down units, roughly equivalent to residential
treatment facilities in the community, where prisoners with serious mental disorders can be partially sheltered as they
undergo treatment,” psychiatrist Terry Kupers, author of Prison Madness, wrote to the Commission. Here too, New York
has an admirable model, with Intermediate Care Programs (ICPs) located in 11 of the state’s 70 prisons. According to the
Correctional Association of New York, a legislativelyauthorized prison oversight group, the ICPs “perform an essential
function for inmates with serious mental illness. They offer a therapeutic, safe environment and access to a range of
services” (Correctional Association of New York 2004). But there are places for just 534 people in the ICPs, far too few,
given that there are at least 10,000 mentally ill prisoners in New York, based on a conservative estimate of the prevalence of
mental illness among prisoners nationally.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Solvency-Mental Health Care (2/2)
Mental healthcare treatment in prisons is key to prisoners successful re-entry into society
Report of the Re-Entry Policy Council: Charting the Safe and Successful Return of Prisoners to the
Community. Council of State Governments. Reentry Policy Council. New York: Council of State
Governments. January 2005. http://reentrypolicy.org/Report/PartII/ChapterIIB/PolicyStatement11/ResearchHighlight11-3
People in prison who have a mental illness, in comparison to the general population, tend to have longer criminal
histories involving violent offenses and are more likely to have been using drugs or alcohol when they committed their
crime. [1] They are also more likely to have histories of homelessness and sexual and physical abuse. [2] Thus, meeting the
needs of people in prison or jail who have a mental illness often involves treating the various issues with which they
may be dealing, such as a history of physical and sexual abuse, often perpetrated by family members or intimate partners;
addiction to alcohol and/or drugs; and homelessness; as well as the problems every individual re-entering society after
incarceration must face. To promote public safety and increase the likelihood of successful re-entry for inmates with
mental illness, it is important to ensure that these individuals continue to receive treatment and that their treatment
services are coordinated and tailored to their needs on an individual basis.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Solvency-Disease Screening
Disease screening and treatment is imperative in prisons to improve health and cut costs
John J Gibbons and Nicholas de B Katzenbach, co-chairs of the federal Commission on Safety and
Abuse in America’s Prisons “Confronting Confinement” June 2006
http://www.prisoncommission.org/pdfs/Confronting_Confinement.pdf
Screen, test, and treat for infectious disease. Every U.S. prison and jail should screen, test, and treat for infectious
diseases under the oversight of public health authorities and in compliance with national guidelines and ensure continuity
of care upon release.
Continues…
The NCCHC report demonstrates that proper screening and treatment of infectious diseases in prisons and jails would
improve public health (NCCHC 2002). While some public health agencies already work with correctional systems to
manage infectious disease, too many county and state public health departments have not shouldered this responsibility.
There are potentially devastating results when corrections departments do not have the help and resources to control
disease. Conversely, well-designed systems of disease control can enormously benefit public health and result in
tremendous cost savings down the road. For example, in New York City in the 1980s and early 1990s there was an
epidemic rise in tuberculosis, including a dangerous jump in the incidence of multi-drug resistant tuberculosis. The rise in
drug-resistant cases, in particular, was believed by many to be largely the result of poor treatment in prisons and jails.
Research shows a correlation between time spent in jail and tuberculosis infection (Bellin et al. 1993). With support from the
Centers for Disease Control and Prevention, the city and state’s coordinated response included establishing a Communicable
Disease Unit in the jails at Rikers Island. The effort was a success. Between 1992 and 1998 tuberculosis cases declined 59
percent citywide, and the number of drug-resistant cases declined 91 percent (Shalala 2000).
Preventative healthcare and disease treatment is essentially to public health in prisons and
communities
Report of the Re-Entry Policy Council: Charting the Safe and Successful Return of Prisoners to the
Community. Council of State Governments. Reentry Policy Council. New York: Council of State
Governments. January 2005. http://reentrypolicy.org/Report/PartII/ChapterIIB/PolicyStatement10/ResearchHighlight10-4
Prisoners account for a substantial share of the total population infected with HIV, AIDS, hepatitis B, hepatitis C, and
tuberculosis. For example, in 1997, individuals released from prison or jail accounted for nearly one-quarter of all people
living with HIV or AIDS, almost one-third of people diagnosed with hepatitis C, and more than one-third of those diagnosed
with tuberculosis. [1] Virtually all people in prison or jail are at high risk for many chronic and communicable
diseases. Individuals in this population, when not incarcerated, are often among the hardest for the health system to identify
in part because the criminal justice system and health system rarely collaborate to discuss their shared population.
Accordingly, periods of incarceration provide what the National Commission on Correctional Health Care describes as a
"window of opportunity" for a variety of preventive, diagnostic, and treatment interventions that stand to benefit not
only inmates, but also their families, partners, friends, and communities.
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Recidivism Uniqueness
DOJ reports criminal recidivism occurs over 50% of the time because of poor unemployment
opportunities, abuse problems, and lack on mental and physical health
Vishner and Travis 03
(Christy A. Visher and Jeremy Travis, June 4, 2003, “TRANSITIONS FROM PRISON TO COMMUNITY: Understanding
Individual Pathways”, http://www.caction.org/rrt/articles/VISHER-PRISON%20TO%20COMMUNITY.pdf)
In the largest study of its kind, the Bureau of Justice Statistics examined criminal recidivism among nearly 300,000
prisoners released in 15 states in 1994 (Langan & Levin 2002). Overall, 67.5% of the prisoners were arrested for a new
offense within 3 years and 51.8% were back in prison, serving time either for a new offense or for a technical violation of
their release. Men were more likely to be returned to prison (53%) than women (39.4%), blacks (54.2%) more likely than
whites (49.9%), non-Hispanics (57.3%) more likely than Hispanics (51.9%), younger prisoners more likely than older ones,
and prisoners with longer prior histories of criminal behavior were more likely to be returned to prison than those with
shorter records. A range of individual circumstances prior to prison also predict recidivism. More importantly for our
purposes, these circumstances may also affect transitions from prison to community. In particular, substance abuse
history, job skills and work history, mental and physical health, and intensity of conventional ties and behavior
predict recidivism and are also likely to be important influences on post prison reintegration. For example, in a 1997
survey of inmates, 52% of prisoners reported that they were under the influence of drugs or alcohol at the time they
committed the offense that sent them to prison (Mumola 1999). Many studies have linked substance abuse problems to
reoffending (e.g., Chaiken & Chaiken 1990, Harrison 2001, White & Gorman 2000). Studies of released prisoners report
that their success or failure to confront their substance abuse problem often emerges as a primary factor in their post prison
adjustment (Califano 1998, Hanlon et al. 2000, Nelson et al. 1999, Sampson & Laub 1993, Zamble & Quinsey 1997).
Although slightly more than half of inmates report being employed full-time prior to incarceration (Ditton 1999), the poor
employment histories and job skills of returning prisoners create diminished prospects for stable employment and
decent wages upon release. However, former prisoners who are able to rejoin the labor market, through previous employers
or contacts from family or friends, are more likely to have successful outcomes after release (Nelson et al. 1999, Sampson &
Laub 1993). The reverse is also true: Former prisoners who were deeply embedded in a criminal lifestyle for many years
prior to incarceration may be at highest risk of poor outcomes after release (Adler 1992, Hagan 1993, Nelson et al. 1999,
Western et al. 2001; for exceptions see Shover & Thompson 1992, Waldorf 1983). This research shows that it is important to
examine an individual’s preprison stakes in conformity and ties to conventional activities, through legitimate work and other
behavior, to fully understand individual transitions from prison to the community and eventual reintegration. Returning
prisoners who can draw on preprison conventional roles and relationships, as opposed to those who burned all bridges prior
to incarceration, may have more successful postprison outcomes. n
52% of prisoners are re-incarcerated from poor medical care
Information Please Database 2007
(Information Please Database, 2007, “U.S. Prisons Overcrowded and Violent, Recidivism High”,
http://www.infoplease.com/ipa/A0933722.html)
Confronting Confinement, a June 2006 U.S. prison study by the bipartisan Commission on Safety and Abuse in America's
Prisons, reports than on any given day more than 2 million people are incarcerated in the United States, and that over the
course of a year, 13.5 million spend time in prison or jail. African Americans are imprisoned at a rate roughly seven times
higher than whites, and Hispanics at a rate three times higher than whites. Within three years of their release, 67% of
former prisoners are rearrested and 52% are re-incarcerated, a recidivism rate that calls into question the
effectiveness of America's corrections system, which costs taxpayers $60 billion a year. Violence, overcrowding, poor
medical and mental health care, and numerous other failings plague America's 5,000 prisons and jails. The study
indicates that even small improvements in medical care could significantly reduce recidivism. “What happens inside jails
and prisons does not stay inside jails and prisons,” the commission concludes, since 95% of inmates are eventually released
back into society, ill-equipped to lead productive lives. Given the dramatic rise in incarceration over the past decade, public
safety is threatened unless the corrections system does in fact “correct” rather than simply punish.
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Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Poverty Recidivism
Recidivism is more likely among people who are impoverished
Edward Zamble (Queens University at Kingston) and Vernon L. Quinsey (Queens University at
Kingston) 1997: The Criminal Recidivism Process
We are led to consider next the differences between the groups on measures of general behavior and lifestyle outside
of prison. Table 4.2 summarizes a number of differences. Measures for recidivists are for the preoffense period, while
for the nonrecidivists they cover a period of comparable length preceding the interview. On the average, the lives of
the nonrecidivists seem to have been much more conventional and mundane than those of the recidivists. They were
significantly more likely to be living as a parent in a nuclear family. Those who were not working full time almost all
had a regular source of income from either unemployment insurance (22%) or welfare (33%), rather than living off the
proceeds of illegal behavior.
People in poverty are more likely to commit crimes and the repeat them – health care solves
Lisa Donnely 2008: What can America do to prevent crime and recidivism.
http://www.associatedcontent.com/article/602373/what_can_america_do_to_prevent_crime.html
Jeffrey Reiman, in his 2004 book The Rich Get Richer and the Poor Get Prison: Ideology, Class, And Criminal
Justice, 7th edition, suggests several ways in which we could prevent crime and recidivism. He states (1) we need to
make a concerted effort to eliminate poverty. Reiman also suggests (2) legalizing drugs and treating drug addiction as
a medical problem rather than a criminal one. (3) Prisons need to reevaluate in-prison and reintegration programs.
Reiman further argues for (4) stricter gun control laws.
Poverty breeds crime. Being a member of the lower socio-economic class (SES) does not make a person into a
criminal, but often the consequences of being poor leads to engaging in a criminal lifestyle. Persons living in poverty
tend to live in inadequate housing, located in rough, often crime-ridden and neglected neighborhoods. The poor tend
to be undereducated. They often suffer from poor nutrition and unhealthy lifestyles. Those in lower SES also must
often do without adequate health care.
People with mental illnesses are more likely to commit crimes after being released
Jill Harrison 2008: Mental Illness, Substance Abuse, and Recidivism among Severely Mentally Ill
Inmates.
http://www.allacademic.com/meta/p_mla_apa_research_citation/2/4/2/7/2/p242729_index.html
Persons with severe mental illness all too commonly become “frequent flyers” in jails and prisons across the United
States, and given the robust relationship between mental illness, substance abuse and repeat incarcerations (MateyokeScrivner, Webster, Hiller, Staton, and Leukefeld 2003; Borum, Swanson, Swartz, and Hiday 1997; Steadman et al,
1998; Swartz et al., 1999), we choose to examine the issue more closely by comparing severely mentally impaired
inmates and a randomized sample of non-mentally ill inmates on measures of re-incarcerations; substance abuse; time
spent in punitive segregation; and loss of meritorious good time. Medical histories and the state prison database serve
as the two sources for data collection, which occurred between November 2006 and July 2007. We find repeat
incarcerations among male inmates (n=124are significantly higher for the mentally ill; although no clear differences
emerge among our small sample of female inmates (n=30). Our research concurs with prior studies that show almost
three-quarters of incarcerated adults have serious mental illnesses that co-occur with substantial histories of substance
abuse (Abram and Teplin 1991; Abram, Teplin, and McClelland 2003; DHHS 2002; Broner et al, 2003; Drake,
Mercer-McFadden, Mueser, McHugo, and Bond 1998; Charles, Abram, McClelland and Teplin 2003; Edens, Peters
and Hills 1997; Peters, Kearns, Murrin, and Dolente 1992; RachBeisel, Scott, and Dixon 1999). Specifically, we find
that crack/cocaine and alcohol mediate the relationship between mental illness and recidivism. Also our analyses show
that mentally-ill female inmates are more likely to spend more time in punitive segregation and lose meritorious good
time than both male and female inmates.
67
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Recidivism Reflects on the System
A high rate of recidivism among detainees is a reflection of the failure of justice system – reducing
recidivism is equivalent to fixing the system
Michael D. Maltz (Department of Criminal Justice and Department of Quantitative Methods
University of Chicago) 1984: Recidivism: Quantitative Studies in Social Relations.
68
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Education solves recidivism (1/3)
Prisoner Education is key to stopping recidivism
Santos 5/10
(Michael Santos; Prisoner Writing About the life in prison, Sunday, May 10th, 2009, “Prison Reform Can Lower Recidivism”,
http://prisonnewsblog.com/2009/05/prison-reform-can-lower-recidivism/)
In 2002, the Bureau of Justice Statistics published Recidivism of Prisoners Released in 1994 by Patrick Langan and David
Levin. “The study found that 30 percent [of] released prisoners were rearrested in the first six months, 44 percent
within the first year, and 67.5 percen within three years of release from prison.” I gathered this data from Professor Joan
Petersilia’s book When Prisoners Come Home. To me, the data makes a compelling case on the need for prison reform.
My 22 years of experience as a federal prisoner give me a strong opinion on the reasons that our system of corrections
breeds so much failure. The prisons in which I have been held extinguish hope. They do not encourage those who strive
to prepare for law abiding lives upon release. The consequence of this flawed policy, from my perspective, is that
prisoners who struggle to sustain focus through incarceration abandon adjustment patterns that could help them prepare for
law-abiding lives upon release. Instead, they embrace adjustment patterns that lead to continuing cycles of failure.
Professor Petersilia reports some of the findings from her distinguished colleague, Professor James Q. Wilson. For many
years I have read of Professor Wilson’s work. He is well known for his 1985 book Thinking About Crime, in which he wrote
that prisons ought to isolate and punish. I’ve served my entire sentence in prisons designed not only to isolate and punish, but
also to extinguish hope. The high recidivism rates that the Bureau of Justice Statistics reported represent the fallout from such
myopic objectives. The problem with prisons is that they condition people to live inside boundaries, though they
simultaneously condition people to fail upon release. We need prison reforms that would lower recidivism rates and
simultaneously lower prison operating costs. The way to accomplish such goals would require fundamental changes
with the ways administrators manage prisons.
Rather than extinguishing hope and erecting barriers that obstruct prisoners from preparing offenders for law-abiding lives
upon release, administrators ought to implement incentive programs that encourage the opposite. As Justice Burger once said
in his speech Factories with Fences. We need prison reforms that will encourage offenders to earn and learn their way
to freedom.
