Ethical Treatment of Prisoners
Ethical Treatment of Prisoners Iris J. O’Halloran Soc 120 Introduction to Ethics and Social Responsibility Brett Cross April 8, 2013 Today there are millions of people in prison throughout the United States; because of this fact the ethical treatment of prisoners is a topic that has been analyzed by many on a constant basis. Many modifications have been made to help accommodate inmates and try and maintain their human rights. Ethics according to Mosser, K (2010), is the study of moral values of human’s behavior. Ethics are also rules and principles that are meant to control the behavior of humans.
According to Mosser K, (2010) there are different theories that philosophers have come up with to explain the meaning of ethics. These theories have different approaches on how to handle the issue of ethical treatment of prisoners. When it comes to the question about the ethical treatment of prisoners, researchers have come up with many answers, but have society done enough regarding the ethical treatment of prisoners or has society made their lives in prison to easy and because of this life in prison is no longer a punishment for inmates?
According to an article which was written in the BJpsych by Dr. Luke, Birmingham prisoners encounter numerous maltreatments while in prison. Dr. Birmingham states that one of the major maltreatments prisoners suffer while in prison is the way their mental illness is dealt with while in prison. Mental disorder is more widely among people in prison that it is in the general population. There are prisoners who require being transfer to psychiatric hospitals for treatment, but these prisoners face long delays.
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According to Birmingham doctors who work in prisons face ethical and legal dilemmas posed by prisoners with mental illness. Another issue that these inmates encounter while in prison is solitary confinement. According to another article written in the Journal of the American Academy of Psychiatry and the Law, which was written by Doctor Metzner and Fellner Esq, in recent years officials have turned to solitary confinement as a way to manage very dangerous and hard to handle prisoners. Many of these prisoners who are placed in isolation which can be there for years have severe mental illness.
The conditions of solitary confinement can make these prisoners more violent or in some instance provoke recurrence. When prisoners are placed in solitary confinement the rules restrict the nature and how much mental health services they can receive. According to Metzner and Fellner another issue is the fact that doctors who work in US prisons face very difficult ethical challenges which rice from poor working conditions, loyalties to patience and employers, and the stress between reasonable medical practice and the prison rules and culture.
Doctors are confronting a new challenge in recent years, the prolonged solitary confinement of inmates with severe mental illness; this is a corrections practice that has become prevalent even knowing the psychological harm it can cause these inmates. Doctor Metzner and Fellner believe that solitary confinement can be psychological stressor, that in many cases can be a clinically stressor and it can be as harmful as physical torture. United States prison officials have raised solitary confinement to a mean of punishment and to control difficult or dangerous prisoners.
Tens of thousands of inmates spend years locked up 23 to 24 hours a day in very small cells that have solid steel doors. These prisoners live with high surveillance and they do not have simple social interactions, they only have three to five hours a week of recreation alone in caged enclosures. These prisoners have little if any at all educational, vocational, or other purposeful activities. The prisoners in solitary confinement are handcuffed and often shackled every time they leave their cells.
According to Metzner and Fullner confinement can cause psychological damage to any prisoner, the severity of the impact depends on the individual, also in the duration, and conditions of the confinement. These psychological effects include anxiety, depression, anger, cognitive disturbances, perceptual distortions, obsessive thoughts, paranoia, and psychosis. The unfavorable effects of solitary confinement are important to a person with severe mental illness.
Because of the stress and because these prisoners are kept away from social contact and days without structure this can increase symptoms or provoke recurrence. Cases of suicides occur more often in segregation units than anywhere else in prison. Many of these prisoners will not get better as long as they are kept in isolation. Psychologists often cannot make less harsh the harm that is associated with isolation. Services provided in segregation units are limited.
Services such as individual therapy, group therapy, structured educational, recreational, life skill enhancing activities and many other therapeutic options are often not available due to insufficient resources and also the rules that require the prisoners to remain in their cells. According to Metzner and Fellner studies have shown that eight to 19 percent of prisoners have psychiatric disorders, this can result in a large functional disabilities. Another 15 to 20 percent do require some form of psychiatric intervention while in prison.
Metzner and Fellner state that a survey done on correctional systems showed that 15 percent or more of their prisoners had been diagnosed with a mental illness. Many correctional health care providers struggle with the lack of resources and the large caseloads that can often limit the services they can provide their patients. The ethical way for these health care professionals to handle these situations is to do the best they can under the circumstances instead of resigning, which would result in less services for these prisoners.
