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Former State Prosecutor and Criminal Trial Attorney

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Shocking & Callous Disregard for Human Life: The Duty of Care in Prison

Since the Supreme Court ruling in Estelle v. Gamble in 1976, correctional health care has been a matter of public debate. Inmates are the only Americans constitutionally entitled to health care, and a range of conduct from outright abuse or neglect to a general failure to deliver adequate medical care could be a violation of the Eighth Amendment. Prison health care is a national concern. And it’s not surprising that the debate has recently centered on Nevada’s Ely State Prison.

Ely State Prison

Ely State Prison is a maximum security facility. Opened in 1989, the prison houses more than 1,000 inmates and is home to Nevada’s death row. Prior to 2007, the national and Nevada branches of the American Civil Liberties Union (ACLU) became concerned about reports of conditions in the state-run facility.

One inmate, Charles Randolph, requested a specific heart medication. The medical staff was happy to oblige, noting the drug was potentially lethal, stating only “Your chances of expiring sooner are increased.”

Another inmate, David Riker, was denied medications and X-rays related to his rheumatoid arthritis. He was told that treating chronic pain was against prison policy.

In 2008, ACLU filed suit against the Nevada Board of Examiners claiming that prison officials put Ely inmates at risk because of inadequate medical care. The suit followed an ACLU-commissioned investigation, which culminated in Dr. William Noel stating that conditions at Ely exhibited “the most shocking and callous disregard for human life and suffering.”

Resulting Legislation

After two years, the ACLU and state of Nevada proposed a deal to settle the dispute. It means major reform for Nevada’s correctional health system. The agreement requires that an independent medical expert monitor, evaluate and report on the prison’s health care system. The settlement also mandates that necessary medications be available, treatment plans developed, and qualified medical personnel remains accessible for both routine and emergency care.

As news reports circulate about inmate deaths and injuries, medical neglect cases are becoming more common. For the injured inmate or his surviving family, the inescapable truth is that inmates have the right to proper medical care, and the state and private medical providers and non-medical personnel, such as prison guards, have a duty to ensure that adequate services are provided.

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