Educate incentives key to stopping prisoners from recidivism
Santos 3/1
(Michael Santos; Prisoner Writing About the life in prison, Sunday; April 1st, 2009, “Reduce RecidivismThrough Reform”,
http://prisonnewsblog.com/2009/04/reduce-recidivism-through-reform/)
As a society, citizens ought to expect our $59 billion prison system to do more than warehouse offenders for the duration of their sentences. When we lock
offenders inside abnormal communities for years or decades at a time, we condition them for non productivity. Rather than encouraging redemption, prisons
extinguish hope and breed resentment. This has been a pattern that manifests itself with high recidivism rates and high costs. Those in law enforcement say
such expenditures are necessary to keep society…that is a problem administrators could change by simply encouraging more
prisoners to adjust in positive ways. Prisoners are human beings, and like all people, they respond better to the
promise of incentives than to the threat of punishment. If administrators were to implement mechanisms through
which prisoners could work toward meaningful lives, more prisoners would feel a sense of self-empowerment. Without
that hope, prisoners feel only the weight of their sentences. Those without a clear understanding of prisons misunderstand the concept of good time.
Administrators do not base good time on positive accomplishments. Rather all prisoners who avoid disciplinary infractions receive good time. That means a
prisoner who plays dominoes all day earns the same good time as the individual striving to prepare for a law-abiding life. Thus good time fails as an
incentive to motivate positive adjustments. It simply rewards an individual for staying out of trouble, which is something he is supposed to do. I advocate the
types of incentives Justice Burger wrote about in his speech Factories with Fences. Prisoners should earn the right to gradual increases in
freedom through merit. As they educate themselves, develop vocational skills, build networks of support, demonstrate
that they have a commitment to reconciling with society and live by American values, they ought to earn graduating
increases in freedom. Such an approach would not diminish the seriousness of crime, but it would instill offenders
with a way out from the poverty of their lives. Rather than simply punishing the offenders for breaking the law, society
would condition offenders to emerge from prison as productive citizens. Simultaneously, the negative influences of the prison would
lose their corrupting power.
Perhaps society should start such a program with nonviolent offenders. Those burdened with life terms would have higher hurdles to cross, and some may
never qualify for the higher level of freedom, though I suspect prison reforms ought to include all prisoners in some way.
69
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Education Solves Recidivism (2/3)
High recidivism rates in status quo from lack of education opportunities
Aborn 05
(Richard M. Aborn, a former Manhattan prosecutor, is managing director of Constantine & Aborn Advisory Services. He
advises police departments and criminal justice agencies on crime reduction strategies, March 5, 2005, “Time to End
Recidivism”, http://www.thenation.com/doc/20050321/aborn)
When Martha Stewart walks out of the Federal Correctional Institute in Alderson, West Virginia, on March 6, she can look forward to returning to her
luxurious $40 million, 153-acre home in Bedford, New York. She already has a job lined up with her company at a salary of nearly $1 million per year. She
is planning a TV reality show in the fall, and there is talk of a potential multimillion-dollar book deal in the works. In short, she will have very little trouble
putting her criminal past behind her and reintegrating into society. But what about the other 177 women who will be released from US prisons that day and
every other day of the year? Will society be as willing to embrace them? What about their housing and employment? What will be their reality show? Most
women released from incarceration face tremendous hurdles as they set out to rebuild normal lives, including such basic needs as finding housing and a job;
re-establishing ties with children, family and friends; and rebuilding self-confidence and self-esteem. These difficulties can be better understood after
considering the background and experiences of the average woman in prison. Of these 177 women--on average, they will be 35 years old--fifty-seven will be
white, eighty-two will be black and twenty-nine will be Hispanic. Fewer than forty-four will be married, and 118 will have minor children. Of those with
children, twenty-six will have an alcohol dependence problem and thirty-seven will have a diagnosed mental illness. Seventy-four will not have finished
high school, and more than half were unemployed before arrest. For those who were working, fifty-eight had incomes of less than $600 per month and fiftythree were on welfare. With little more than the proverbial bus ticket and pocket money, the women will be released from prison and told to stay out of
trouble. Not surprisingly, the net result is that within three years of leaving prison, 101 will commit a new offense and sixty-nine will go back to jail. But this
doesn't have to be. Recidivism is a significant issue, and if we want to achieve long-term reductions in crime it must be
addressed. Nationally, the recidivism rate is 67 percent. For women--a fast-growing segment of the prison population-the rate is 58 percent. A 2002 federal study showed that the recidivism rate of prisoners released in 1994 was 5 percent
higher than of prisoners released in 1983. While we have made enormous gains in reducing crime on the street, we have not
progressed at all in stopping those who are released from prison from committing new offenses. This result is not surprising.
One of the unfortunate aspects of the "tough on crime" attitude of the 1990s was a severe cutback in prison-based
programs to prepared inmates for re-entry into society. These cuts affected rehabilitation measures like drug
treatment programs, as well as vocational and educational classes. By mid-decade, just 6 percent of the $22 billion
that states spent on prisons was being used for in-prison programs like vocational, educational or life skills training,
according to an Urban Institute study. Most funding for prison college programs was eliminated, leading to the closing of
some 350 such programs nationwide. Many states, including New York, barred inmates from taking college extension
courses. The 1994 federal crime bill made inmates ineligible to receive federal Pell Grants to fund the costs of college
study. Even secondary education programs suffered. In California the number of prison teachers actually fell by 200 during
the 1990s even as the number of prisoners jumped from 30,000 to 160,000. As a result, by the end of the decade only 9
percent of inmates were participating in full-time job training or education programs, and 24 percent remained completely
idle. While strong on rhetoric, the results were predictably weak on crime. Severe underfunding of pre- and postrelease
education and job placement programs runs counter to what we know about proven interventions to reduce
recidivism. Studies have clearly shown that participants in prison education, vocation and work programs have recidivism
rates 20-60 percent lower than those of nonparticipants. Another recent major study of prisoners found that participants
in education programs were 29 percent less likely to end up back in prison, and that participants earned higher wages
upon release. The idea of forgiveness is deeply entrenched among the American people. Witness any number of public
figures who have erred, only to be accepted back into mainstream society. The issue is that while we are willing to accept the
errant ways of noted figures, are we similarly willing to accept the errant ways of those not notable? Support for quality
education, job training and employment cuts across the political spectrum. The self-esteem and self-confidence that flow
from quality education and employment are society's best deterrent against crime. Providing tools to ex-offenders so they can
remove themselves from the cycle of crime is no less worthy than providing those same tools to those who needed to escape
the cycle of welfare. And in doing so, we not only help ex-offenders become productive, law-abiding citizens, but we can
further reduce crime--a goal all should support. It is time to end recidivism as we know it.
70
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Education Solves Recidivism (3/3)
Education incentives key to stopping recidivism
Miroff 06
(Nick Miroff; is a former volunteer Spanish instructor at San Quentin State Prison, July 2, 2006, “Prison reform? Education
Schools offer incentives to steer parolees away from crime “, http://www.sfgate.com/cgibin/article.cgi?file=/chronicle/archive/2006/07/02/INGIJJM4VC1.DTL)
California has the largest and one of the least effective correctional programs in the country: 33 prisons (all at nearly
200 percent capacity), 169,000 inmates, a $7.4 billion budget and one of the nation's highest recidivism rates. Doomed by
design, California's prison system is notoriously violent, dangerously overcrowded and increasingly ungovernable -- a failed
state within the state. California facilities such as San Quentin and Folsom prisons already present major security risks to
guards and inmates alike. They should be converted into prison-universities for the state's high-achieving, low-security
convicts (think UC San Quentin, or Cal State Folsom). Word would spread around prison yards across California that a better
life awaits those willing to study their way to rehabilitation. Presently, and for good reason, the dominant organizing
principle of prison life is security. When inmates first arrive, they are assigned a point value commensurate with their
perceived security risk. Gang affiliation and the nature of their felony convictions are then balanced against
mitigating factors like good behavior and participation in rehabilitation activities. A prison educational meritocracy could
greatly enhance, if not transform, this system: Each institution would offer inmates a range of academic and vocational
programs in a demanding work-study environment. Nonviolent, motivated inmates who worked hard and showed
results would be allowed to graduate into more advanced programs with the perks and privileges of better living
conditions. Unreconstructed gang members and violent felons who attempt to corrupt others would move in the opposite
direction, toward tighter restrictions and ever-slimmer possibilities for parole. The greatest advantage of such a meritocratic
system, however, isn't in prison, it's outside. Upward mobility based on education is a better approximation of the society that
awaits the parolee. Right now, our sentencing laws are putting ex-cons on the street who have been socially conditioned to a
prison environment with little resemblance to a productive life beyond the cellblock. Inmates would have to choose the
path of education; but at least we would be providing more incentives for them to do so. This type of meritocracy would
obviously have limits. A capital offender like Stanley "Tookie" Williams (who was executed at San Quentin in December)
wouldn't be allowed to read and write his way out of jail. But for every Tookie there are 20 lesser criminals who will end up
back on the streets anyway. In the crammed cages we have now, a prison sentence is just lost time, or worse: an
apprenticeship to more serious criminal activity. Californians are justifiably wary of tax increases to feed an already bloated
prison budget. But the long-term savings of a smaller prison population is too good an investment to pass up. Even if we
entice new prison teachers with a generous starting salary of $60,000 a year, they'll pay for themselves by simply keeping
two inmates out of jail the next time around. Quality education and vocational programs have a proven impact on recidivism
rates, reducing them by as much as 30 percent. A classroom-based meritocracy would require a major commitment from
Californians teachers, prison administrators and taxpayers alike. But it'll pay for itself in the long term. And we've already got
the campuses.
71
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Recidivism Impact
Crime kills the economy – recent report proves
John Lovik 2008: U.S. Crime Affects Economy.
http://crime.suite101.com/article.cfm/costs_of_crime_threaten_us_law_enforcement
According to a United Nations report posted by MSNBC, the United States is the leading country in financial loss due
to violent crimes; the cost estimated around 45 billion dollars. During a time of recession, this information sheds more
light on the impact crime has on our society. Combined with the very real struggle law enforcement agencies face to
retain employees and maintain budgets, the report signals a very serious factor degrading our communities.
72
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Inherency – BOP Lacks Funding (1/3)
Prison construction is delayed due to the BOP’s lack of funding.
United States Government Accountability Office, May 2008, (Clear Communication on the Accuracy of
Cost Estimates and Project Changes Is Needed, http://www.gao.gov/highlights/d08634high.pdf , GAO)
For these three projects, delays in starting construction or disruptions in available funding that interrupted construction
contributed to increases in cost estimates due to inflation and unexpected increases in construction material costs.
According to BOP officials, delays resulted from problems with selecting and approving the sites for the prisons
and with the availability of funding. BOP officials stated that they expected costs to increase by the inflation rate
during the delay period, but did not anticipate that market forces would cause the construction costs to increase
above the inflation rate, as they did. For example, steel prices rose about 60 percent and oil prices rose by almost
170 percent between the time that BOP prepared the initial cost estimates for these projects and when construction
was ready to begin. In addition, because BOP estimates initial project costs early in the planning process, generally
before an actual prison location is selected, variance from the initial estimates would be expected to some extent, even
if the projects are not delayed. BOP, like other agencies, is not required to communicate how much it expects costs
may vary from its estimates in its budget documents. Without such information, Congress and other stakeholders do
not know the extent to which additional funding may be required to complete the project, even absent any project
delays. BOP eliminated or reduced portions of two projects to remain within the amount that was funded and
plans to use its construction management policies and procedures to control further cost increases and schedule delays.
When awarding the contract for FCI Mendota in 2007, BOP eliminated a UNICOR facility, which would have
provided additional employment and job skills training opportunities for inmates, and the minimum-security
prison camp. At FCI Berlin, BOP eliminated the UNICOR facility when it awarded the contract in 2007, but
subsequently added a smaller UNICOR facility to the project, which will be paid for by UNICOR.
Funding for BOP is lost due to current policies.
Waldman, June 24th, 2009 (Homeland Security Appropriations, http://www.congressmatters.com/tag/Appropriations ,
Daily Whip Line)
Roe - The amendment would reduce Bureau of Prisons (BOP), Salaries and Expenses by $97.4 million, the entire
increase in the bill above the FY10 request. The increase was precisely calculated, based on an in-depth analysis, to
be the minimum amount necessary to restore BOP's base budget. Without this increase, BOP will be unable to
hire additional correctional officers to address a critically low staff-to-prisoner ratio and may not be able to
activate two newly constructed prisons to address 37% overcrowding. Understaffing and overcrowding creates
unsafe conditions for correctional workers and prisoners, and prevents BOP from implementing effective
prisoner reentry programming.
73
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Inherency – BOP Lacks Funding (2/3)
The BOP is underfunded
Mark Peacock Law, June 2009 (USP Atwater-Officer Jose Rivera E.O.W. June 20, 2008-- We Will Never Forget,
http://markpeacocklaw.com/live/ )
WASHINGTON—The union that represents federal correctional officers throughout the Federal Bureau of Prisons’
(BOP) 115 facilities, including Supermax, will hold a press conference in response to new findings in the murder of
Correctional Officer Jose Rivera. At that time, the American Federation of Government Employees (AFGE) and the
Council of Prison Locals (CPL) also will demand immediate action from the BOP to fully staff and fund the agency,
and provide correctional officers with stab resistant vests and non-lethal weaponry such as batons, pepper spray and
TASER guns. An internal BOP investigation found gross inadequacies and unconscionable conditions in the
management and security controls at the United States Penitentiary in Atwater, Calif., which clearly affected the
murder of Rivera. We want our correctional officers to be protected on the job. Immediate action is the only
acceptable outcome.” Federal correctional officers are unarmed and decreasing staffing levels put them at
greater risk of an attack by an inmate. Stab resistant vests and other protective equipment for correctional officers
have become a top priority for CPL since the tragic death of Rivera. For years, AFGE and CPL have been advocates
for additional staffing and funding throughout the BOP in an effort to safely maintain our nation’s prisons and
surrounding communities. Continued lack of funding and inadequate staffing throughout the BOP have left
federal correctional officers and the surrounding communities in grave danger. Staffing levels are decreasing
while inmate population levels are increasing. The union says serious inmate overcrowding and correctional
worker understaffing plague the BOP system nationwide, and create hazardous conditions for federal prison
inmates, federal correctional workers, and the communities in which they work. ### The American Federation of
Government Employees (AFGE) is the largest federal employee union, representing 600,000 workers in the federal
government and the government of the District of Columbia.
Lack of funding in prisons causes a decrease in staffing, this makes violence and death inevitable.
Associated Content, July 2008, (Lewisburg Prison Employees Complain Lack of Funding Places Them at Risk,
http://www.associatedcontent.com/article/868089/lewisburg_prison_employees_complain.html?cat=17 )
As reported by The Daily Item in Sunbury, Pennsylvania, prison workers at the state's Lewisburg Federal
Penitentiary are upset that the need for proper staffing and equipment is not being met. Lewisburg Federal
Penitentiary, a maximum security prison, has been on lockdown since July 2. The publication goes on to report that
cost-cutting has placed Lewisburg in a precarious position as voiced by Tony Liesenfeld, secretary/treasurer of The
American Federation of Government Employees Local 148 at Lewisburg. Liesenfield indicates he no longer "feels
safe" and says "It's all about funding". The Federal Bureau of Prisons has proposed a cut of 143 millions which
affects virtually every aspect of prison safety including proper staffing. Further tension exists when the prison
employees look west to the Allenwood Federal Penitentiary in Atwater, California; The Item continues in its
assessment. During a routine lockup guard Jose Rivera was killed; stabbed to death by two inmates with handmade knives. While the Allenwood tragedy is an isolated incident at this point, it is feared that unless steps are
quickly taken to remedy the prison employees' needs, other major problems could occur in various ways all
across the nation; it would appear to be a national prison crisis.