According to Metzner and Fellner it is ethical for psychologist to treat inmates who have been abused, and that they should also take measures to end this abuse. These health professionals should not only provide services to mental ill prisoners, but they should also try and change the prison’s system and segregation policies and if that fails these health professionals should go public. Although going public with these prison issues can be difficult to do for these health professionals because of the risk of losing their jobs, they should not do this task alone. Their professional organizations should help them.
These organizations should realize that prolonged segregation of prisoners with severe mental illness violates basic tenets of mental health treatment. The standards of the NCCHC recommend that mentally ill inmates be excluded from extreme isolation, the placement of these prisoners into these conditions can clinically deteriorate their condition and it will not improve. These are only a recommendation done by NCCHC. Because very few APA and AMA physicians have experience or have knowledge about correctional mental health care, they are not familiar with the difference between general population housing unit and a segregation nit, therefor the recommendations cannot be made mandatory instead of optional. Metzner and Fellner state that a serious educational effort must be established so that none correctional mental health practitioners have a better understanding of the world in which their correctional co-workers work in, and to better understand the challenges they face, including the isolation of severe mental ill patients for month at a time and sometimes years.
According to Metzner and Fellner studies have shown that prisons can operate safely and they can be securely without putting prisoners that have mental illness in segregation. In some prisons mentally ill prisoners are given more time outside their cells, and they are also provided with group therapy and other therapeutic interventions. These improved clinical responses to prisoners with mental illness have been achieved with little sacrifice to needed control of prisoners who willfully violate prison rules.
Mental health organizations should acknowledge that is unethical to keep silence about the conditions of confinement and the harm that this confinement cause inmates, and violates human rights. These organizations should also make sure that practitioners provide ethical services to segregated prisoners with mental illness, and they should also strive to change harmful segregation policies. The organizations should also make use of their institutional authority to press for nationwide rethinking of the use of isolation.
By doing this the medical commitment to ethics and human rights would be well served. According to another article which was written in the National Academy of Science, the conditions of confinement in today’s prisons have the same features that were of concern to the national commission for the protection of human behavioral research about 30 years ago. However new factors have emerged that will require consideration. These factors are the correctional population has grown from 1. million to almost seven million between 1978 and 2004, because of tougher sentencing laws and the war against drugs. According to the article due to the closing of large state mental institutions, prisons have become the new mental illness asylums. Health care in some of these prisons is very poor. Many class actions have been put in place about the inadequate of state prisons health-care system. According to the article a high number of prisoners suffer from infectious deceases, chronic diseases, and mental illness.
A three year study that was requested by congress and that was done in May 2002 by the National Commission of correctional health care revealed that thousands of prisoners are being released into communities every year with deceases that were not diagnosed and were not treated while they were in prison. According to the article while in prison white inmates were more likely than black and Hipic inmates to receive mental health treatment. Without the necessary treatment mentally ill prisoners suffer painfully symptoms and often their condition deteriorates.
The article states that prisons were never intended to be mentally ill facilities, yet that is one their primary role today. Often man and woman that cannot afford to get mental illness help in their communities are swept away into criminal justice system after they commit a crime. In the United States there three times more mentally ill people in jail than in mental hospitals, inmates have mental issues that are two to four times higher than members of the general public. The New York Times conducted a yearlong examination of prison health services; this examination revealed that in many instances the medical care was inadequate and lethal.
According to the National Academy of Science the New York City department of health and mental hygiene showed that at Rikers Island and at a jail in lower Manhattan the prison health failed to earn a passing grade on 12 of 39 performance standards, these performance standards are set by the city to evaluate the treatment of inmates. The prison health did not meet standards on practices from HIV and diabetes therapy to timely distribution of medication to properly conducting mental health evaluations.
An article written in the American Bar Association, standard of treatment of prisoners, (2010) states that in February 2010, the ABA House of Delegates approved a set of ABA criminal justice standards on treatment of prisoners. The new standards supplant prior ABA criminal justice standards. Standard 23-2. 5, Health Care Assessment, this standard states each prisoner should receive a comprehensive medical and mental health assessment and these should be done by a qualified medical and mental health professional and it should be provided no later than 14 days after admission to a correctional facility.
