Constitutional Rights of Inmates

1
Constitutional Rights of Inmates Chapter
10 Right to Rehabilitation Programs Right to
Medical Aid, and Right to Life Andrew Fulkerson,
JD, PhD Southeast Missouri State University
2
Right to Rehab

• U.S. Supreme Court in Pell v. Procunier
• stated rehabilitation was one of three primary
  purposes
• of punishment
• American Correctional Association
• Prison serves to protect society from crime
• When its emphasis is on rehabilitation
• Many states have statutes that encourage rehab

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Court Decisions

• Courts have refused to hold there is an absolute
  right to rehabilitation

4
Right to Rehab

• Padgett v. State, 406 F.Supp. 287 (M.D.Pa. 1976)
• Inmates sued claiming failure to provide
  meaningful rehab programs was cruel and unusual
  punishment
• Court held no constitutional duty on govt to
  rehabilitate prisoners
• Question as to whether state should try to
  rehabilitate inmates in view of issue of
  effectiveness of rehabilitation programs
• Public policy issue best left to legislatures

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Does Rehab Work?

• 1970s trend among researchers was that nothing
  works
• If programs are ineffective, no reason to require
  states to attempt rehab

6
Does Rehab Work?

• Recent research indicates that treatment programs
  do reduce recidivism
• Drug treatment courts (DTCs)
• Offenders who complete DTC have statistically
  significantly lower recidivism rates

7
Rehab in Prison

• Prison and the inmate culture not conducive to
  effective treatment
• Inmates who sign up for rehab or educational
  programs just to build their parole file
• Treatment works best in a therapeutic community
• But research does support use of rehab programs
  in prison

8
Right to Rehab

• Lack of meaningful rehabilitation programs has
  been one factor that courts have cited in finding
  state prison systems unconstitutional
• But only an element, not the sole element

9
Right to Rehab

• Penal system cannot be operated in manner that
  impedes ability of inmates to attempt their own
  rehabilitation
• Harris County, Texas jail ordered to provide
  educational and vocational programs
• But inmates had no right to attend rehab programs
  outside institution

10
Rehab Without Consent

• Aversion therapy (Clockwork Orange treatment)
  held unconstitutional.
• Inmates given nauseating injections for
  infraction of rules.
• Attempt to produce Pavlovian aversion to bad
  behavior.
• 8th Circuit held this cruel and unusual
  punishment.
• It was not treatment regardless of what they
  called it.

11
Rehab Without Consent

• Courts held institutions could require
  educational programs
• Arkansas inmates sued to enjoin mandatory
  literacy programs
• Court held state had sufficient interest in
  eliminating illiteracy among inmates, and could
  require participation
• More than mere attendance can be required
• States can require meaningful participation, and
  impose sanctions for failure
• Completion of educational/vocational programs can
  be a factor for parole release.

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Consent to Experiments

• Is inmates consent voluntary or coerced?
• Scientists need volunteers
• Parole boards can reward volunteers for
  experiments
• Is it truly voluntary?

13
Consent to Treatment

• Inmate has right to refuse drug treatment

14
Type of Treatment

• Scope of rehabilitation is left to institution
• Court held that it within administration
  discretion to reject inmates for x-ray technician
  training program
• Absent arbitrary or capricious selection, court
  will not intervene
• Court has held pre-trial detainees entitled to
  continue methadone treatment program they were in
  prior to arrest

15
Mental Health Cases

• District Court D.C. held persons who had been
  involuntarily committed to mental institution
  after acquittal on basis of insanity had right to
  treatment
• Minnesota D.C. has held that persons who were
  committed after involuntary civil commitment
  hearing were entitled to at least minimal
  treatment
• NYDC held that persons who had been committed
  were entitled to treatment regardless of whether
  commitment was civil or criminal

16
Mental Health Cases

• OConnor v. Donaldson, 422 U.S. 563 (1975)
• 5th Circuit had held that mental patient who had
  been involuntarily committed to state hospital
  was entitled to rehabilitative treatment, or at
  least to adequate habilitation if treatment was
  impossible.
• Non-dangerous person could not be held in custody
  if he could survive on his own or with help of
  family or friends.
• Superintendent of hospital entitled to defense of
  qualified immunity to civil damages because there
  was state law that authorized continued
  confinement of person like P.
• U.S. Supreme Court reversed the 5th Circuit and
  remanded for determination of liability in light
  of qualified immunity defense.
• Supreme Court refused to decide whether mental
  patients have constitutional right to treatment
  as result of their detention by the state.