74
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Inherency – BOP Lacks Funding (3/3)
The Bureau of prisons is experiencing shortfalls, decreasing funding for prisons and eliminating
jobs.
AFGE, 4/14/08, (BUREAU OF PRISONS: FY 2008 FUNDING PROBLEM,
http://www.afge.org/index.cfm?page=bureauofprisons&fuse=content&contentid=1511 )
The Bureau of Prisons (BOP) has informed the AFGE Council of Prison Locals (CPL) that BOP is facing a
projected FY 2008 shortfall of $433 million in its operational “salaries and expenses” account. To help reduce
this shortfall, BOP has identified $143 million in possible reductions, including delaying the opening of the new
Pollock, LA prison, not replacing vehicles and equipment, eliminating overtime, reducing correctional officer
training, etc. But even with these reductions, BOP will be left with $289 million in unfunded “base” spending
requirements – the majority of which are related to correctional officer staffing. BOP has told the CPL that the
agency – despite its strong opposition - will be forced to consider cutting 4,000 BOP correctional staff positions if
BOP does not obtain an additional $289 million in FY 2008 funding via this spring’s FY 2008 supplemental
appropriations bill.
75
Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Inherency – Abstinence Only Approach
Current “abstinence-only” approaches fail, and increased efforts are needed to prevent disease
spread in prisons
Medical News Today online medical journal and news source April 15 2009
http://www.medicalnewstoday.com/articles/146122.php
Increased efforts are needed to curb the spread of HIV and other bloodborne diseases in prisons, "where
infection rates are high and inmates can easily spread disease through unprotected sex or by sharing needles,"
a New York Times editorial says. It adds, "Drug treatment in prison is clearly part of the solution. But by some
estimates, fewer than one in five inmates who need formal treatment are actually getting it." This is "alarming,
given that about half the prison population suffers from drug abuse or dependency problems," according to the
editorial. The editorial continues that the "most effective programs provide inmates with high-quality treatment in
prison and continue that treatment when prisoners return to their communities." In addition, treatment programs "have
been shown to reduce drug use and recidivism," the editorial says.
According to a study in the Journal of the American Medical Association, prisons "typically rely on the abstinenceonly model, which fails miserably with heroin addicts," the editorial says. It adds that "prison officials are
notoriously hostile toward methadone maintenance and other chemically based therapies that have long been a
standard for people addicted to opiates." The editorial says that treatment for drug users in New York state prisons is
"particularly disastrous," according to a new report from Human Rights Watch, which says that drug users in prison
are "typically shut out of treatment until their sentences are nearly over because of ill-conceived policies that
give priority to those who are about to be released."
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Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Courts Have The Authority
Courts have the authority to provide health care to federal prisons under Estelle v Gamble
KIM MARIE THORBURN,(MD)1995: Health care in correctional facilities.
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1303263&blobtype=pdf
During the 1970s, prisoners successfully accessed federal courts to apply constitutional rights to their conditions of
incarceration. In the case Estelle v Gamble (429 US97 [1976]), the United States Supreme Court concluded that
"deliberate indifference to the serious medical needs of prisoners constitutes the 'unnecessary and wanton infliction of
pain,"' in violation of the Eighth Amendment. This landmark case and others that followed established health care as a
constitutional right of correctional inmates. (A glossary of terms used in this article is given in Figure 1.) Organized
medicine also became involved in correctional health care during the time that federal courts were calling for adequate
health services. In 1972 the American Medical Association (AMA) surveyed health services in jails throughout the
United States and found serious deficiencies.' The AMA received a grant from the Law Enforcement Assistance
Administration to develop standards for correctional health services and to start a pilot project of accreditation
programs through state medical associations. This program evolved to a free-standing accreditation group, the
National Commission on Correctional Health Care, which continues to update standards for health services in jails,
prisons, and juvenile facilities.24 Other professional associations, including the American Public Health Association
and the American Correctional Association, also have standards for correctional health services.56
Federal courts can act – there is a legal precedent, support for prison reform, and a mechanism for
implementation
SUSAN P. STURM (Associate Professor of Law, University of Pennsylvania) 1993: ARTICLE:
THE LEGACY AND FUTURE OF CORRECTIONS LITIGATION. Lexis
Most of the case studies of litigation's impact on correctional institutions conclude that courts have had a significant
and positive, though limited, impact. However, several recent works, notably Gerald Rosenberg's The Hollow Hope:
Can Courts Bring About Social Change?, n48 Donald Horowitz's The Courts and Social Policy, n49 and John DiIulio's
Governing Prisons, n50 are quite pessimistic about courts' potential to achieve institutional reform. Because of the
attention these works have attracted and their profoundly negative view of courts' capacity to achieve change in
correctional institutions, n51 these works warrant additional comment. [*653] In The Hollow Hope, Gerald Rosenberg
attempts to develop and test a theory of judicial effectiveness that explains and predicts courts' limited capacity to
produce "significant social reform." He argues that courts are limited by three separate constraints built into the
structure of the American political system: the limited nature of constitutional rights, the lack of judicial
independence, and the judiciary's lack of power of implementation. n52 These constraints can be overcome when: (1)
there is "ample legal precedent for change"; and (2) there is "support for change from substantial numbers in Congress
and from the executive"; and (3) "there is either support from some citizens or at least low levels of opposition from
all citizens" n53 plus at least one of the following four conditions: (a) positive incentives to induce compliance, (b)
costs to induce compliance (c) a market mechanism for implementation, or (d) administrators and officials crucial for
implementation who are willing to act and see court orders as a tool for leveraging additional resources or for hiding
behind. n54
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Courts Solve Best
1. Courts are key – Estelle v Gamble set the precedent for prison health care and allows for the best
possible care
Lester N. Wright, MD, MPH January 2008: Health Care in Prison Thirty
Years After Estelle v. Gamble.
http://www.realcostofprisons.org/materials/healthcare_in_prison_30_years_after_estelle.pdf
Raising access to health care for incarcerated people to a constitutional right radically changed correctional health
care. It also established a constantly changing standard of required care because the right is based on evolving
standards of health care in the general community. A prison system must continually monitor new health care
possibilities and attempt to determine what is required. Correctional health care must consider access, quality, and cost
together as part of a system; this may be easier to do in a clearly defined setting such as corrections than in the
community. Estelle also taught incarcerated people that lawsuits can be used to improve care and to attempt to force
the prison system to provide the care they want.
2. Litigation on prison reform is key to accountability of prisons – media and others
SUSAN P. STURM (Associate Professor of Law, University of Pennsylvania) 1993: ARTICLE:
THE LEGACY AND FUTURE OF CORRECTIONS LITIGATION. Lexis
Litigation has opened corrections institutions to scrutiny by lawyers, judges, state and local agencies, and the media.
Institutions previously insulated from rigorous scrutiny by their remote locations, the lack of public concern over their
inadequacies, and their careful control over public access face regular evaluation by lawyers, state agencies, and the
courts. The sustained presence of outsiders, particularly inmates' lawyers, has reduced some of the more egregious
practices and has led to greater adherence to rules and regulations. n132 In some cases, litigation has led to the
institution of regular inspections by state agencies charged with overseeing [*670] compliance with state health and
safety regulations. Litigation has also generated considerable media coverage of prison conditions. Virtually every
case study reports extensive media coverage of the litigation and the conditions and practices in the targeted
institutions. n133 This media coverage exposed serious abuses and inhumane conditions in correctional institutions, and
is widely credited with increasing public awareness of the inadequacies in correctional institutions and acceptance of
the need for reform. n134
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Ext #1 – Estelle v. Gamble
Courts solve best – treatment standards provided by Estelle v Gamble are enforced and uniform
Lester N. Wright, MD, MPH January 2008: Health Care in Prison Thirty
Years After Estelle v. Gamble.
http://www.realcostofprisons.org/materials/healthcare_in_prison_30_years_after_estelle.pdf
With the expectation that community-level care will be provided in corrections has come the resultant issue of cost. It
is recognized in health care policy that access, quality, and cost must be addressed together. They are interrelated. In
effect, correctional health care has become not merely a “health insurance program” but in reality a “managed care
system.” Managed care has earned itself a bad name in the community because in too many cases it is the bottom line
that is being managed rather than the health care. In corrections, there are a number of technical factors that make it
possible to use the tools of management to improve care, including mandatory enrollment, relatively low turnover in
enrollees, limited provider choice, and a universal budget. However, Estelle results in one essential difference from
the community: A constitutional guarantee of fulfillment of all required health care needs will outweigh management
of the bottom line. Using the tools of management to improve care means, for example, that computerized systems are
used to schedule the 130,000 specialty consults needed last year across New York using regional clinics, most of
which are based in prisons, with services provided by more than 1,000 specialists on contract to us. It means that we
choose to pay the specialist the same amount for his/her time whether the consult is provided in person or through the
use of telemedicine, because we consider the security cost of the medical trips as well as the cost of the specialist’s
encounter. It also means that primary care practice guidelines are developed or adapted in an attempt to achieve
uniformity of care systemwide.
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Ext #2 – Accountability
Court intervention is key to accountability – litigation exposes failings in prisons to the public
resulting in reform
SUSAN P. STURM (Associate Professor of Law, University of Pennsylvania) 1993: ARTICLE:
THE LEGACY AND FUTURE OF CORRECTIONS LITIGATION. Lexis
Corrections litigation has prompted the professionalization of correctional leadership, both in many individual cases
and in the corrections field more generally. n112 Twenty years ago, many correctional administrators had little training
or expertise in management. n113 Often, the corrections commissioners or directors were purely political appointments.
n114
As long as administrators maintained a low profile and avoided major scandals or disturbances, their performance
remained insulated from public scrutiny. The corrections field lacked any effective political or institutional incentives
to develop performance standards and mechanisms for holding administrators accountable. n115
Judicial intervention opened prisons and corrections administrators to public scrutiny and evaluation in relation to
standards of performance. The high visibility of conditions litigation exposed existing management's inability to
respond effectively to judicial requirements that conditions be brought up to minimal standards of decency. In many
cases, this exposure triggered the replacement of correctional leadership with qualified, trained leaders possessing
greater sensitivity to the demands of running constitutional facilities. n116 Litigation challenging the adequacy of
medical care [*666] in correctional institutions has frequently resulted in the involvement of private professional
health providers, such as university medical schools. n117 A national commission on correctional health care now
publishes a quarterly journal, certifies correctional health care professionals, and sponsors regular professional
conferences. n118 Several case studies report that this trend toward professionalization, however, has not permeated the
lower levels of corrections administration. n119 Consequently, some studies link litigation to a widening gap in
perspective between administration and line staff and suggest that this gap has limited the managerial capacity of
corrections administrators. n120 In some systems, lower level staff members have shown considerable resistance to
reform-minded administrators and remarkable ingenuity in their capacity to frustrate the efforts of progressive
administrators. n121 There are [*667] some indications that this gap may be temporary and that the process of
professionalization has begun to affect corrections staff as well. n122
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Courts Solve State Prisons
Federal courts empirically have power over state prisons and have readily used it
William A. Taggart 1989: Redefining the power of the federal judiciary: The impact of courtordered prison reform on state.
http://heinonline.org/HOL/Page?handle=hein.journals/lwsocrw23&collection=journals&page=241
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Courts Solve State Prisons
Federal courts overrule state decisions
Whitehouse.gov 2009
Federal courts enjoy the sole power to interpret the law, determine the constitutionality of the law,
and apply it to individual cases. The courts, like Congress, can compel the production of evidence
and testimony through the use of a subpoena. The inferior courts are constrained by the decisions
of the Supreme Court — once the Supreme Court interprets a law, inferior courts must apply the
Supreme Court's interpretation to the facts of a particular case.
Federal courts have highest authority in federal affairs and interstate affairs
Whitehouse.gov 2009
The Court's caseload is almost entirely appellate in nature, and the Court's decisions cannot be
appealed to any authority, as it is the final judicial arbiter in the United States on matters of federal
law. However, the Court may consider appeals from the highest state courts or from federal
appellate courts. The Court also has original jurisdiction in cases involving ambassadors and other
diplomats, and in cases between states.
States can only appeal to federal courts- jurisdiction reaches over lower state courts
Whitehouse.gov 2009
State judicial branches are usually led by the state supreme court, which hears appeals from lowerlevel state courts. Court structures and judicial appointments/elections are determined either by
legislation or the state constitution. The Supreme Court focuses on correcting errors made in lower
courts and therefore holds no trials. Rulings made in state supreme courts are normally binding;
however, when questions are raised regarding consistency with the U.S. Constitution, matters may
be appealed directly to the United States Supreme Court.
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Courts Test Case – California (1/2)
The time to rule is now – the courts are already engaged with Schwarzenegger over prison health
issues
Bob Egelko (San Francisco Chronicle), June 26, 2009: Governor dumps plans to build prison
hospitals. http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/06/26/MNE718E0D4.DTL
Schwarzenegger issued a statement saying he "cannot agree to spend $2 billion on state-of-the-art medical facilities
for prisoners while we are cutting billions of dollars from schools and health care programs for children and seniors."
As Cate acknowledged, however, the agreement would not have worsened California's $24.3 billion general fund
deficit, the focus of a partisan deadlock in the Legislature that could force the state treasurer to start issuing IOUs to
creditors next week.
The health care money would have come from other sources: bonds for the new hospitals, and already-appropriated
prison construction funds for the renovations to existing medical centers.
'Not backing away'
Cate said the state needs more prison hospital beds but will have to find another way to pay for them. He insisted that
the Schwarzenegger administration is "not backing away from our dedication to improve health care to meet
constitutional standards."
But Thursday's development returns the initiative to federal judges, one of whom has already threatened to order the
state to spend more on prison mental health care.
Another judge has begun contempt-of-court proceedings against Schwarzenegger for defying his order to turn over
$250 million that the Legislature has approved for prison construction, but which the state has not allocated. The state
says federal judges lack authority to order California to spend money on prison construction.
"This will make the courts have to intervene more, because the state has said it won't do even what the secretary
(Cate) says is necessary," said Donald Specter, a lawyer for inmates who sued in 2001 over health care in California's
33 prisons. "It shows, once again ... a completely dysfunctional system."
There was no comment from Clark Kelso, the receiver appointed by a federal judge to manage the state prison health
system. "This is now a matter for the courts," said Luis Patino, Kelso's spokesman.
One death a week
U.S. District Judge Thelton Henderson of San Francisco removed the $1.1 billion health system from state control in
2005, saying an average of one inmate a week was dying because of inadequate care and that the state was unable to
meet constitutional standards.
In a separate case, U.S. District Judge Lawrence Karlton of Sacramento has found prison mental health care grossly
substandard and ordered improvements.
Kelso has submitted a 10-year plan to build between 5,000 and 10,000 hospital beds, at a cost of $4 billion to $8
billion. He reached a tentative agreement with Cate last month to limit the plan to four years, reduce the number of
beds and start returning some management functions to the state.
Schwarzenegger's rejection of the deal was disclosed in a letter from Cate to Kelso, citing the state's "precarious
financial condition" and saying it wasn't clear whether all the new construction was "necessary to achieve
constitutionally adequate medical care."
