In order to be considered for compassionate release, an inmate must first be diagnosed with a terminal illness. The inmate must also be considered eligible under legal guidelines. Accordingly, the prisoner must be deemed to pose no risk to society if released.
A second part to compassionate release entails a prisoner applying through a maze of paperwork and regulations. The application must then be examined by prison medical and correctional staff, and then decided upon. Unfortunately, many eligible prisoners die waiting for an answer.
A recent article, Balancing Punishment and Compassion for Seriously Ill Prisoners published in the Annals of Internal Medicine, the journal of the American College of Physicians addresses the issues of obtaining compassionate release, and also provides suggestions to make the process easier, faster and better.
Doctor Brie Williams, Assistant Professor of Medicine, Division of Geriatrics, at the University of California, San Francisco, along with Doctors R. Sean Morrison, Rebecca Sudore, and Robert Greifinger assert that one of the biggest problems in the compassionate release system is “prognostication,” which the physicians claim is unreliable. Prognostication, when used in the area of compassionate release, refers to predicting when a patient might die, or what course a disease might follow.
The doctors who authored the article maintain that such predictions are not always accurate, and a better system should be implemented. Suggestions include appointing a panel to recommend standardized guidelines pertaining to compassionate release. The panel, the doctors agree, should include experts in palliative medicine, geriatrics, and correctional health care.
The proposed guidelines would include providing an inmate with an advocate to guide the prisoner through the system and who would represent a prisoner who could not represent him or her self. The new guidelines would also present a way that a prisoner with a short life expectancy could expedite the process.
The application procedure, according to the doctors, should be easy to understand, and easy to obtain, with the rights of applicants clearly outlined. The authors of the article further contend critically ill prisoners should be categorized as follows:
1) Prisoners with terminal illnesses and predictably poor prognoses
2) Prisoners with Alzheimer and related dementias
3) Prisoners with serious, progressive, nonreversible illness with profound functional/cognitive impairments.
Those prisoners, according to the authors, should receive palliative care while awaiting a decision for compassionate release. Those who are denied compassionate release, would continue receiving palliative care by prison health care providers.
The new guidelines would, in the opinion of Doctors Williams, Morrison, Sudore, and Griefinger, reduce prisoner deaths, correct flaws in the compassionate release system, and cut correctional health care budgets Additionally, new guidelines would allow those in corrections to make informed decisions regarding compassionate release.
Sources: CURE National and American College of Physicians, Annals of Internal Medicine, June 1, 2011
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