17
Mills v. Rogers, 457 U.S. 291 (1982)
18
Youngberg v. Romeo, 457 U.S. 307 (1982)
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Juveniles and Treatment

• District of Columbia Juvenile Court Act mandates
  treatment
• Morales v. Turman, US District Court (E.D. Texas)
  held that incarcerated juvenile had to be placed
  in treatment program that had been designed to
  suit needs of juvenile.
• These cases could indicate a trend that could
  eventually expand to adults and treatment.

20
Sex Offenders and Treatment

• California enacted indeterminate sentence for
  sex offenders (1 day to life)
• Calif. Supreme Court held that confinement for
  this sentence without treatment was cruel and
  unusual punishment
• Indeterminate sentence implied that inmate could
  be released if he got better and no longer a
  danger
• Only way to get better was through treatment

21
Sex Offenders and Treatment

• New York modified its sex offender statute to
  eliminate a right to treatment
• Ohlinger v. Watson, 9th Circuit ruled Oregon sex
  offender statute requires treatment for sex
  offenders
• Research on effectiveness of treatment of sex
  offenders mixed results

22
Right to Treatment

• If state confines a man for purpose of helping
  him
• Right to withhold freedom depends on whether help
  is provided
• When legislature justifies confinement on promise
  of treatment, it commits state to provide
  resources to fulfill promise

23
Administrative Review

• Supreme Court held that administrative review
  (rather than court review) was most effective way
  to determine whether or not inmates should be
  required to take antipsychotic drugs

24
Administrative Review

• Washington State Prison had special unit for
  felons with severe mental disorders
• Some inmates refused to take medication
  prescribed

25
Administrative Review

• State Prison administration established review
  board to conduct administrative hearing to
  determine whether inmates should be required to
  take drugs
• Hearing conducted by review board
• Psychiatrist
• Psychologist
• Associate warden of unit

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Administrative Review

• None of board members were involved in treatment
  of inmates
• Hearing complied with Turner v. Safley
• State had interest in safety and security which
  may exceed rights of inmate to refuse treatment
• Inmate had right to be present at hearing
• Right to present evidence
• Right to counsel substitute
• Any decision to medicate was subject to periodic
  review

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Right to Medical Care

• Common complaint is inadequate medical care
• Inmate cannot provide for own medical care
• Inmates are restrained
• Cannot select treatment provider
• Cannot control treatment from open market

28
Right to Medical Care

• Inmates have greater need for medical care than
  general public
• Many inmates have mental problems
• 70 inmates have drug or alcohol problems
• AIDS, hepatitis and TB
• Overcrowding, poor nutrition, lack of exercise
  aggravate problems
• Incarceration intensifies concern over physical
  symptoms due to boredom

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Inmate Suits Over Medical Care

• Inadequate medical care
• Denial of medical care
• Improper medical care

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Federal Jurisdiction Over Medical Care Issues

• Inmate must allege existence of a federally
  protected right.
• Due process under 5th and 14th Amendments
• Right to be free from abuse of discretion
  regarding life and health
• Right to be free from cruel and unusual
  punishment under 8th Amendment
• Intentional denial of needed medical care
• Officials conduct indicates deliberate
  indifference to medical needs of inmate

31
Federal Tort Claims Act 42 USC 2674

• Provides cause of action against US government
  for negligence, including medical negligence
• Applies to medical treatment of federal prisoners

32
Americans With Disabilities Act 42 USC 12101

• Prevents discrimination against persons with
  disabilities
• Applies to persons in any federally funded
  program or activity
• Can apply to federal prisoners

33
Right to Medical Care - Remedies

• Constitutional guarantee against cruel and
  unusual punishment do not mean inmate will be
  cured of any real or imagined medical problems
• Inmate only entitled to medical care through
  diagnosis and treatment as is reasonably
  available under the circumstances of his
  confinement and medical condition

34
Adequacy of Medical Care

• Gates v. Collier, 501 F.2d 1291 (5th Cir. 1974)
• Medical treatment at Mississippi State
  Penitentiary
• 1800 inmates
• One full-time physician and several inmate
  assistants
• Substandard hospital
• Court ruled services and conditions inadequate

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Adequacy of Medical Care

• Gates v. Collier, 501 F.2d 1291 (5th Cir. 1974)
• State ordered to employ three full-time
  physicians, including one psychiatrist two
  full-time dentists two full-time physicians
  assistants six full-time RNs or LPNs one
  medical records librarian two medical clerical
  personnel consultant services of a radiologist
  and pharmacist.
• Upgrade hospital and equipment
• Comply with American Correctional Association
  standards regarding medical care for inmates