Federal Courts appeals case pending on prison health care
CBS May 25, 2009: SF Court Rejects Gov. Appeal On Prison Health Care
http://cbs5.com/local/prisoner.health.care.2.967819.html
A federal appeals court in San Francisco Wednesday turned down a bid by Gov. Arnold Schwarzenegger to overturn
an order requiring the state to give a court-appointed receiver a $250 million down payment for improved prison
health care.
The 9th U.S. Circuit Court of Appeals said the order issued by U.S. District Judge Thelton Henderson last October
was not open to appeal because it was not a final ruling.
A three-judge panel said Schwarzenegger and state Controller John Chiang could either appeal the order at a later
stage, after being found in contempt of court, or challenge it in a different proceeding in the receivership case.
Henderson put the prison health care system into receivership in 2005 after concluding that inmate medical care in the
state's overcrowded prisons was so deficient it fell below minimum constitutional standards.
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Courts Test Case – California (2/2)
California Cut Health Care Programs for Prisons and fails without federal court oversight
San Francisco Cronicle 6/25/09
(Bob Egelko, Chronicle Staff Writer, 6/25/09, “Governor dumps plan to build prison hospitals”, http://www.sfgate.com/cgibin/article.cgi?f=/c/a/2009/06/26/MNE718E0D4.DTL)
06-25) PDT SAN FRANCISCO -- Gov. Arnold Schwarzenegger disowned a tentative agreement Thursday to build
prison hospitals to settle lawsuits over shoddy health care for inmates, saying the state won't borrow $1.9 billion for
the effort while it's slashing other services. "It's just not the right time," state Corrections Secretary Matthew Cate said, four
weeks after he announced the plan to build two hospitals for 3,400 inmates, refurbish existing medical centers and start
returning control of prison health care from federal courts to the state. "At this time, we're going to have to live within our
means." Schwarzenegger issued a statement saying he "cannot agree to spend $2 billion on state-of-the-art medical
facilities for prisoners while we are cutting billions of dollars from schools and health care programs for children and
seniors." As Cate acknowledged, however, the agreement would not have worsened California's $24.3 billion general fund
deficit, the focus of a partisan deadlock in the Legislature that could force the state treasurer to start issuing IOUs to creditors
next week. The health care money would have come from other sources: bonds for the new hospitals, and alreadyappropriated prison construction funds for the renovations to existing medical centers.
'Not backing away' Cate said the state
needs more prison hospital beds but will have to find another way to pay for them. He insisted that the Schwarzenegger
administration is "not backing away from our dedication to improve health care to meet constitutional standards." But
Thursday's development returns the initiative to federal judges, one of whom has already threatened to order the state to
spend more on prison mental health care. Another judge has begun contempt-of-court proceedings against Schwarzenegger
for defying his order to turn over $250 million that the Legislature has approved for prison construction, but which the state
has not allocated. The state says federal judges lack authority to order California to spend money on prison construction.
"This will make the courts have to intervene more, because the state has said it won't do even what the secretary
(Cate) says is necessary," said Donald Specter, a lawyer for inmates who sued in 2001 over health care in California's 33
prisons. "It shows, once again ... a completely dysfunctional system." There was no comment from Clark Kelso, the receiver
appointed by a federal judge to manage the state prison health system. "This is now a matter for the
courts," said Luis Patino, Kelso's spokesman.
One death a week U.S. District Judge Thelton Henderson of San Francisco removed the $1.1 billion health
system from state control in 2005, saying an average of one inmate a week was dying because of inadequate care and that the state was unable to meet
constitutional standards. In a separate case, U.S. District Judge Lawrence Karlton of Sacramento has found prison mental health care grossly substandard
and ordered improvements. Kelso has submitted a 10-year plan to build between 5,000 and 10,000 hospital beds, at a cost of $4 billion to $8 billion. He
reached a tentative agreement with Cate last month to limit the plan to four years, reduce the number of beds and start returning some management functions
to the state. Schwarzenegger's rejection of the deal was disclosed in a letter from Cate to Kelso, citing the state's "precarious financial condition" and saying
it wasn't clear whether all the new construction was "necessary to achieve constitutionally adequate medical care."
Population could be cut The letter noted
the governor's proposal to remove 19,000 of California's 170,000 prisoners by transferring undocumented immigrants to federal custody and releasing some
elderly or seriously ill inmates to hospitals, local programs or electronic monitoring. The courts may have more to say about prison population, however. A
three-judge panel, including Henderson and Karlton, has concluded after extensive hearings in San Francisco that overcrowding at the prisons, now filled to
twice their designed capacity, is the chief cause of poor health care. The panel has tentatively ordered the release of between 37,000 and 58,000 inmates to
local custody, treatment programs or parole. The Schwarzenegger administration has said it will appeal any final release order to the U.S. Supreme Court.
Karlton, meanwhile, said at a hearing June 16 that unless the state approved Cate's tentative agreement, or came up with an alternative to improve prison
mental health care in the next three months, "I'm going to start eating into their budget in a real dramatic way."
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AT: State Courts CP
Federal courts are preferred over state courts for prison health legislations – Estelle v Gamble
allows inmates to make charges based on both malpractice and the 8th amendment
Lester N. Wright, MD, MPH January 2008: Health Care in Prison Thirty
Years After Estelle v. Gamble.
http://www.realcostofprisons.org/materials/healthcare_in_prison_30_years_after_estelle.pdf
One other effect of Estelle is the litigation. Although inmates file suits about many aspects of their criminal justice
experience, one of the most common aspects is their health care. Estelle provides the foundation for their suits charging
“deliberate indifference.” In the community, suits against medical providers usually allege “malpractice,” which is really
professional liability for unacceptable outcomes. In correctional health care, most of the lawsuits are filed in federal courts
alleging Eighth Amendment violations, not in state courts alleging malpractice. And federal courts, while enunciating the
distinction between deliberate indifference and malpractice, do issue judgments based on malpractice even though they are
described as deliberate indifference.
Managed care provided by states is inadequate and unconstitutional – federal courts are
responsible to enforce under Estelle v Gamble
IRA P. ROBBINS (Scholar and Professor of Law and Justice, American University, Washington
College of Law) Fall 1999: Managed health care in prisons as cruel and unusual punishment.
Lexis
This is not an isolated case. In an effort to cut costs or to provide constitutionally adequate health care to inmates, an
increasing number of prisons have been using managed care systems [*196] to provide health care. n7 Although the
use of managed care has saved states money, the quality of health care arguably has decreased. Inadequate care has
been a recurring problem in prisons run by private managed health care firms. Consequently, prisoners and staff
continue to complain, and prisoners are filing suits asserting that their constitutional rights have been violated. n8
Courts have evaluated claims of constitutional violations in cases in which prisoners have challenged the adequacy of
their medical treatment under the "deliberate indifference" standard, first announced by the Supreme Court in 1976, in
Estelle v. Gamble. n9 In Estelle, the Supreme Court established that, when prison officials are deliberately indifferent
to the serious medical needs of prisoners, the prisoners' Eighth Amendment right to be free from cruel and unusual
punishment has been violated. n10 In Ancata v. Prison Health Services, n11 for example, the United States Court of
Appeals for the Eleventh Circuit held that, "if necessary medical treatment has been delayed for non-medical reasons,
a case of deliberate indifference has been made out." n12 Financial considerations constitute "non-medical reasons."
n13 Thus, the use of managed care in prisons with the intent of cutting costs may constitute an institutional deliberate
indifference on the part of the prisons.
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AT: Court Intervention  Prison Violence
Court intervention doesn’t cause violence – violence is short lived and brings long term reform
SUSAN P. STURM (Associate Professor of Law, University of Pennsylvania) 1993: ARTICLE:
THE LEGACY AND FUTURE OF CORRECTIONS LITIGATION. Lexis
A number of commentators have observed that litigation contributes, at least in the short run, to inmate violence and
staff demoralization by raising inmates' expectations, undermining prison officials' authority, widening the gap
between administration and staff, and by limiting the discretion of prison officials vis-a-vis inmates. n127 The most
frequently cited studies, however, fail to establish a causal chain between violence and litigation. n128 Others have
attributed violence following litigation to abdication by prison administrators and staff of responsibility for developing
legitimate forms of inmate control to replace the traditional, repressive control mechanisms invalidated by the courts.
n129
Similar short-term [*669] reactions have been observed in connection with purely administrative attempts to
reform prison programs and organization, suggesting that any attempt at prison reform will initially trigger
destabilization and resistance. n130 Case studies analyzing the impact of litigation suggest with virtual unanimity that
even when violence and turmoil occur, they may well be short-lived and may give way to effective and legal methods
of control over inmate behavior. n131
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2AC Death Row Wait Add-On
1. Court intervention leads to the court creating broader interpretation on similar issues – Rhodes v.
Chapman proves
Melvin Gutterman (Professor of Law, Emory University School of Law) 1995: The Contours of
Eighth Amendment Prison Jurisprudence: Conditions of Confinement. Lexis
Rhodes v. Chapman n76 marked the United States Supreme Court's first consideration of a full-fledged Eighth
Amendment claim based upon prison conditions. Although the Court, in Estelle v. Gamble, n77 established that prison
officials had an obligation to provide medical care to its inmates, and that deliberate indifference to their serious
medical needs constituted an "unnecessary and wanton infliction of pain" proscribed by the Eighth Amendment, n78
the decision advanced a relatively narrow principle. Justice Powell, writing for the Rhodes majority, believed he had a
fresh slate on which to consider prison conditions in the context of the Eighth Amendment.
The Rhodes facts unquestionably presented an easy target for criticism of the activist role the federal bench had
assumed. The Southern Ohio Correctional Facility (SOFC), as described by the district court, was "unquestionably a
top-flight, first-class facility." n79 It was atypical of the sort of institutions in which federal courts had ordinarily been
involved. Its only failing was the practice of "double celling" prisoners caused by overcrowding. The overcrowding
did not overwhelm the SOCF's facilities or staff. The food was adequate in every respect. The heating, plumbing and
ventilation were adequate. The cells were substantially free of offensive odor, and the noise in the cellblocks was not
excessive. Overcrowding had not reduced significantly the availability of space for visitation, or for stays in the
dayrooms, nor had it rendered inadequate the library resources, although inmate job opportunities had been "watered
down." There was no indifference to medical or dental needs by the staff, although there were isolated instances of
neglect. Even though violence had increased with the prison population, evidence was lacking that double celling
itself caused greater violence. n80 "Despite these generally favorable findings, the District Court concluded that double
celling at SOCF was cruel and unusual punishment." n81 [*383]
2. Delayed executions are questionably in violation of the eighth amendment – inmates claim
delays constitute torture
Ryan S. Hedges (University of Southern California Law School) 2001: JUSTICES BLIND: HOW
THE REHNQUIST COURT'S REFUSAL TO HEAR A CLAIM FOR INORDINATE DELAY OF
EXECUTION UNDERMINES ITS DEATH PENALTY JURISPRUDENCE. Lexis
In mid-1999, the United States Supreme Court received petitions for writ of certiorari from two death row inmates,
Carey Moore of Nebraska and Thomas Knight of Florida. n3 Having spent nearly twenty and twenty-five years on
death row respectively, n4 these petitioners asked the Court to consider, apart from all other arguments concerning the
death penalty, whether inordinate delay of execution itself violates the Eighth Amendment as "cruel and unusual
punishment." n5 While the narrow issue is not a new one, the Court once again denied certiorari, declining to rule on
the merits of the claim. n6
Although lower courts addressed the issue as early as 1959, n7 the Supreme Court did not acknowledge the claim until
1995 in Lackey v. Texas. n8 Clarence Lackey, who had served seventeen years on death row, would see his name
become legal shorthand for the Eighth Amendment claim he raised in his application for a stay of execution. In a
memorandum respecting the denial of certiorari to Mr. Lackey's petition, Justice Stevens acknowledged the novelty of
the Lackey claim, its legal complexity, and "its potential for far-reaching consequences." n9 He suggested that the two
social purposes served by the death penalty, retribution and deterrence, may not be furthered in the instance of
"prisoners who have spent some seventeen years under a sentence of death." n10 He also noted that penal and medical
experts agree that the dehumanizing effects of a prolonged wait for execution amount to "psychological torture." n11
Finally, Justice Stevens recognized that the highest courts in other countries have found such arguments persuasive;
n12
[*579] these courts have responded by commuting death sentences. n13 The Court granted Mr. Lackey a stay of
execution, pending review of an application for writ of habeas corpus by the district court, but postponed addressing
the Eighth Amendment issue, calling instead for further study in the "laboratories" of lower federal and state courts.
n14
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Ext #1 – Court Intervention  Precedent
Court rulings create a legal precedent which is then more likely to be upheld in future cases
James Spriggs and Thomas Hansford, 2001, Explaining the Overruling of U.S. Supreme Court
Precedent, November, 2001
www.law.berkeley.edu/institutes/csls/precjopfinal.pdf
In addition to acting on their policy preferences, justices on the Court respond to constraints imposed by formal or informal
rules. The Court, first of all, can not realistically overrule all prior decisions with which it disagrees. To do so could quite
possibly undermine the Court’s authority and legitimacy and thus reduce the impact of its opinions (see Gibson, Caldeira, and
Baird 1998; Knight and Epstein 1996; Mondak 1994). The Court may also feel bound to follow precedent so that its
decisions are respected by future Courts (Rasmusen 1994). By changing law incrementally and, at some level heeding
precedent, the Court maximizes the probability of its opinions having greater impact. In this sense, stare decisis may
constitute a self-enforcing norm resulting from the justices’ desire to write efficacious legal doctrine. In sum, the overuse of
the power to overrule precedent can erode the legitimacy of the Court and undermine the impact of its opinions. For this
reason, we argue that justices abide by a set of informal norms regarding the limited appropriate context for the overruling of
precedent.
Future courts will adhere to both the precedent set by the plan and its method of reasoning
Antonin Scalia, Associate Justice, United States Supreme Court. “The Rule of Law as a Law of
Rules,” University of Chicago Law Review FALL, 1989 56 U. Chi. L. Rev. 1175
But in the context of this discussion, that particular value of having a general rule of law is beside the point. For I want
to explore the dichotomy between general rules and personal discretion within the narrow context of law that is made
by the courts. In a [*1177] judicial system such as ours, in which judges are bound, not only by the text of code or
Constitution, but also by the prior decisions of superior courts, and even by the prior decisions of their own court,
courts have the capacity to "make" law. Let us not quibble about the theoretical scope of a "holding"; the modern
reality, at least, is that when the Supreme Court of the federal system, or of one of the state systems, decides a case,
not merely the outcome of that decision, but the mode of analysis that it applies will thereafter be followed by the
lower courts within that system, and even by that supreme court itself. And by making the mode of analysis relatively
principled or relatively fact-specific, the courts can either establish general rules or leave ample discretion for the
future.
The plan establishes a new precedent – it will spill over to other areas
James Spriggs and Thomas Hansford, 2001, Explaining the Overruling of U.S. Supreme Court
Precedent, November, 2001
www.law.berkeley.edu/institutes/csls/precjopfinal.pdf
Second, the norm of stare decisis, as operating through prior legal treatment, influences the Court. A
precedent is at greater risk of being overruled if the Court previously interpreted it in a negative manner.
