Dying Inside: The HIV/AIDS Ward at Limestone Prison

Chapter 4. Courts, Legal Change, and Institutional Struggle

CHAPTER 4 Courts, Legal Change, and Institutional Struggle It is clear that the birth of the prisoner rights movement in the United States cannot be separated from the emergence of the civil rights movements of the late 1960s. For the ‹rst time, the myriad injustices behind bars were made transparent to the general public. In addition to the racist, violent, and unsanitary conditions of the nation ’s jails and prisons, civil rights lawyers and activists exposed the near absence of adequate health care and prenatal care for incarcerated mothers. In a time when few, if any, organizers were working with incarcerated women or girls, the work of imprisoned black women activists, such as Angela Davis and Assata Shakur, paved the way for a far more expansive movement of the 1970s. Early into that decade, grassroots organizations, such as Aid to Incarcerated Mothers , Prison Mothers and Their Children (Prison MATCH), and Legal Services for Prisoners with Children, began to emerge around the United States. These organizations drew explicitly on a radical feminist ethos that highlighted, among other concerns, the inclusion of all members, including former and current prisoners. Very early on, the line between prison and the community was blurred in the work of these organizations . Indeed, ex-prisoners were hired as staff, served on direc71 torial boards, started new programs in their own communities, and were active members in shaping the identity of these early prisoner rights organizations. Ellen Barry, founder of Legal Services for Prisoners with Children, explained: We were then and continue now to be very conscious about building a class of people who see themselves as part of an organizing structure. They are part of an effort to change the system, whether it is about medical care or it is about expanding alternatives to incarceration for pregnant women or whatever. The idea is that we are all conscious of each other and thus are responsible to each other.1 The Struggle in the Courts The early—and, in many ways, contemporary—prisoner rights movement is often characterized by a strong skepticism of litigation as a reliable tool for redressing prisoner abuses. However, as the movement began to pick up momentum in the sixties, so did the support for prisoner rights in the courts. Speci‹cally, the Warren Court’s revolutionary steps to protect basic prisoner rights under the Constitution ensured prisoners the basic rights to use the prison law library, practice their religion, and have access to lawyers. In the late seventies and early eighties, this trend in the courts toward upholding stronger prisoner rights protections continued. In perhaps its most pronounced af‹rmation, the Supreme Court ruled in Estelle v. Gamble (1976) that when prison of‹cials are deliberately indifferent to the serious medical needs of prisoners, they are acting unconstitutionally under the Eighth Amendment’s right to be free from cruel and unusual punishment. In Estelle v. Gamble, a Texas prisoner, J. W. Gamble, was denied adequate treatment for a severe back injury sustained while performing a prison work assignment. Still suffering from his injury, Gamble refused to go back to work and was subsequently placed in solitary con‹nement. While the Supreme Court did not rule in Gamble’s favor , it did take the opportunity to clarify a new standard—“deliberate indifference”—for what constituted “cruel and unusual treatment” of prisoners. 72 dying inside An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met. In the worst cases, such a failure may actually produce physical “torture or a lingering death,” the evils of most immediate concern to the drafters of the Amendment. In less serious cases, denial of medical care may result in pain and suffering which no one suggests would serve any penological purpose. The in›iction of such unnecessary suffering is inconsistent with contemporary standards of decency as manifested in modern legislation codifying the common law view that it is but just that the public be required to care for the prisoner, who cannot by reason of the deprivation of his liberty, care for himself. We therefore conclude that deliberate indifference to serious medical needs of prisoners constitutes the “unnecessary and wanton in›iction of pain.”2 In the decades since Estelle, the Supreme Court has dramatically narrowed the meaning of “deliberate indifference.”Rather than holding penal institutions accountable for indifference to prisoner suffering and...