36
Adequacy of Medical Care

• Gates v. Collier, 501 F.2d 1291 (5th Cir. 1974)
• Not punish inmates for seeking medical care
  unless superintendent finds the inmate was
  malingering
• Not use inmates to fill above positions, but may
  use inmates to supplement this staff

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Adequacy of Medical Care

• Lack of funds is not a defense
• When institution reaches the level that care is
  adequate courts again back off to the old
  hands off position

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Adequacy of Medical Care

• Individual treatment
• Generally, court will find a constitutional
  violation only if the medical condition was
  serious and not attended to
• The deliberate indifference standard

39
Estelle v. Gamble, 429 U.S. 97 (1976)
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Deliberate Indifference

• Elements
• Objective element- must be sufficiently serious
• Subjective element - Official must act with
  sufficiently culpable state of mind

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Deliberate Indifference

• More than negligence, but less than intentional
  conduct
• Knows of and disregards a substantial risk of
  serious harm

42
Deliberate Indifference

• What is sufficiently serious? (need not be
  life-threatening)
• Mandates treatment
• Even lay person would recognize condition needs
  doctors attention
• Causes pain
• Condition significantly affects persons daily
  activities
• Possibility of life-long handicap or serious loss
  if untreated.

43
Pre-Trial Detainees

• Supreme Court has not ruled on what standard
  applies
• Lower courts have held same standards of medical
  care of Estelle v. Gamble that apply to prison
  inmates apply to pretrial detainees

44
Initial Screening

• Several cases have held adequate medical system
  requires medical screening of all inmates within
  reasonable time after entering the prison
• Determine whether inmate has a condition that
  requires treatment
• Whether inmate has any contagious disease

45
HIV Inmates

• Acquired Immune Deficiency Syndrome
• Disease where immune system fails
• Viral agent is human immunodeficiency virus (HIV)
• If virus is in persons blood they are HIV
  positive
• If virus develops into AIDS, it is fatal

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HIV Inmates-Litigation

• Testing/Screening
• Tests became available in 1985, but not fully
  reliable
• Delay between infection and when test will show
  positive
• Suits to require testing for AIDS
• Courts usually defer to judgment of prison
• Suits to prohibit mandatory testing-grounds that
  it violates right to privacy
• Courts usually defer to prison
• Held that prison has reasonable basis for testing
  inmates

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HIV Inmates-Litigation

• Segregation
• Uninfected inmates have sued to force segregation
  of HIV positive inmates. Courts have refused to
  require prisons to segregate
• Infected inmates have sued to prevent being
  segregated. Courts have refused to prevent
  segregation when prison deems it necessary.

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HIV Inmates-Litigation

• Reasons given for upholding segregation are
  prevention of spread of disease protection of
  infected inmates from hostile uninfected inmates
  and diagnostic and treatment ease.

49
HIV Inmates-Litigation

• Confidentiality
• Some courts have found that unnecessary
  disclosure of HIV status violates right to
  privacy
• Crucial factor is whether disclosure is necessary
• disclosure to doctor will always be necessary
• disclosure to another inmate usually not
  necessary

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HIV Inmates-Litigation

• Treatment
• AIDS inmates entitled to treatment just like any
  other disease
• Failure to treat will be 8th Amendment violation
• Inmate only entitled to minimally adequate
  treatment
• Negligence is not enough for a valid claim-must
  be deliberate indifference
• Education on spread of AIDS is essential element
  of AIDS treatment programs

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HIV Inmates-Litigation

• Access to Programs and Services
• HIV inmates often segregated-this results in
  denial of certain prison programs
• Early cases held this was not a violation
• Recent cases look at whether or not the denial is
  reasonably related to medical factors

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HIV Inmates

• HIV inmates who are seriously ill should seek
• Early release
• Medical furlough
• Clemency

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Suicide

• Jail suicide is a serious problem
• Intoxicated inmates make up large number of jail
  suicides
• Duty to protect inmates who are at risk for
  suicide
• No liability on part of city or county unless
  plaintiff can show a causal link between the
  suicide and the jail policy.