In addition, particular characteristics of precedents affect the overruling of precedent by helping
structure how justices subsequently interpret and implement opinions. Thus, the greater the consensus
and clarity of a precedent, as seen in its voting and opinion coalitions, the less likely it will be overruled.
The Court, however, appears not to respond to any potential separation-of-powers constraint. In
conclusion, our analysis indicates that Supreme Court justices are constrained decision makers. Justices
are motivated by their policy preferences, but when deciding to overrule cases they are also constrained
by both informal norms and specific precedent characteristics. Indeed, our empirical results indicate that
legal norms exert a stronger substantive influence on the overruling of precedent than the justices’
policy preferences. Thus, one of the principal implications of this research is that legal norms can exert
considerable influence on Supreme Court decision making.
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Ext #2 – Death Row Wait = Torture
Delayed executions amount to torture – under the 8th amendment
Ryan S. Hedges (University of Southern California Law School) 2001: JUSTICES BLIND: HOW
THE REHNQUIST COURT'S REFUSAL TO HEAR A CLAIM FOR INORDINATE DELAY OF
EXECUTION UNDERMINES ITS DEATH PENALTY JURISPRUDENCE. Lexis
The Lackey petitioner may make two distinct Eighth Amendment claims. The first is that an inordinate amount of
time spent on death row constitutes "psychological torture" and is itself cruel and unusual punishment. n132 In this
analysis, the time a capital defendant serves in the shadow of death is scrutinized separately and apart from the death
sentence itself. Such punishment cannot survive modern Eighth Amendment analysis and the appropriate remedy is
commuting the sentence to life imprisonment. The second claim argues that executing an individual after inordinate
delay retains no penological justification. In Gregg v. Georgia, the Court determined that capital punishment could be
justified by the [*597] social and penological purposes of retribution and deterrence. n133 Both of these justifications
are frustrated by an inordinate delay between sentencing and execution; at some point, the frustration becomes so
severe that executing the prisoner furthers neither purpose. Under Furman v. Georgia, when a punishment serves no
penological purpose more effectively than a less severe punishment, it is unreasonably excessive and thus prohibited
by the Eighth Amendment. n134 The appropriate remedy in this instance is also commutation to life imprisonment.
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AT: Court Overrule
1. Courts won’t overrule – our plan follows the precedent of Estelle v. Gamble
James Spriggs and Thomas Hansford, 2001, Explaining the Overruling of U.S. Supreme Court
Precedent, November, 2001
www.law.berkeley.edu/institutes/csls/precjopfinal.pdf
The traditional view of the overruling of precedent, moreover, is that it is causally linked to past Supreme Court
treatments of the precedent (Ball 1978; Ulmer 1959). The Court’s reliance on a precedent to justify subsequent
decisions (i.e., positive treatment) should institutionalize a precedent and reduce the likelihood of it being overruled in
the future. Ulmer (1959), for example, concludes that if opinions were previously followed at least two times then
they were less likely to be overruled. Wahlbeck (1997) shows that the probability of restrictive legal change decreases
when the Court had ruled consistently in the past. We further expect that the Court’s prior negative treatment of a
precedent makes it less costly for the Court to overrule it. It does so by influencing the justices’ beliefs about the
likely impact that the overruling of precedent will have on the legitimacy and ultimate impact of the Court’s opinions.
Conventional wisdom, for example, suggests that the Court is more likely to overrule a precedent that has been
gradually undermined by being negatively interpreted in a series of cases. According to Justice Douglas: “Commonly
the change extended over a long period; the erosion of a precedent was gradual. The overruling did not effect an
abrupt change in the law; it rather recognized a fait accompli” (Douglas [1949] 1979, 524). Based on our expectation
that the overruling of a precedent depends in part on the Court’s past interpretations of that case: Hypothesis 3a: The
more often the Court has treated a precedent positively (i.e., expressly followed the precedent), the less likely the
precedent will be overruled. Hypothesis 3b: The more often the Court has treated a precedent negatively (e.g., by
distinguishing or limiting it), the more likely the precedent will be overruled.
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AT: Congress Rollback
1. Prison reform initiatives have widespread support in Congress and in lobbies
Culpepper ‘9 (Lamar Culpepper is a former board member and Chairman, Board of Directors,
Rosebud Advocaacy (f.k.a. Rosebud Foundations, June 13th 2009, ‘Testimony at Senate Hearing
on National Prison reform’, http://www.examiner.com/x-7357-Atlanta-Criminal-RehabilitationExaminer~y2009m6d13-Testimony-at-Senate-Hearing-on-national-prison-reform)
The U.S. Senate Committee on the Judiciary, Subcommittee on Crime and Drugs convened a hearing on proposed national
prison reform legislation. Virginia Senator Jim Webb introduced bill S.714 in March to create a commission to thoroughly
review the entire criminal justice system and make recommendations for reform in several areas of significant concern. (See
related article: ‘Senator Jim Webb proposes 2009 national prison reform.’) Since being introduced, the bill already has
widespread support with 29 cosponsors in the Senate including Chairman of the Senate Judiciary Committee, Senator Patrick
Leahy (D-VT), Chairman of the Subcommittee on Crime and Drugs Senator Arlen Specter (D-PA) and Ranking Member
Senator Lindsey Graham (R-SC), and Judiciary Committee member Senator Orrin Hatch (R-UT). Numerous organizations,
currently numbering 42, now endorse the legislative endeavor with interest continuing to expand as public awareness
increases.
2. Congress won’t rollback anything that they are in favor of even if it violates separation of powers
James Spriggs and Thomas Hansford, 2001, Explaining the Overruling of U.S. Supreme Court
Precedent, November, 2001
www.law.berkeley.edu/institutes/csls/precjopfinal.pdf
The third relevant institutional rule is the American political system’s reliance on separation of powers and checks and
balances. These formal rules provide the broader political environment with the potential to constrain the Court and thus
create a context in which the Court’s behavior may be dependent on the actions of the elected branches of government.
Congress, in particular, possesses a variety of tools that can be used in response to a Court opinion (see Eskridge 1991). For
this reason, scholars commonly argue that the Court acts strategically to prevent negative responses from Congress. That is,
while the Court makes decisions and writes opinions as close as possible to its true preferences, it must also anticipate and
preemptively defuse possible congressional and presidential responses (Hansford and Damore 2000; Spiller and Gely 1992;
cf. Segal 1997). The Court may thus consider Congress’ and the President’s agreement with a precedent in deciding whether
to overrule it. Thus, we expect: Hypothesis 4: The closer ideologically the prevailing political environment is to the precedent
the less likely the precedent will be overruled.
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2AC Death Penalty Add-on 1/2
1. Court intervention leads to the court creating broader interpretation on similar issues – Rhodes v.
Chapman proves
Melvin Gutterman (Professor of Law, Emory University School of Law) 1995: The Contours of
Eighth Amendment Prison Jurisprudence: Conditions of Confinement. Lexis
Rhodes v. Chapman n76 marked the United States Supreme Court's first consideration of a full-fledged Eighth
Amendment claim based upon prison conditions. Although the Court, in Estelle v. Gamble, n77 established that prison
officials had an obligation to provide medical care to its inmates, and that deliberate indifference to their serious
medical needs constituted an "unnecessary and wanton infliction of pain" proscribed by the Eighth Amendment, n78
the decision advanced a relatively narrow principle. Justice Powell, writing for the Rhodes majority, believed he had a
fresh slate on which to consider prison conditions in the context of the Eighth Amendment.
The Rhodes facts unquestionably presented an easy target for criticism of the activist role the federal bench had
assumed. The Southern Ohio Correctional Facility (SOFC), as described by the district court, was "unquestionably a
top-flight, first-class facility." n79 It was atypical of the sort of institutions in which federal courts had ordinarily been
involved. Its only failing was the practice of "double celling" prisoners caused by overcrowding. The overcrowding
did not overwhelm the SOCF's facilities or staff. The food was adequate in every respect. The heating, plumbing and
ventilation were adequate. The cells were substantially free of offensive odor, and the noise in the cellblocks was not
excessive. Overcrowding had not reduced significantly the availability of space for visitation, or for stays in the
dayrooms, nor had it rendered inadequate the library resources, although inmate job opportunities had been "watered
down." There was no indifference to medical or dental needs by the staff, although there were isolated instances of
neglect. Even though violence had increased with the prison population, evidence was lacking that double celling
itself caused greater violence. n80 "Despite these generally favorable findings, the District Court concluded that double
celling at SOCF was cruel and unusual punishment." n81 [*383]
2. The death penalty is evaluated under the eighth amendment
Ryan S. Hedges (University of Southern California Law School) 2001: JUSTICES BLIND: HOW
THE REHNQUIST COURT'S REFUSAL TO HEAR A CLAIM FOR INORDINATE DELAY OF
EXECUTION UNDERMINES ITS DEATH PENALTY JURISPRUDENCE. Lexis
The political nature of imposing the death penalty has been a source of consternation for Supreme Court Justices,
inspiring some of the most impassioned judicial rhetoric ever written. n38 However, regardless of an [*584] individual
Justice's opinion, because of the textual "obstacle" and the pillars of federalism, separation of powers, and judicial
restraint, the Court has never held capital punishment unconstitutional per se. n39 The Court has instead applied a caseby-case and statute-by-statute analysis in determining the constitutionality of capital punishment as it is practiced. n40
Whether attacks on the constitutionality of a death sentence challenge due process or the method of execution, the
Court tends to review them under the Eighth Amendment. n41 While there have been a few instances where the Court
has found methods of execution "inhuman and barbarous," n42 and even though the Court recognizes that this standard
is progressive and constantly evolving, n43 attacks on a death sentence have been most successful when challenging the
discretion of the sentencing authority. Thus, statutes that provide for mandatory death sentences or too little discretion
in sentencing have been rejected by the Court because they do not take into account the uniqueness and potentially
mitigating circumstances of each case. n44 In Lockett v. Ohio, the Court expressly held that because of the
"nonavailability of corrective or modifying mechanisms [*585] with respect to an executed capital sentence," the
sentencer in a capital case shall "not be precluded from considering, as a mitigating factor, any aspect of a defendant's
character or record and any of the circumstances of the offense that the defendant proffers as a basis for a sentence
less than death." n45
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2AC Death Penalty Add-on 2/2
3. We have a moral obligation to eliminate the death penalty – it reinforces the use of slave labor for
the profit of the state by allowing the government to eliminate all who resist it
Silvia Federici and George Caffentzis, Monthly Review, July/August, Proquest, 2001
The death penalty clearly has many other political uses for the globalization agenda. First, it is a political weapon
against revolutionaries. The case of Mumia Abu-Jamal is indicative here. Like Joe Hill, and Sacco and Vanzetti,
Mumia is on death row while embodying a movement that has been identified as the major threat to the status quo and
his case is supposed to teach a lesson to others aspiring to this role. In this sense, capital punishment plays the role that
political assassination has played in other countries (death squads of Argentina, El Salvador and Guatemala) or in
other times in the United States (the COINTELPRO). [11]
Second, the death penalty is crucial in the reconstruction of an apartheid society, by instilling in people the belief in
the existence of two categories of human being--or better, a belief that some are not human at all. It literally constructs
the image of people who cannot be rescued or rehabilitated and consequently who have lost all rights, since their
humanity is gone (if they ever possessed it). The most important power of any capitalist political project is its ability
to create divisions and hierarchies within the working class. The problem for capital is equality among workers, which
might produce unity against their exploiters. This was a wisdom learned early on by capitalists in the Americas who,
though tempted to treat all "servants" as not-fully-human robots, realized that they had to differentiate "servants" into
a wide variety of types (especially racial and sexual) to keep them from forming insurrectional associations (as in
Bacon's rebellion) [12]
The death penalty has been an active force of division and not a passive reflection of popular views on justice. It has
created the bogus sense of the animalistic and/or demonic enemies within, who by the simple fact that they inhabit
death row, become in the popular imagination objects of ultimate blame and legitimate extirpation. It therefore
exonerates capital and the state from responsibility for the most devastating of crimes (e.g., environmental hazards and
workplace accidents) and for the social conditions that stimulate crimes committed by proletarians [13]
Third, the death penalty is a crucial pillar of mass incarceration and the attendant use of prison labor for the state's
consumption or private profit. The large-scale use of slave-like forms of labor in the prisons inevitably leads to
resistance, and the sanctioning of the death penalty makes it possible to punish prisoners in rebellion, as in Attica in
1971. For the administrators of the plantation prison economy, it is only logical to assume that in the final analysis the
only control they can impose on long-term prisoners is the ultimate penalty: death.
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Ext #3 – Impact
Death Penalty Manages Our Culture's Fear of Mortality Through Human Sacrafice
Donald P. Judges (Professor of Law, University of Arkansas) Fall, 1999: U.C. Davis Law
Review (33 U.C. Davis L. Rev 155) pp. 164-6
Terror management theory's central claim is that culture offers not only direct but also symbolic defense against such
threats and their concomitant extreme anxiety. Culture directly seeks to reduce the risk of injury and mortality through
a variety of familiar mechanisms. For example, criminal, civil, and regulatory laws attempt to control health- and lifethreatening activities, and medical [*165] science combats disease-related threats. Such protections, including the
penological goals of deterrence and incapacitation, are tangible. Ultimately, however, no cultural institution can
completely insulate one from harm; in the end death claims us all. Culture therefore performs the additional necessary
function of offering "a symbolic means of minimizing [the] existential terror" that awareness of this grim reality
elicits. n32
My central point is that capital punishment functions more as symbolic protection against fear of death awareness than
direct, tangible protection against physical harm itself. As described below, it performs that function as an act of ritual
human sacrifice. n33
The need for symbolic protection against fear of death is well recognized. Describing what Otto Rank referred to as
"immortality systems," for example, Robert Jay Lifton observed that "we thus seek a sense of immortality, of living
on in our children, works, human influences, religious principles, or in what we look upon as eternal nature." n34
Lifton expressly tied this concept to statesanctioned homicide, and, moreover, a strong sense of symbolic immortality
is empirically associated with less self-reported fear of death and reduced manifestation of fear of death awareness. n35
Existential terror is moderated cultural worldview, an individualized version of which we acquire through
socialization. n36 Faith in and adherence to the standards embodied in one's worldview defend against existential terror
in two ways. First, cultural worldviews contain a religious component that promises actual immortality conditioned on
observance of prescribed standards. n37 Second, [*166] culture offers symbolic immortality through association with
institutions, religious and secular, that are more enduring than one's own corporeal self. Identification with such
institutions assures that an important aspect of one's being will continue to exist after physical death. In general, then,
successful management of the potential terror of death awareness depends on the extent to which the individual
embraces an operative cultural worldview. People experience less anxiety in the face of mortality awareness when
they enhance their self-esteem by defending their worldviews. Symbolic-cultural institutions and activities, both
religious and secular, play a central role in worldview defense. Indeed, the terror management effect has been
explicitly tied to the phenomenon of American civil religion. n38 I contend that both that effect and that phenomenon
manifests in capital-punishment-as-ritual-human-sacrifice. And research outside the terror management field indicates
that support for capital punishment derives more from basic worldview than from specific beliefs and attitudes about
crime. n39
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Removing Death Penalty Solves Biopower
Eliminating the death penalty is key to solving biopower
CARY FEDERMAN (University of Ljubljana) DAVE HOLMES (University of Ottawa) 2005:
BREAKING BODIES INTO PIECES: TIME, TORTURE AND BIO-POWER.
http://www.springerlink.com/content/f6kv4516j4161451/fulltext.pdf
Power over life is situated bureaucratically within prisons and the deathwatch. How is this power organized? BOP
protocol states: ‘‘Not all of the persons involved need to practice together’’ (2001: 9). ‘‘Individual teams will practice
as units, with inter-team practices scheduled, as necessary by the Warden, to facilitate coordination and smooth
interaction.’’ A republican, seemingly egalitarian, form of government is firmly in place during the deathwatch, yet
one that accommodates hierarchy and whose sole concern is the regulation of a captive population, the smooth
administration of death to the convicted. The assembly-line approach to death management in American prisons is a
supervisory technique for the mortification of prisoners. The intended beneficiaries are doctors, nurses, and
bureaucrats who bear the burden of bringing the inmate to the death chamber.
