When disability becomes punishment

In the last couple of weeks I’ve been talking about compassionate release, specifically as it relates to the seriously ill and elderly. While it doesn’t precisely fit into the same discussion, individuals with disabilities face many of the same challenges. Some prisoners’ disabilities may indeed make them candidates for release, but regardless of their status in that respect, their cases deserve the same type of attention, and require us to look more carefully at conditions of incarceration and how they relate to the health concerns of prisoners.

I try to impress upon people through my work, that the fact that prisoners give up their freedom while incarcerated, they do not give up their rights as humans or even citizens (though certain citizenship rights are removed for the duration of their time in prison). Just as the physician I quoted last week so eloquently summarized, prison is the punishment, not a place within which to be punished. But for those prisoners with disabilities, prison can become a near torturous experience beyond that which your average inmate will ever experience.

Many of the concerns that arise are directly related to the technological and medical insufficiencies of the average prison. When someone with a specific or rare medical condition is taken to hospital, the odds are generally pretty good that somewhere amongst the staff, there will be someone at least somewhat familiar with it. But in the prison setting, the odds are stacked against the disabled. In fact, they might be lucky if the doctor is even at the facility that day, let alone if they have the expertise and wherewithal to deal with anything that goes beyond the knowledge base of a general practitioner.

In the UK, a prisoner’s health condition was so complex and life-threatening (Freidrich’s ataxia) that it was difficult for him to be cared for even in a hospital setting, let alone a prison. It was only a few hours after 35-year-old Daniel Roque Hall entered the facility that he was rushed to a hospital and put on life support. Ultimately the courts ruled that the 18 months he spent in hospital under guard was a sufficient amount of his three-year sentence to have served; Roque Hall’s condition is such that he’s unlikely to live far into his 40s.  Roque Hall's condition highlights the more severe risks posed, but even seemingly less restrictive disabilities can present serious challenges and safety concerns.

When an individual with a disability is incarcerated, the state assumes responsibility for their care—like it or not. So if a prisoner is deaf or blind, for example, facilities must provide whatever tools and operations are needed for them to be able to access all aspects prison services.

In a great many cases, this access is non-existent. But even in those prisons make an attempt to accommodate the visual or hearing impaired, the system is fraught with problems. For example, they often rely on fellow inmates to act as guides or interpreters for an individual, but without vetting the inmate or providing any oversight (the ADA does not specify that an interpreter need be trained in American Sign Language). The result is that disabled prisoners are placed in a vulnerable and potentially dangerous positions, being abused and manipulated by those entrusted with their care.

As The Nation pointed out several years ago, President Obama takes great pains each year to publicly issue his support for the Americans with Disabilities Act, but with nary a word dedicated to how this act relates to prisoners. It seemed particularly remiss for him to do so this year, when he has been so boldly extolling his commitment to prison reform. The act extends to prisons just as it does any other state facility in the US. Every year, thousands of complaints from prisons are filed as violations of the ADA. Mobility aids and their lack of appropriate infrastructure for prisoners to utilize them are also serious sources of complaints under the ADA. They may be inadequate for the facility, making it difficult or impossible to navigate or to ensure personal hygiene.  All this is to say nothing of the abuses of vulnerable prisoners, the likes of which were revealed earlier this year in Texas

As is so often the case, prison officials resort to segregation as a solution for any problem. Prisoners with the same medical conditions are excluded from participation in general population activities. Those with mental disabilities are placed in special “wings” where they are prohibited from interacting with inmates outside their unit, for no reason other than providing them with the resources to do so might constitute an inconvenience 

Because general population cells are not typically designed with mobility concerns in mind, some facilities resort to placing prisoners in wheelchairs or the like, into segregated housing units (aka solitary confinement). Inmates who may already face serious stigmatization and ostracizing as a result of their disability, then find themselves plunged into further isolation and, often, depression. The cruelty of the practice was recognized earlier this year in California but to date, there seems to be little movement on the part of the Federal Bureau of Prisons to engage in the kind of physical structural changes needed to accommodate a growing population of disabled inmates.