Access to Death: Prisons, Hospice and Voices



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Since, 1992 the number of inmates over the age of fifty in the United States has almost tripled. This rapidly growing population of elderly inmates is due to a national “tough on crime” attitude, which has put 1 in 100 Americans behind bars, many of whom will age and die in a correctional setting. The National Center on Institutions and Alternatives estimates that housing and caring for American inmates over fifty-five, costs state and federal governments an annual sum of $2.1 billion – almost three times the amount it costs to accommodate a younger prisoner . To successfully provide mental and physical care for a geriatric patient is not only expensive, but also costly in the sense that elderly patients require a more sophisticated level of care. Coupled with longer sentencing, and the War on Drugs law-enforcement initiative, there is a greater need for long-term and eventually end-of-life medical care in prisons. Ironically, prison inmates in the United States are the only citizens who have an inalienable right to health care. Yet, with an increasing emphasis on life sentencing and prison privatization, dying inmates are not receiving the level of care they deserve, which poses the question: who has access to a humane death? This project examines both who, in fact, has access to a meaningful death, and also what constitutes a “good death” behind bars. Correctional hospice programs exemplify a new and modern initiative to make hospice and a “good death” accessible to inmates – some of America’s most underrepresented citizens. Prison Hospice represents a shift from an inhumane death in prison towards a compassionate consideration for a dying inmate. Although the hospice movement in prisons is growing, many wonder if hospice behind bars will ever measure up to traditional, community hospice programs. There is the very real possibility that, with the current infrastructure of correctional facilities coupled with strict security procedures, a successful prison hospice program will never be achieved. Still, prison hospice could become a catalyst for improving America’s prison system. Perhaps a successful hospice program is the catalyst the United States needs to implement better care for its inmates. No prison hospice program will ever be successful without two essential elements: the autonomous voice of the prisoner and sympathetic support. I present the majority of my argument in the context of the prisoner’s voice and the manner in which the inmate’s autonomous choices dictate the success of a prison hospice program, in giving dying inmates what they deserve: access to a good and meaningful death.



Religion, Ethics