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
2AC AT: Solvency Takeouts (8th Specific)
1. Court intervention leads to the court creating broader interpretation on similar issues – Rhodes v.
Chapman proves
Melvin Gutterman (Professor of Law, Emory University School of Law) 1995: The Contours of
Eighth Amendment Prison Jurisprudence: Conditions of Confinement. Lexis
Rhodes v. Chapman n76 marked the United States Supreme Court's first consideration of a full-fledged Eighth
Amendment claim based upon prison conditions. Although the Court, in Estelle v. Gamble, n77 established that prison
officials had an obligation to provide medical care to its inmates, and that deliberate indifference to their serious
medical needs constituted an "unnecessary and wanton infliction of pain" proscribed by the Eighth Amendment, n78
the decision advanced a relatively narrow principle. Justice Powell, writing for the Rhodes majority, believed he had a
fresh slate on which to consider prison conditions in the context of the Eighth Amendment.
The Rhodes facts unquestionably presented an easy target for criticism of the activist role the federal bench had
assumed. The Southern Ohio Correctional Facility (SOFC), as described by the district court, was "unquestionably a
top-flight, first-class facility." n79 It was atypical of the sort of institutions in which federal courts had ordinarily been
involved. Its only failing was the practice of "double celling" prisoners caused by overcrowding. The overcrowding
did not overwhelm the SOCF's facilities or staff. The food was adequate in every respect. The heating, plumbing and
ventilation were adequate. The cells were substantially free of offensive odor, and the noise in the cellblocks was not
excessive. Overcrowding had not reduced significantly the availability of space for visitation, or for stays in the
dayrooms, nor had it rendered inadequate the library resources, although inmate job opportunities had been "watered
down." There was no indifference to medical or dental needs by the staff, although there were isolated instances of
neglect. Even though violence had increased with the prison population, evidence was lacking that double celling
itself caused greater violence. n80 "Despite these generally favorable findings, the District Court concluded that double
celling at SOCF was cruel and unusual punishment." n81 [*383]
2. {solves random DA on case or solvency deficit: insert what you want}
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Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Racial Disparity in the Justice System
Massive racial disparity in the Justice system- empirical studies
John M. Hagedorn, editor of racialdisparity.org, 2009
It is important to understand the meaning of the term “racial disparity.” Racial disparity in the criminal justice system
exists whenever the proportion of a racial/ethnic group within the control of the system is greater than the proportion
of that group within the general population. For example, in 1999 African Americans represented 3.5% of
Minnesota’s population, but 35% of the adult male prison population. This is clear evidence of a racial disparity in
Minnesota’s prison population. However, it is not evidence in and of itself, that the disparity is the result of racial bias. The racial disparity in the justice
system can stem from a number of different causes including socioeconomic factors, difference in crime rates, cultural
norms, and racial bias. While a portion of the Council’s research was devoted to examining crime rates, it was
primarily focused on identifying what portion of the disparity, if any, could be attributed to racial bias within the
justice system. Racial bias can occur at either the individual or institutional level and can be intentional or unintentional.
The Council’s focus was on institutional bias which most often takes the form of a policy or practice that has greater
negative consequences for persons of color than for Whites.
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No current efforts to solve
No current efforts to decrease racial disparity
John M. Hagedorn, editor of racialdisparity.org, 2009
Despite the diverse nature of the research that was conducted under the Racial Disparity Initiative, two themes were
consistently present. First, people of color who live in high crime areas fear victimization and express a need for
increased public safety yet empathize with offenders and the struggles that they face upon release from incarceration.
This balanced perspective provides a unique opportunity to develop community driven responses to crime and
provide support for ex-offenders. To capture this opportunity is very important. As communities faced with absorbing
the ever growing population of ex-offenders become politically disenfranchised, lose commercial investment, and
develop a transient nature, their ability to effectively support returning offenders, for example, becomes sharply
limited (Council: Collateral Effects, 2006).3 Second, there is a lack of consistent, effective dialogue between the
justice system and communities of color; a fundamental necessity to addressing the racial disparity in the justice
system while enhancing public safety within these communities. Throughout the Council’s research, both justice system and community
interviewees spoke to the need to work together to decrease the racial disparity. However, both groups also felt that this is not currently taking place in
any meaningful ongoing way
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Longer Sentences
Black Americans serve longer sentences for offences- empirical studies
John M. Hagedorn, editor of racialdisparity.org, 2009
The total number of jail bookings for 18 – 30 year old black men was 1.8 times higher than jail bookings of white men
of the same age, 12,726 total bookings for blacks and 6934 total bookings for whites. These numbers reflect booking
episodes, a individual person may be booked multiple times with each of those bookings counted in the total. The 15
most common charges for which African Americans were booked are given in Table X. Three of the charges
(weapons, lurking, and trespassing) are not among the 15 charges with the most bookings for whites. The 15 charges
with the most bookings for whites include DWI, aggravated DWI, aggravated driving and public consumption,
charges that are not included in the top 15 for blacks. The length of time that 18 to 30 year-old African Americans stay
in jail is longer than whites. This is particularly true for certain crimes such as narcotics, crimes against the
person, property crimes and weapon violations. This is true for both the unadjusted and the adjusted averages. The
adjusted average was calculated by removing cases that exceed three standard deviations from the unadjusted mean.
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Discrimination makes poverty inevitable
Racial disparity of the justice system makes poverty inevitable- multiple warrants
John M. Hagedorn, editor of racialdisparity.org, 2009
Many employers, however, find it difficult to accurately assess a criminal
record and are uninformed of the laws protecting applicants from discrimination.6 As criminal
records are not easily understood (due to frequent use of abbreviations and technical language)
employers struggle to ascertain the context and disposition of a criminal charge. For example,
those individuals with an arrest that did not lead to a conviction, including an arrest-only record,
are not easily distinguishable from those with convictions, serving to severely limit their
employability and capacity to become productive citizens.7 Furthermore, since arrests that often
do not lead to a conviction, such as for lurking and loitering, are known to disproportionately
involve persons of color, the racial disparities at point of first contact cause the collateral
consequences to fall disproportionately on populations of color (Council: Low Level Offenses,
2004).
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Black Hyper-Incarceration
Black incarceration rates skyrocketing
LOÏC WACQUANT-University of California, Berkeley, No Date Given
Three brute facts stare the sociologist of racial inequality and imprisonment in America in the face as the new millenium
dawns. First, since 1989 and for the first time in national history, African Americans make up a majority of those walking
through prison gates every year. Indeed, in four short decades, the ethnic composition of the US inmate population has
reversed, turning over from 70 percent white at the mid-century point to nearly 70 percent black and Latino today, although
ethnic patterns of criminal activity have not been fundamentally altered during that period (LaFree et al., 1992; Sampson
and Lauritzen, 1997). Second, the rate of incarceration for African Americans has soared to astronomical levels unknown in
any other society, not even the Soviet Union at the zenith of the Gulag or South Africa during the acme of the violent
struggles over apartheid. As of mid-1999, close to 800,000 black men were in custody in federal penitentiaries,
,a
figure corresponding to one male out of every twenty-one(4·6 percent) and one out of every nine ages 20 to 34 (11·3
percent). An additional 68,000 black women were locked up, a number higher than the total carceral population of any one
major western European country (Beck, 2000).1Several studies, starting with a series of well-publicized reports by the
Sentencing Project, have documented that, on any given day, upwards of one-third of African-American men in their
twenties find themselves behind bars, on probation or on parole (Donziger, 1996: 104–5). And, at the core of the for- merly
industrial cities of the North, this proportion often exceeds two-thirds.
state prisons and county jails
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Torture
Not only to Black Americans have substantial rates of incarceration, but physical pain is inflicted
solely on Black Americans in prisons
(Craig Haney Department of Psychology and Philip Zimbardo Department of Psychology Stanford
University 1998)
The aggregate statistics describing the extraordinary punitiveness of the U.S. criminal justice system
mask an important fact: The pains of imprisonment have been inflicted disproportionately on minorities,
especially Black men. Indeed, for many years, the rate of incarceration of White men in the United
States compared favorably with those in most Western European nations, including countries regarded
as the most progressive and least punitive (e.g., Dunbaugh, 1979 ). Although in recent years the rate of
incarceration for Whites in the United States has also increased and no longer compares favorably with
other Western European nations, it still does not begin to approximate the rate for African Americans.
Thus, although they represent less than 6% of the general U.S. population, African American men
constitute 48% of those confined to state prisons. Statistics collected at the beginning of this decade
indicated that Blacks were more than six times more likely to be imprisoned than their White
counterparts ( Mauer, 1992 one-half times ( Bureau of Justice Statistics, 1996 men at a rate that is
approximately four times the rate of incarceration of Black men in South Africa ( King, 1993 ). All races
and ethnic groups and both sexes are being negatively affected by the increases in the incarcerated
population, but the racial comparisons are most telling. The rate of incarceration for White men almost
doubled between 1985 and 1995, growing from a rate of 528 per 100,000 in 1985 to a rate of 919 per
100,000 in 1995.6 of 24 10/8/01 6:31 PM The impact of incarceration on African American men, Hispanics,
and women of all racial and ethnic groups is greater than that for White men, with African American
men being the most profoundly affected. The number of African American men who are incarcerated
rose from a rate of 3,544 per 100,000 in 1985 to an astonishing rate of 6,926 per 100,000 in 1995. Also,
between 1985 and 1995, the number of Hispanic prisoners rose by an average of 12% annually (
Mumola & Beck, 1997 ). (Additional data on some of the disparities in imprisonment between Whites
and Blacks in the United States can be found in the Appendix , Tables A3 and A4 , and Figure A2 .)
PsycARTICLES http://spider.apa.org:80/plweb/fulltext/in...066X.53.7.709&CFID=777706&CFTOKEN=16890114
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The “Supermax” of Federal Prisons
Prisons are dangerously overcrowded, lacking education, and healthcare- this escalates to a form of
genocide for Black Americans in prisons
(Craig Haney Department of Psychology and Philip Zimbardo Department of Psychology Stanford
University 1998)
In addition to becoming dangerously overcrowded and populated by a disproportionate number of
minority citizens and drug offenders over the past 25 years, many U.S. prisons also now lack meaningful
work, training, education, treatment, and counseling programs for the prisoners who are confined in
them. Plagued by increasingly intolerable living conditions where prisoners serve long sentences that
they now have no hope of having reduced through "good time" credits, due to laws imposed by state
legislatures, many prison officials have turned to punitive policies of within-prison segregation in the
hope of maintaining institutional control (e.g., Christie, 1994 ; Haney, 1993a ; Haney & Lynch, 1997 ;
Perkinson, 1994 ). Indeed, a penal philosophy of sorts has emerged in which prison systems use longterm solitary confinement in so-called supermax prisons as a proactive policy of inmate management.
Criticized as the "Marionization" of U.S. prisons, after the notorious federal penitentiary in Marion,
Illinois, where the policy seems to have originated ( Amnesty International, 1987 ; Olivero & Roberts,
1990 ), one commentator referred to the "accelerating movement toward housing prisoners officially
categorized as violent or disruptive in separate, free-standing facilities where they are locked in their
cells approximately 23 hours per day" ( Immarigeon, 1992 , p. 1).
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Racism is unacceptable
Racism functions to prevent us from reaching human potential, make poverty inevitable, and
slowly destroy society.
(Joseph Barndt, Methodist Minister 1991)
To study racism is to study walls. We have looked at barriers and fences, restraints and limitations, ghettos and
prisons. The prison of racism confines us all, people of color and white people alike. It shackles the victimizer as well
as the victim. The walls forcibly keep people of color and white people separate from each other in our separate
prisons. We are all prevented from achieving human potential that God intends for us. The limitations imposed
on people of color by poverty, subservience, and powerlessness are cruel, inhumane, and unjust; the effects of
uncontrolled power, privilege, and greed, which are the marks of our white prison, will inevitably destroy us as well.
But we have also seen that the walls of racism can be dismantled. We are not condemned to an inexorable fate, but
are offered the vision and possibility of freedom. Brick by brick, stone by stone, the prison of individual, institutional,
and cultural racism can be destroyed. You and I are urgently called to join the efforts of those who know it is time to
tear down once and for all, the walls of racism.
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The Solution
The Solution is clear- we must rethink policy decisions to make prisons more humane, this
includes increased healthcare and education in prisons
(Craig Haney Department of Psychology and Philip Zimbardo Department of Psychology Stanford
University 1998)
The policy implications of these observations seem clear. For one, because of their harmful potential,
prisons should be deployed very sparingly in the war on crime. Recognition of the tendency of prison
environments to become psychologically damaging also provides a strong argument for increased and
more realistic legal and governmental oversight of penal institutions in ways that are sensitive to and
designed to limit their potentially destructive impact. In addition, it argues in favor of significantly
revising the allocation of criminal justice resources to more seriously explore, create, and evaluate
humane alternatives to traditional correctional environments.
This includes the healthcare and education provided by the plan
(Vickie L. Shavers and Brenda S. Shavers, Journal of the National Medical Association, 1996)
Research reports often cite socioeconomic status as an underlying factor in the pervasive disparities in
health observed for racial/ethnic minority populations. However, often little information or
consideration is given to the social history and prevailing social climate that is responsible for
racial/ethnic socioeconomic disparities, namely, the role of racism/racial discrimination. Much of the
epidemiologic research on health disparities has focused on the relationship between
demographic/clinical characteristics and health outcomes in main-effects multivariate models. This
approach, however, does not examine the relationship between covariate levels and the processes that
create them. It is important to understand the synergistic nature of these relationships to fully understand
the impact they have on health status. PURPOSE: A review of the literature was conducted on the role
that discrimination in education, housing, employment, the judicial system and the healthcare system
plays in the origination, maintenance and perpetuation of racial/ethnic health disparities to serve as
background information for funding Program Announcement, PA-05-006, The Effect of Racial/ Ethnic
Discrimination/Bias on Healthcare Delivery (http:// grants.nih.gov/grants/ guide/pa-files/PA-05006.html). The effect of targeted marketing of harmful products and environmental justice are also
discussed as they relate to racial/ethnic disparities in health. CONCLUSION: Racial/ethnic disparities in
health are the result of a combination of social factors that influence exposure to risk factors, health
behavior and access to and receipt of appropriate care. Addressing these disparities will require a system that
promotes equity and mandates accountability both in the social environment and within health delivery
systems.
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States Fail (1/2)
States can no longer manage prisons and have begun to close them
New York Times “To Trim Costs, States Relax Hard Line on Prisons” March 25, 2009. Lexis
For nearly three decades, most states have dealt with lawbreakers in two ways: lock more of them up for longer
periods, and build more prisons to hold them. Now many governments, out of money and buried under mounting
prison costs, are reversing those policies and practices. Some states, like Colorado and Kansas, are closing prisons.