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Suicide

• Two categories of liability for jail suicide
  claims
• Jailer failed to discover the inmates suicidal
  tendencies
• Jailer discovered suicidal tendency, but failed
  to take preventive measures

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Rellergert v. Cape Girardeau County, 924 F.2d 794
(8th Cir. 1991)
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Suicide

• Most cases of jail suicide will be negligence
  cases, not constitutional cases of deliberate
  indifference.
• Cases that are deliberate indifference will be
  for failure to have adequate staff to monitor
  inmates failure to train staff in screening for
  suicidal tendencies.
• Also, liability will be found when suicidal
  tendency of inmate is discovered, and failure to
  take basic steps to prevent such as observation
  of inmate and training of officers.

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Right to Life

• Derived from 8th Amendment prohibition against
  cruel and unusual punishment
• Originally intended to prohibit torture and
  related punishment
• Furman v. Georgia held that it applied to death
  penalty
• Death penalty was applied in arbitrary and
  capricious manner
• 2 justices held death penalty was cruel and
  unusual per se

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Right to Life

• Majority of states modified death penalty
  statutes to create standards
• Gregg v. Georgia considered standards of five
  states death penalty laws
• Georgia had bifurcated proceeding
• Jury decided whether to impose death penalty
• Considered aggravating and mitigating
  circumstances
• Automatic review by appellate court

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Right to Life

• U.S. Supreme Court upheld three states DP laws,
  Georgia, Florida and Texas, and struck down two,
  North Carolina and Louisiana
• Florida law had bifurcated proceeding where
  judges decide penalty based upon specific
  standards, following recommendation by jury
• Texas had bifurcated proceeding whereby jury
  decided penalty based upon specific guidelines
• North Carolina and Louisiana had mandatory DP for
  certain offenses. This was struck down.

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Standards fo Death Penalty

• Supreme Court has not allowed DP where defendant
  did not kill victim

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Coker v. Georgia, 433 U.S. 584 (1977)
62
Kennedy v. Louisiana, No. 07-343, Decided June
25, 2008
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Death Penalty Standards

• Enmund v. Florida, reversed DP for
  non-triggerman in felony murder case. But in
  that case the reason for reversal was because
  state did not allow evidence of lack of intent
• Court will allow DP where killer did not have
  specific intent to kill if evidence shows
  reckless indifference to human life

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Mitigating Circumstances

• Supreme Court has held that state may not prevent
  jury from considering mitigating factors in
  deciding penalty
• State must allow all relevant evidence of
  mitigating factors
• Sumner v. Nevada, 483 U.S. 66 (1987) Nevada law
  required DP for prisoner who convicted of murder
  while serving life without parole for an earlier
  murder. Court ruled this unconstitutional.
  State must allow jury to consider mitigating
  circumstances.

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Aggravating Circumstances

• States list of aggravating circumstances may be
  so vague as to allow too much discretion.

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State Constitutional Law

• States may have higher standards than U.S. Const
• Thirteen states have abolished capital punishment

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Mental Condition of Defendant

• 8th Amendment prohibits DP for insane defendant.
  Ford v. Wainwright
• In 2002 Atkins v. Virginia held DP for mentally
  retarded person was cruel and unusual punishment

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Age of Defendant

• 16-17 year old person may get DP, Penry v.
  Lynaugh
• DP reversed for 15 year old defendant, Thompson
  v. Oklahoma

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Methods of Execution

• Hanging has been upheld
• Hanging was method of capital punishment at time
  of ratification of Constitution and the 8th
  Amendment
• Just because hanging does not always cause
  instantaneous death not render it cruel and
  unusual
• Method must only not cause unnecessary and wanton
  infliction of pain.

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Methods of Execution

• Lethal Injection

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Methods of Execution

• Baze v. Rees, 553 U.S. ___ (2008)

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Civil Disabilities

• Loss of civil rights
• Historically felons lost all civil right civil
  death
• This no longer the law

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Voting rights

• Supreme Court held California law which
  disenfranchised felons not violate equal
  protection clause.
• Some states allow felons to vote after completion
  of sentence
• All states allow voting after pardon

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Firearms

• Gun Control Act prohibits felon from possessing
  firearm that has been shipped in interstate
  commerce.
• Includes firearm that was ever shipped interstate
  even if felon purchased the firearm within his
  state
• Persons convicted of misdemeanor or felony
  domestic violence also prohibited from possessing
  firearm

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Americans with Disabilities Act (ADA)

• Supreme Court held that ADA does apply to state
  prisons-
• Pennsylvania Dept. of Corrections v. Yeskey, 524
  U.S. 206 (1998)

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