Litigating for Better Medical Care
Litigation to improve correctional health care has been—and, indeed, continues to be—a critical catalyst to better medical care for prisoners, and therefore to better public health. We no longer openly accept, as we once did, that prisoners are entitled to bare scraps of medical care, the leavings of a facility’s lean resources. We now recognize and enforce the right of incarcerated persons to receive adequate professional care for their serious medical and mental health needs. It was the coercive power of litigation, rather than an enlightened public policy, that made this right meaningful.
However, much of the early promise of litigation has been quashed by the courts and Congress. As with so much else in the formation of criminal justice policy, political opportunism and retribution have led to policies (in practice, statute, and decisional law) that endanger the public health and safety. Just as our sentencing policies overly rely on thoughtless, punitive, and long-lasting confinement at the expense of rehabilitative and reintegrative opportunities, so policymakers and judges seek to curtail opportunities for prisoners to improve the conditions of confinement. Among the most important of those conditions is accessible and adequate physical and mental health care.
In this chapter, I first examine the peculiar nature of and context for l awsuits that seek to improve prison medical care. I next discuss the present state of the legal right to that care and the obstacles to realizing that right. I then suggest some promising ways in which litigation can successfully be used—despite those obstacles—to drive medical care forward. I hope to show that restricting prison medical care litigation is bad correctional policy and bad public health policy. Because the political process disfavors prisoners and the litigation that protects their rights (even when the public health is at stake), it is critical to have access to the courts to achieve what the majoritarian branches neglect. The protection, even support, of litigation to help ensure good quality care is necessary to improve the prognosis for prisoners and for the public as well.
KeywordsHuman Immune Deficiency Virus Federal Court Correction Official Prison System Correctional Institution
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