Others, like New Jersey, have replaced jail time with community programs or other sanctions for people who violate
parole. Kentucky lawmakers passed a bill this month that enhances the credits some inmates can earn toward release.
Michigan is doing a little of all of this, in addition to freeing some offenders who have yet to serve their maximum
sentence. And last Wednesday, Gov. Bill Richardson of New Mexico, a Democrat, signed legislation to repeal the
state's death penalty, which aside from ethical concerns was seen as costly. Being tough on crime and sentencing has
long been the clear path toward job retention for state lawmakers -- Republicans and Democrats alike. But the
economic crisis is forcing them to take a more pragmatic approach as prisoners are increasingly seen less as indistinct
wrongdoers and more as expenses that must be reined in. ''When state budgets are flush,'' said Barry Krisberg,
president of the National Council on Crime and Delinquency, ''prisons are something that governors and legislators all
support, and they don't want to touch sentencing reform. But when dollars are as tight as they are now, you have to
make really tough choices. And so now things are in play.'' Recessions tend to prompt changes to corrections policies.
After the recession at the start of this decade, numerous states enacted laws eliminating some long mandatory
minimum sentences; several began to offer early release and treatment options to some drug offenders. Those
changes, though, were far less reaching than what is happening now and did little to curb exploding corrections
budgets. In the past 20 years, correction department budgets have quadrupled and are outpacing every major spending
area outside health care, according to a recent report by the Pew Center on the States. With 7.3 million Americans in
prison, on parole or under probation, states spent $47 billion in 2008, the study said. Faced with such costs, even
states known for being particularly tough on crime are revisiting their policies and laws.
The courts have ruled that state prison health care has failed and is turning over control to the
federal government
Los Angeles Times “CALIFORNIA; State loses bid on healthcare plan for inmates; A judge refuses to drop court
oversight despite improvements, saying he has 'no confidence' progress will continue.” March 25, 2009
A federal judge Tuesday rejected a bid by Gov. Arnold Schwarzenegger and state Atty. Gen. Jerry Brown to end
court oversight of healthcare in state prisons and to drop construction plans for inmate medical facilities estimated to
cost up to $8 billion. U.S. District Judge Thelton Henderson, who seized control of the prison health system in 2006,
wrote in a 24-page decision that the state had not proved it would, on its own, bring the quality of care up to standards
consistent with inmates' constitutional rights. His ruling escalated the showdown between state officials and the
federal courts over conditions in California prisons. Brown and Schwarzenegger's aides said they would seek to have
the decision overturned by the U.S. 9th Circuit Court of Appeals.
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States Fail (2/2)
31 states have announced problems with prisons and have began to close them
USA TODAY “To save money on prisons, states take a softer stance; Critics see threat to public safety” March 18, 2009.
Lexis
As 31 states report budget gaps that the National Governors Association says totaled nearly $30 billion last year,
criminal justice officials and lawmakers are proposing and enacting cost-cutting changes across the public safety
spectrum, with uncertain ramifications for the public. There is no dispute that the fiscal crisis is driving the changes,
but the potential risks of pursuing such policies is the subject of growing debate. While some analysts believe the
philosophical shift is long overdue, others fear it could undermine public safety. Ryan King of The Sentencing
Project, a group that advocates for alternatives to incarceration, says the financial crisis has created enough "political
cover" to fuel a new look at the realities of incarcerating more than 2 million people and supervising 5 million others
on probation and parole. "It's clear that locking up hundreds of thousands of people does not guarantee public safety,"
he says. Joshua Marquis, a past vice president of the National District Attorneys Association, agrees the economy is
prompting an overhaul of justice policy but reaches a very different conclusion about its impact on public safety.
"State after state after state appears to be waiting for the opportunity to wind back some of the most intelligent
sentencing policy we have," Marquis says. "If we do this, we will pay a price. No question." Among recent state
actions: *Kansas officials closed two detention facilities last month to save about $3.5 million. A third will be
shuttered by April 1, says Roger Werholtz, chief of the state prison system. Inmates housed in the closed units will be
moved to other facilities in the state. *A California panel of federal judges recommended last month that the cashstrapped state release up to 57,000 non-violent inmates from the overcrowded system to help save $800 million.
*Kentucky officials last year allowed for the early release of non-violent offenders up to six months before their
sentences end to serve the balance of their time at home. *New Mexico and Colorado are among seven states where
some lawmakers are calling for an end to the death penalty, arguing capital cases have become too costly to prosecute,
reports the Death Penalty Information Center, which tracks death penalty law and supports abolition of the death
penalty. "State governments operated on the principle that if you built it, they would come," King says of prison
construction during the economic boom. Since 1990, corrections spending has increased by an average of 7.5%
annually, reports the National Association of State Budget Officers. "As soon as they built those prisons, they filled
them," King says. "They were never able to keep up with it. There is certainly a different atmosphere now."
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States Fail - Funding
Several states are incapable of funding prisons in the status quo.
Sears 2k7
(Senator Richard Sears, July, 2007 “Vermont can't afford to keep locking up nonviolent offenders”)
In 10 years, Vermont's incarceration rate has increased 73 percent, compared with 19 percent nationwide. In those
same 10 years, Vermont's violent crime rate has increased by 2 percent and property crime has decreased by 31
percent. A recent study, released in February by the Pew Charitable Trust, estimates that, "By 2011, without changes
in sentencing or release policies, Alaska, Arizona, Idaho, Montana and Vermont can expect to see one new prisoner
for every three currently in the system."
Over the past 10 years, Vermont has seen an increase of about 100 beds per
year. On June 6, 2006, Vermont's in-state prison population was 1,591, and there were 562 out of state, for a total of
2,153. In fact, state spending on corrections has risen faster than any other area of state government; double-digit
increases have been the norm for several years.
Between 2006 and 2008 the budget rose by 16.4 percent, from $110
million in 2006 to nearly $129 million for fiscal year 2008, and if nothing changes, that trend can be expected for the
foreseeable future. To put it another way, a family of four will pay an average of $800 in state taxes just to support
corrections.
It may be little consolation, but we are not alone: In 1982 American taxpayers spent $9 billion for
corrections; by 2002 that number had mushroomed to $60 billion. The Pew Charitable Trust study found that "one in
every 32 U.S. adults is currently under some form of correctional supervision" and that "by 2011 … one in every 182
U.S. residents will live in prison."
I doubt many would argue the need for prison space for violent offenders, but in
Vermont between 40 percent and 45 percent of the males who are incarcerated are in prison for offenses that the
Corrections Department classifies as nonviolent. With females, roughly 70 percent are incarcerated for nonviolent
offenses. That means that on any given day, from 900 to 1,000 offenders are incarcerated for nonviolent offenses.
States Cannot fund prisons now.
Ryan, 2k7
(Beth Gorczyca Ryan, December 6th, 2007, Counties Re-Examine How to Fund Regional Jails)
During the past several years, counties around the state have struggled to come up with a way to pay the state
Regional Jail and Correctional Facilities Authority for inmates the county sends to local regional jails.
Counties, particularly Cabell County, say they don't have enough money to pay the bills, which can exceed
millions of dollars each year. The Regional Jail Authority, however, says state law requires counties to pay their share,
and if they don't it puts the entire regional jail system in jeopardy.
The dispute reached to the state Supreme Court of Appeals, which recently issued a writ of mandamus saying the
Regional Jail Authority is right -- Cabell County and other counties are required by law to pay their jail bill.
"Given this Court's duty to uphold the laws of this state, which includes the enactments of our Legislature, we are ...
constrained to recognize the mandatory language directing that the counties 'shall pay' for the 'costs of operating the
regional jail facilities of this state to maintain each inmate' as well as statutory language that imposes responsibility on
the counties for 'costs incurred by the Authority for housing and maintaining inmates in its facilities,'" Justice Joseph
P. Albright wrote in the majority's opinion.
Justice Larry Starcher concurred with the rest of the Court but reserved the right to file his own opinion.
As a result of the high court's ruling, Cabell County must pay the estimated $1.8 million it owes the regional
jail system.
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States Fail – Funding Tradeoff
Lack of state prison funding results in trade off.
The Guardian 2k9
(The Guardian, February 2009, “US states cut prison spending in attempt to balance budget”)
Legislators in some states are slashing prisoner rehabilitation programmes, releasing inmates early or packing
them more tightly into crowded facilities to save money.
Others are using technology, such as satellite tracking, to monitor sex offenders, drunken drivers and other criminals
instead of keeping them behind bars. To avoid building new prisons, many states ship inmates to private facilities
that often are thousands of miles away.
Other states are exploring long-term strategies aimed at preventing recidivism, a leading factor behind overcrowded
prisons and jails - and rising costs. At any given time, more than 2.3 million people are locked up in federal, state and
local facilities in the US, and more than half of those released from prison are back behind bars within three years,
according to the federal Bureau of Justice Statistics.
"We're at a crossroads. I think there is an acknowledgment that if we continue the status quo, we're going to continue
to have a prison population that increases to untenable levels," said Ryan S King, a policy analyst with The
Sentencing Project, which lobbies for changes in sentencing laws as a way to reduce incarceration rates.
For the first time, one in every 100 adults in the US is behind bars, according to a February 2008 report by the Public
Safety Performance Project (which, like Stateline.org, is part of the Pew Centre on the States).
The booming prison population cost states nearly $50bn in 2007, but the high incarceration rate has had no discernible
effect "either on recidivism or overall crime", the report said.
Nationally, corrections trails only healthcare, education and transportation in consuming state dollars. Prison
spending increased 127% from 1987 to 2007, and at least five states - Connecticut, Delaware, Michigan, Oregon
and Vermont - now spend as much or more on corrections as they do on higher education, according to the
National Association of State Budget Officers and the Public Safety Performance Project.
The statistics are alarming state legislators in all regions of the US and, increasingly, on both sides of the political
aisle. Criminal justice reform - for years a controversial issue for legislators wary of being labelled "soft on crime" - is
finding new proponents as public officials seek ways to save money. But a single strategy to tackle incarceration costs
has yet to emerge, and some critics say state policymakers are dragging their feet and avoiding comprehensive
changes that have become necessary.
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Fed Key
Federal prisons provide the best way to target disease spread because the period of stay is longer
Drs. Peter M Ford and Wendy L Wobeser are with the Department of Medicine, Queen’s University,
Kingston, Ont 2000 http://www.cmaj.ca/cgi/reprint/162/5/664.pdf
Screening for disease and provision of adequate treatment programs in short-term detention facilities (i.e.,
provincial jails), which have high turnover rates, is difficult although possible, if these programs are integrated with
community services. Because periods of stay are longer in federal penitentiaries, these institutions should be
able to do better. Unfortunately, the same problems exist at the federal level.
Continues…
Failure to provide adequate screening and failure to provide timely treatment may increase the burden of ill
health later on and may also increase the costs to the health care system. Transmissible diseases that spread in
prisons and that are left undetected or untreated will ultimately spread to the community.
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States Model Federal Action
The aff will be modeled by the states
New York Times [staff writer Tom Wicker] “the wrong model” July 27, 1972
If the Federal Government wants to set up a model, it ought to be doing better things than building prisons,
particularly when the trend in many states is toward closing them .... Mr. Carlson undoubtedly is correct that there will
always be some offenders who have to be imprisoned for public safety; but these are the few rather than the many, and
they scarcely justify the federal government embarking now on a vast program of prison construction. That seems
exactly the wrong model to provide, at a time when federal leadership and assistance might go far toward eliminating
an American penal system that encourages rather than prevents crime.
States model federal policies to gain access to federal funds
Bart Stupak [United States Congressman, D- Michigan] “Stupak wants prison closures re-evaluated” June 11th 2009
http://www.connectmidmichigan.com/news/news_story.aspx?id=311574
“Unprecedented federal funds have been made available to states,” Stupak said. “Three states have already tapped
their federal stimulus allocations to sustain their prison systems, and I urge Michigan officials to explore all
opportunities to do the same. I stand ready to assist in any way I can to help identify and secure federal assistance
should the state seek it.”
States must model federal prison standards or lose critical funds
AP “Panel Issues Report On Reducing Prison Rapes” June 23rd 2009
http://www.npr.org/templates/story/story.php?storyId=105816522
(ChattahBox)—The National Prison Rape Elimination Commission released its five-year-long study, proposing across
the board changes in our nation’s prisons to do more to reduce the occurrence of rapes inside prison walls. Once the
Justice Department adopts new national standards, prisons receiving federal funding must implement them within a
year or lose a portion of their federal funds.
States model national guidelines. NY proves
Washington Post “N.Y. Governor, Lawmakers Agree To Soften Drug Sentencing Laws” March 28th 2009. Lexis
Gov. David A. Paterson (D) and legislative leaders on Friday announced an agreement to roll back the state's strict,
36-year-old drug laws, including eliminating tough mandatory minimum sentences for first-time, nonviolent drug
offenders. The "Rockefeller Drug Laws," named after former governor Nelson Rockefeller (R), are among the
strictest in the country and for critics have become a symbol of the failure of the "war on drugs," which locked up
large numbers of nonviolent drug offenders while having little apparent effect on drug use. The agreement,
announced in the state Capitol, follows a national shift away from criminal penalties to public health and treatment in
America's decades-old fight against illegal drug use.
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States Model Federal Action
States are beginning to model federal correction guidelines. Connecticut proves
Meyer [former federal prosecutor and professor at the Quinnipiac University School of Law] October 28th 2007
“Abolish Parole”. Lexis
THE killings in Cheshire this summer have prompted calls to reform Connecticut's criminal justice system. Most of
the outrage has focused on the ill-informed decision of Connecticut's Board of Pardons and Parole to release the two
men accused in the killings from prison just months before this ghastly crime.
Now the governor has suspended parole for violent offenders while the General Assembly rewrites the rules. But
rather than tinker with the guidelines, Connecticut should follow the lead of the federal government and abolish
parole altogether. Criminal sentences should be based on justice, not on predictions about when an offender will no
longer be a threat to society.
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World Models US Action
Europe models the American prison system
Roy Walmsey [Consultant to HEUNI (United Nations) and Associate of the International Centre for Prison Studies at
King’s College, University of London] “European prison populations: recent growth and how to reduce it” 03
ad.vscr.cz/news_files/03_Walmsley.doc
If steps are not taken to reduce prison populations and stem the growth, we will be in danger of adopting the
extraordinary practice in the United States. There, about 1 in 80 of all male citizens are locked up, at great cost in
human as well as financial resources. As a distinguished American criminologist has put it, this does not happen
because the public needs protection from so large a number, or because imprisonment will be effective in some way,
but just because harsh policies are an expression of the public mood.* If that happens in this continent, then the 2
million prisoners in European countries will soon be approaching 3 million. Let us instead attempt to convince the key
people to take the necessary measures, so that prison populations stop growing, so that they are reduced, and so that
they stabilize at a rate of no more than 100 per 100,000 of the national population. Such a level is currently achieved
by about 56% of European countries.**
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Politics-Plan Bipartisan (1/3)
Public sentiment is forging bipartisan support for prison reform
Segura ‘8 (Liliana Segura is a staff writer and editor of AlterNet's Rights and Liberties and War on Iraq
Special Coverage, March 5th 2008, ‘America Behind Bars: Why Attempts at Prison Reform Keep
Failing’, http://www.alternet.org/rights/78648/?page=entire)
While public shock and dismay over the criminal justice system is a good thing, policy reform usually only comes once those
in power recognize public support for measures otherwise considered too politically risky. (Iraq war notwithstanding.)