This medical treatment should be done periodically thereafter, and it should include mental health screening. Dental examinations should also be done by a dentist or trained personnel directed by a dentist and they should be done within 90 days of admission this if the prisoner’s confinement exceeds one year and it should be done annually thereafter. Standard 23-2. 6 Rationales for Segregated housing, states correctional authorities should only place prisoners in segregation if it relates to discipline, security, and ongoing investigation of misconduct or crime, protection from harm, medical care, or mental health care.
This segregation should be for a brief time and under the least restrictive conditions practicable. When necessary due to an investigation, correctional facilities should be permitted to confine an inmate to segregation for a period of no more than 30 days. Standard 23-2. 8, Segregated housing and mental health, this standard states no inmate who is diagnosed with serious mental illness should be placed in long term segregated housing. The implementation of these few standards has improved the treatment of inmates across the country, but there are still many correctional facilities that require more improvements.
According to Mosser, K (2010) there are different ways in which the ethical treatment of prisoners can be dealt with. Mosser states that there are different theories that philosophers have come up with to explain ethics. Three main theories are Utilitarianism, Deontology, and Virtue ethics. There are also three different approaches to these ethics theories, Relativism, Emotivism and ethical Egoism. All of them give a different approach and a different solution to the ethical treatment of prisoners.
The Utilitarianism is the theory that one should choose to do that which produces a better outcome for the largest number of people. This theory evaluates whether an act is wright of wrong in terms of the acts consequences. Mosser, (2010). Deontology states that are ones duty an obligation to threat other people with respect, human beings have dignity and we must take that dignity into consideration when dealing with them. Deontology can lead to results that contradict common sense and the conception of right and wrong.
Another theory is Virtual ethics this theory looks at the character of the person performing the act. There are three different approaches to the theories according to Mosser, K. (2010), these are Relativism, Emotivism, and Ethical Egoism. Relativism according to Mosser is ones beliefs and values are understood in terms of one’s society, culture, and one’s individual values. Emotivism according to Mosser, it sees our moral evaluations as the expression of whether we respond to a given act by liking it, or not liking it.
This approach involves emotional feelings. Ethical egoism, this approach contrast with ethical theories of utilitarianism, deontology, virtue ethics, and most religions. Ethical egoism according to Mosser states that our moral evaluations should be made in terms of our desires and goals. After evaluating all of the different theories and approaches to these theories, I would have to agree with the theory of Utilitarianism as being the best approach as how to solve the ethical treatment of prisoners.
I would also have to agree with the Deontology theory, because I strongly agree that even though prisoners have committed a crime they should be treated with dignity after all they are still humans. From the three approaches to the main theories, relativism, emotivism, and ethical egoism, I would say relativism would help resolve the problem with a more positive outcome. Because relativism indicates that one’s beliefs and values are understood in terms of one’s society and culture, the majority of our society believes that if you commit a crime you should pay for it.
The theory of Utilitarianism states that the moral worth of an action should be determined by its usefulness in increasing utility and reducing negative utility. The ethical treatment of prisoners has for the most part improved. Standards have been put in place to aid these issues and help the improvement of the treatment of prisoners. For the most part the whole world has a moral code on how people should behave themselves, and what is wrong and wright. It is a worldwide fact that to commit murder is wrong, it is wrong to steal, and to intentionally hurt another human being physically.
The utilitarian theory can be used in jails to help prisoners correct their behavior, and when prisoners do not have a life sentence they can come out into society with a better look on life and not a negative one like when they first went into prison. I know that some crimes can be horrific in nature and once we have looked at those horrific crimes we can become outraged and very angry, but if we can keep an open mind and be humanitarian towards those criminals we can find some kind of peace in our hearts. References Jeffrey L. Metzner. M. D and Jamie Fellner Esq.
Solitary Confinement and Mental Illness in US prisons: A challenge for medical ethics. www. jaapl. org/content/38/1/104. full Mark, Earthrowl, John, O’Grady, and Luke Birmingham. Providing treatment to prisoners with mental disorders: development of a policy. Bjp. rcpsych. org/content/182/4/299. short Standards on Treatment of Prisoners. http://www. americanbar. org/publications Mosser, K. (2010). Introduction to Ethics and Social Responsibility. San Diego, CA: Bridge point Education, Inc. Banks, C. (2004) Criminal Justice ethics: theory and practice. SAGE
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