From Inquest:
The activist Mariame Kaba famously describes jails and prisons as “death-making institutions.” She means this literally: The incarceration apparatus is designed to promote premature mortality. Throughout the COVID-19 pandemic, jails and prisons have been the loci of some of the largest viral outbreaks in the country, a fresh reminder that incarceration creates conditions for rampant infectious disease transmission — a lesson we’d already learned time and again, through HIV and TB epidemics and annually during flu season. Correctional facilities are “epidemiologic pumps,” concentrating disease and then spreading it out to the surrounding community. Even prior to the pandemic, however, prisons and jails had long been sites where a person became statistically more likely to experience harm the minute they crossed the threshold.
Safety within facilities could be considered part of the question of whether prisons and jails make us safer, as Victoria Law ponders in the title of her recent book. But this isn’t the way the “safety” question is usually asked. We’ve long had the data to demonstrate that no, in fact, when it comes to the well-being of people who are detained by the state, incarceration itself puts their lives at risk. And disregarding safety inside to be a factor in the overall safety equation leaves us perpetually shocked at the results these institutions deliver.
We are both physicians who work in the New York City jail system. Between us we’ve taken care of hundreds of jail-detained people who were medically vulnerable or who had serious mental illness or substance-use disorders. We have also both devoted significant time in our careers to compassionate release work, the health-based legal advocacy required to divert someone who is seriously ill from jail incarceration. That the institutions where we deliver care should be considered “death-making” is deeply uncomfortable for us, but it is also illuminating. It makes our work feel simultaneously urgent and Sisyphean.
What does it mean to practice medicine in death-making institution? Continue reading >>>
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