Indeed, a significant part of the Pew study (which was written mainly with politicians in mind) is devoted to showing that
policy makers are starting to come around on the prison issue, increasingly talking about being "smart" rather than "tough" on
crime. The hope is that others will take their lead. "There's a shift away from the mindset of lock them up and throw away the
key," one Ohio Republican legislator is quoted as saying. Alternatives include investing in drug treatment for prisoners -- as
well as "drug courts" -- relaxing stringent parole rules and curbing mandatory minimums. Ironically (if necessarily) the states
that appear to be paving the way on prison reform are the ones who lock up the most people. Take Texas: Between 1985 and
2005, its prison population rose by 300 percent, a growth rate even the state's death row machinery couldn't offset. Now, with
an estimated prison population of 171,790, according to the Pew study, the Lone Star State is forging "a new path," with a
bipartisan decision last year to authorize a "virtual makeover" of the prison system. The overhaul will include more drug
treatment for prisoners and "broad changes in parole practices" aimed to curb recidivism rates. If all goes according to plan,
the state may be able to shelve emergency blueprints for three new prisons. "It's always been safer politically to build the next
prison, rather than stop and see whether that's really the smartest thing to do," the Houston-based chair of the Texas senate's
criminal justice committee said. "But we're at the point where I don't think we can afford to do that anymore."
Prison reform initiatives have widespread support in congress and in lobbies
Culpepper ‘9 (Lamar Culpepper is a former board member and Chairman, Board of Directors, Rosebud Advocaacy (f.k.a.
Rosebud Foundations, June 13th 2009, ‘Testimony at Senate Hearing on National Prison reform’,
http://www.examiner.com/x-7357-Atlanta-Criminal-Rehabilitation-Examiner~y2009m6d13-Testimony-at-Senate-Hearingon-national-prison-reform)
The U.S. Senate Committee on the Judiciary, Subcommittee on Crime and Drugs convened a hearing on proposed national
prison reform legislation. Virginia Senator Jim Webb introduced bill S.714 in March to create a commission to thoroughly
review the entire criminal justice system and make recommendations for reform in several areas of significant concern. (See
related article: ‘Senator Jim Webb proposes 2009 national prison reform.’) Since being introduced, the bill already has
widespread support with 29 cosponsors in the Senate including Chairman of the Senate Judiciary Committee, Senator Patrick
Leahy (D-VT), Chairman of the Subcommittee on Crime and Drugs Senator Arlen Specter (D-PA) and Ranking Member
Senator Lindsey Graham (R-SC), and Judiciary Committee member Senator Orrin Hatch (R-UT). Numerous organizations,
currently numbering 42, now endorse the legislative endeavor with interest continuing to expand as public awareness
increases.
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Politics-Plan Bipartisan (2/3)
Prison reform is gaining bipartisan support
The Institute for Southern Studies ‘9 (Facing South- the online magazine of the Institute for Southern Studies, ‘The
American Lockdown: Is prison reform on the horizon?, June 12 th 2009, http://www.southernstudies.org/2009/06/post18.html)
The prison crisis in the United States is at a historic high. As Facing South has reported before, the United States incarcerates
one out of every 100 adults. Combine this with the number of people under probation or parole, and the statistic is even
starker: one in 31 adults (7.3 million people) is under some form of correctional supervision. But talk of prison reform has
been making its way through Congress this year. On Thursday the Senate Judiciary Committee held a hearing on the National
Criminal Justice Commission Act of 2009, SB 714. This important piece of legislation was introduced in late March by Sen.
Jim Webb (D-VA), and if passed would create a "blue-ribbon commission" charged with completing an 18-month "top-tobottom review" of the country's entire criminal-justice system, ultimately providing Congress with specific, concrete
recommendations for reform. The legislation has received bipartisan support and currently has 29 cosponsors in the Senate.
Prison reform has bi-partisan support.
Dalfonzo, 2k8,
(Gina Dalfonzo, June 30, 2008 “Prison Reform Transcends Boundaries”, http://thepoint.breakpoint.org/2008/06/markearley-and.html)
Today the New York Times profiles PFM president Mark Earley and vice president (and Justice Fellowship head) Pat
Nolan, focusing on how advocates of prison reform are crossing lines in a way that few had thought possible.
Motivated both by religious faith and a secular analysis of public policy, Mr. Earley and the fellowship’s vice
president, Pat Nolan, a former California legislator, have regularly testified before Congress, written op-ed essays
and given speeches on behalf of efforts to roll back mandatory-minimum sentencing, equalize penalties for crack
and powder cocaine, and offer nonviolent offenders treatment rather than incarceration, among other initiatives.
On the surface a redoubt of the religious right, firmly rooted in evangelical Christianity and conservative politics, the
Prison Fellowship Ministries’ liberal position on such issues underscores the increasing irrelevance of such rigid
categories. The group’s role in criminal justice bears similarity to the stance taken by evangelical leaders like Rick
Warren, pastor of the Saddleback Church in Southern California, on global warming, AIDS prevention and Third World
poverty. “What’s distinct is that we’re in an ‘Aha!’ moment now,” Mr. Earley, 53, said in a phone conversation. “The
crime issue used to be such a driving wedge between liberals and conservatives, Democrats and Republicans, and now it’s
not. In the presidential campaign this year, when have you heard crime as a wedge issue? It’s a common-ground issue,
and no one would have envisioned that in the ’70s and ’80s.”
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Politics-Plan Bipartisan (3/3)
Prison reform is bi-partisan in Congress
Institute for Southern Studies, 2k9
(The Institute for Northern Studies, June 12, 2009, “The American Lockdown”,
http://www.southernstudies.org/2009/06/post-18.html)
The prison crisis in the United States is at a historic high. As Facing South has reported before, the United States
incarcerates one out of every 100 adults. Combine this with the number of people under probation or parole, and the
statistic is even starker: one in 31 adults (7.3 million people) is under some form of correctional supervision. But talk
of prison reform has been making its way through Congress this year. On Thursday the Senate Judiciary
Committee held a hearing on the National Criminal Justice Commission Act of 2009, SB 714. This important piece
of legislation was introduced in late March by Sen. Jim Webb (D-VA), and if passed would create a "blue-ribbon
commission" charged with completing an 18-month "top-to-bottom review" of the country's entire criminal-justice
system, ultimately providing Congress with specific, concrete recommendations for reform. The legislation has
received bipartisan support and currently has 29 cosponsors in the Senate.
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Politics-Webb
Plan Would be a Win and Olive Branch to Webb
Chris Good, @ The Atlantic, 3/26/’9 [A Push for Prison Reform,
http://politics.theatlantic.com/2009/03/a_push_for_prison_reform.php]
Sen. Jim Webb (D-VA) will launch an effort to reform the nation's prison system today at noon, his staff says, introducing a bill--the
National Criminal Justice Act of 2009--that would create a bipartisan commission on reform. The commission would undertake an 18-month review of the
U.S. prison system, offering recommendations at the end . Prison reform is a difficult thing to achieve, politically. Nearly every politician wants to be
perceived as "tough on crime," and suggesting that too many Americans are being incarcerated can seem to run against that. (Webb has, in fact, pointed out
that the U.S. has attained the highest incarceration rate in the world.) Add tough discussions of prison conditions, inmate crime, and abuse, and it's not an
easy task for a politician to undertake. Webb has succeeded in pushing major legislation through Congress before, as his 21st
Century GI Bill passed last year. And it's hard for anyone to accuse the former Navy secretary of not being "tough" enough. Reported
support from Democratic leaders, President Obama, and interest from Judiciary Committee Ranking Member Arlen Specter could help
him in this latest endeavor.
That’s Huge - Webb Has a Ton Of Clout
James Fallow, @ The Current, 11/21/’6 [Master of the Senate, http://thecurrent.theatlantic.com/archives/2008/05/master-ofthe-senate.php]
As Barack Obama considers his vice presidential options, he would be very wise to take Jim Webb seriously. By now the idea that Webb
could help Obama connect with the Scots-Irish voters of Greater Appalachia is familiar to most of those who follow the presidential horse race. And
Webb's military experience, together with his years in Ronald Reagan's Pentagon, give him national security expertise that
few leading Democrats can match. Yet there is another reason the Virginia Senator would make an excellent vice presidential nominee. As he's
demonstrated this week, Webb can be a masterful legislative tactician. Though no one will ever mistake Webb for a gladhanding
backslapper, he has mobilized an extraordinary coalition of Democrats and Republicans behind a dramatic expansion of veterans'
educational benefits. After passing by an overwhelming margin in the House, Webb's Post-9/11 Veterans Educational Assistance Act won 75 votes in the
Senate. Because the measure was attached to the Democrats' Iraq War spending bill, which included a number of other spending proposals favored by
Democrats and opposed by the Bush White House, there is good reason to believe that the entire package will be vetoed. But there is also good reason to
believe that something like Webb's proposal will eventually be made law, thanks in no small part to the measure's overwhelming popularity among veterans
and military families.
Webb Supports the Aff
Jim Webb, U.S. Senator - VA (D), 6/11/’9 [Why We Must Reform Our Criminal Justice System,
http://www.huffingtonpost.com/sen-jim-webb/why-we-must-reform-our-cr_b_214130.html]
Ex-offenders are also confronted with a lack of meaningful re-entry programs. With the high volume of people who are coming out of
prisons, it is in the self-interest of every American that national leadership design programs that provide former offenders a true pathway towards a
productive future. An examination is required as to what happens inside our prisons. Our correctional officers deserve better support in
dealing with violent criminals under their supervision. It is also imperative that we facilitate a safe environment for all inmates, and
examine ways to better prepare them for their release back into civil society. The de-humanizing environment of jails and
prisons compounds these challenges.
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Plan Popular-State Reforms Prove
Prison reform already popular in individual states
MSU ‘9 (Michigan State University Red Tape Blog, 4/28/09, ‘State Senators Speak in Favor of Prison Reform’,
http://blogpublic.lib.msu.edu/index.php/2009/04/28/state-senators-speak-in-favor-of-prison?blog=5)
A group of state senators called today for changes in the state's prison system they said would cut
down on recidivism, protect public safety and save millions of dollars.
The measures included
expanding the participation of religious organizations in rehabilitation and more comprehensive
preparation of prisoners for parole.
Bipartisan Support for prison reform already exists- individual states prove
Tilton ‘8 (James E. Tilton is the California Secretary of the Department of Corrections and Rehabilitation, ‘Investing in
Prison Reform Pays in Safety- Sets Bedrock for Lasting Reform, June 2008,
http://www.cdcr.ca.gov/News/CDCR_News/page_8.html)
One year ago, Governor Arnold Schwarzenegger signed the most comprehensive and bipartisan prison reform legislation that
California has ever seen. The law’s passage was in response to a combination of crises that had the state’s prison system on
the verge of collapse. While there is still much hard work to be done, California is finally on the right track toward real prison
reform. Before the passage of Assembly Bill 900, the Public Safety and Offender Rehabilitation Act of 2007, the state had no
concrete plan to address the myriad serious issues facing our prison system. Overcrowding was near record highs, and
California was very close to running out of beds for new inmates. Federal judges were contemplating imposing a population
cap to force the release of inmates who had not served their full sentences. Fortunately the Governor, working with
legislators from both parties, law enforcement and community leaders, crafted a plan to address these issues head-on. The reform measure authorized
transferring up to 8,000 inmates to out-of-state facilities, funded up to 53,000 beds in state prisons and local jails to reduce overcrowding, and set
benchmarks to ensure that all inmates sent to prison are given access to rehabilitation programs.
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Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Plan Popular-Republicans
Republicans support prison reform.
New York Times, 2k6
(The New York Times, “The Right Has a Jailhouse Conversion”, December 24, 2006,
http://www.nytimes.com/2006/12/24/magazine/24GOP.t.html)
This decline in the exploitation of crime coincides with an odd and surprising change in the politics of crime. The
G.O.P., the party of Richard Nixon’s 1968 law-and-order campaign and the Willie Horton commercial, is beginning to
embrace the idea that prisoners have not only souls that need saving but also flesh that needs caring for in this world.
Increasingly, Republicans are talking about helping ex-prisoners find housing, drug treatment, mental-health
counseling, job training and education. They’re also reconsidering some of the more punitive sentencing laws
for drug possession. The members of this nascent movement include a number of politicians not previously known
for their attention to prisoners’ rights. Senator Jeff Sessions of Alabama, a former federal prosecutor whom The New
Republic once accused of being stained “with the taint of racism,” wants to reduce the penalty for possession of small
amounts of crack. Referring to mandatory-minimum sentences, Representative Bob Inglis of South Carolina, whose
district is home to Bob Jones University, declared on the floor of the House: “I voted for them in the past. I will not do
it again.” Perhaps most remarkably, the outgoing Republican-controlled Congress came tantalizingly close to
passing the Second Chance Act, a bill that focuses not on how to “lock them up” but on how to let them out.
The bill may become law soon, if Democrats continue to welcome the new conservative interest in
rehabilitation.
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Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Plan Popular- Democrats
Democrats support prison reform.
The Atlantic, 2k9
(The Atlantic Monthly, March 26 2009, “Push for Prison Reform”
http://politics.theatlantic.com/2009/03/a_push_for_prison_reform.php)
Sen. Jim Webb (D-VA) will launch an effort to reform the nation's prison system today at noon, his staff says,
introducing a bill--the National Criminal Justice Act of 2009--that would create a bipartisan commission on reform.
The commission would undertake an 18-month review of the U.S. prison system, offering recommendations at the
end.
Prison reform is a difficult thing to achieve, politically. Nearly every politician wants to be perceived as "tough
on crime," and suggesting that too many Americans are being incarcerated can seem to run against that. (Webb has, in
fact, pointed out that the U.S. has attained the highest incarceration rate in the world.) Add tough discussions of prison
conditions, inmate crime, and abuse, and it's not an easy task for a politician to undertake.Webb has succeeded in pushing
major legislation through Congress before, as his 21st Century GI Bill passed last year. And it's hard for anyone to accuse
the former Navy secretary of not being "tough" enough. Reported support from Democratic leaders, President Obama,
and interest from Judiciary Committee Ranking Member Arlen Specter could help him in this latest endeavor.
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Prison Aff
DDW 2009
Kade, Daniel, James, Ben, Emily, Jenny, Michael, Josh, Gonzo, Anna, David
Politics-Obama Will Push
Obama is going to push for prison reform
Michael Santos, an extensive author and publisher on the subject of prisons, MA from Hofstra] March 14 2009
http://prisonnewsblog.com/2009/03/president-obama-and-prison-reform/
I feel confident that President Obama will take significant steps forward with regard to prison reform. I know that our
country faces significant challenges going forward. American citizens are rightfully concerned about the economic crisis that
has brought high unemployment. They want to see reduced costs and expanded coverage for health care. They want reforms
to our nation’s education system. The time will come for prison reform. When it does, I feel confident that President
Obama will exercise leadership and rely upon objective data to guide his decisions.
Continues…
Prison lobbyists have driven the prison boom over the past two decades. And a paucity of leadership from prior
presidents has resulted in extraordinarily high costs for taxpayers. I expect to see prison reforms under President Obama’s
leadership that will change these trends.
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