Few imagine dying in prison. Most people hope for a peaceful death in old age surrounded by family and loved ones. Yet prison is a place where deaths occur, and much more frequently than we might imagine. Some deaths in prison are unexpected, resulting from over-doses or sudden moments of inter-prisoner violence. Other deaths, such as suicide attempts, may be anticipated but occur through failures in observation protocols and other safeguards. A small but growing number of deaths are known in advance, the prisoner with a diagnosis of a terminal illness.
The number of older people within Irish prisons is growing and with this the likelihood of a person developing a terminal illness during their sentence. Debate does exist over the definition of an older prisoner. This essay will understand those over 50 years old as an older prisoner. Those who spend time in prison, or have a chaotic lifestyle resulting in regular contact with the criminal justice system, generally have a physiological age greater than a person of similar age in the wider population. So, prisoners aged 50 years old have an equivalent health status to a person aged 60 who has not spent time in prison.
In 2014, less than 10% of the Irish prison population under sentence were aged 50 years or older. This proportion has grown steadily. Recent figures reveal that a sixth of prisoners (male and female) are now in the older category, the fastest growing demographic within Irish prisons.This increase mirrors a similar shifting prisoner demographic in the United Kingdom where prisoners aged 50 and over are also 16% of the prison population; the number of over 60s has almost tripled; and there are increasing numbers of frail prisoners (aged 85 and over).
In addition to Irish prisons now having an older population, the length of sentences which people are serving suggest that more prisoners will become infirm during their sentences and have increasingly complex health needs.
At present, 40% of older prisoners are either serving life sentences or sentences of greater than 10 years. Turner and colleagues suggest that a key cause of this shifting prisoner demographic is the growing number of men convicted of ‘historic’ sexual offences, many of whom are imprisoned in old age. This prompts an increased demand on health care and other wellbeing needs within prison and the number of deaths in prison from illness are also anticipated to rise.
In a recently published death in custody investigation, the Irish Inspector of Prisons reported on a 2018 case where, after spending 33 years in custody, a terminally ill 53-year-old man was in custody up to the morning prior to his death. He later died in hospital after being transferred to receive medical treatment, following the report of severe pain. Warning that there must be no repeat of this incident, the Inspector of Prisons recommended that “the IPS [Irish Prison Service] should review the application of its Compassionate Temporary Release Policy to ensure that prisoners who are temporarily ill are appropriately released on license in order to avoid the indignity of dying in prison.”
There is much to be highly critical of in the case of Mr I (each person whose death is investigated receives a letter for anonymity): movement from a low-security open prison to a closed prison to access appropriate healthcare; failure to grant compassionate temporary release; and the inexcusable delay in bringing Mr I to hospital after complaint of severe pain. Despite institutional justifications, cruelty and inhumane treatment – whether intentional or as a result of human resource issues and bureaucratic failures – is still cruelty and inhumane treatment.
Failings raised in the Inspector of Prisons’ report will receive much attention from a best practice perspective and the Irish Prison Service has furnished an Action Plan based on recommendations. Wishing to sidestep the contested nature of the details, this essay will consider what does it mean to die in custody under sentence, firstly from a sociological perspective and then with a more theological register.
This article appeared first in Issue 55 of Justice Reflections, a publication of theological insights into the ethical, moral, pastoral or restorative aspects of justice.
Download ‘Deaths Under Sentence: The Terminally Ill in Prison’ here