Hospice Programs Provided in Pennsylvania Prisons
by Ruth Hoskins, Ph.D., H.H.S., LCSW
Nine people were granted compassionate release in Pennsylvania from 2010 to today. – Public Source Roundup
Prisoners have the same concerns about death as everyone else. What will it be like to die? Will I die in pain? Will I die alone? Will there be someone to comfort me and answer my questions? Will I be forgiven?
No one wants to be alone when they die, and people are afraid of dying in pain. End of life issues occur at a complicated time with strong emotions and anxious anticipation. According to Kaitlyn Mattson, writing for Home Health Care News, “Advocates are pushing for ways to help the incarcerated die with dignity, and hospice providers are beginning to serve this patient population in greater numbers.”
Yet according to the AMA Journal of Ethics, based on 2011 data, “prison hospices are available only at 69 of 1,719 state correctional facilities.”
The Pennsylvania Department of Corrections (DOC) originally implemented a program that trained prisoners to assist with the care of patients at SCI Dallas in 2001. On August 16, 2005, a hospice program was launched at SCI Graterford; after Graterford closed, the program continued at SCI Phoenix when that facility opened in July 2018.
Currently there are 19 active infirmaries in Pennsylvania’s prison system, and facilities without infirmaries have combined services with neighboring prisons. All facilities with infirmaries can have hospice programs. SCI Laurel Highlands also offers hospice services for long-term care patients.
Prisoners who volunteer to provide hospice care are subject to security reviews by prison staff; thus, there may not always be enough volunteers available at each facility to staff hospice programs.
The hospice support team is comprised of prison medical staff, administrative staff, chaplaincy and prisoner volunteers, all of whom have cared for approximately 65 terminally ill prisoners, helping them die peacefully and with dignity. Although the SCI Phoenix hospice program is growing, deferment of sentence medical parole – also called compassionate release – is not. Only three prisoners have been granted medical release to a licensed hospice facility or home hospice since the inception of the hospice program at SCI Graterford. There was just one compassionate release at Graterford in 2017.
There are many reasons why compassionate release is difficult for prisoners and their families to obtain; for one, they often do not know how to begin the process. The Journal of Ethics states that “Nationwide, compassionate releases occur relatively infrequently. Out of 2,621 requests for compassionate release during a one-year span in the Federal Bureau of Prisons, only 85 (3.24 percent) were granted. State prison systems are likely to have similar if not lower rates of release. These low rates stem in large part from state and federal policies with restrictive medical and criminological eligibility criteria for release.”
A prisoner’s family and doctor play a key role in advocating for compassionate or medical release. “Each person has dignity, which is not subject to circumstance and persists regardless of the situational context in which a person may find himself, including incarceration,” the Journal of Ethics states. “While physicians have professional responsibilities to uphold the dignity of their patients in an exam room, for example, they also have obligations to advocate for policy changes when they observe patient dignity being undermined in specific circumstances, such as incarceration.”
Education on this issue is needed; it is important to learn about the policies and requirements for medical release, which vary from state to state. In Pennsylvania, prisoners can seek assistance from the Pennsylvania Legal Aid Network.
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Ruth Hoskins, a licensed psychotherapist, provides support for the men who sit vigil at the bedside of dying prisoners at SCI Phoenix. She is an advocate for medical/compassionate release, and wrote this article exclusively for Prison Legal News. She can be contacted at prisonhospice@gmail.com.
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