Civil Liberties

When Prisons Become Nursing Homes

The case for compassion


When Americans think of federal prisons, they probably don't picture nursing homes. But maybe they should. Thanks to the long mandatory sentences that come with many drug offenses, elderly inmates have emerged as the fastest-growing sector of the federal prison population.

As of June 2017, there were nearly 35,000 federal inmates over the age of 51; 10,000 were over the age of 60. Many of these prisoners suffer the same illnesses afflicting the elderly population in free America, from heart disease to Type 2 diabetes to cancer. The difference is that elderly prisoners receive care while shackled to a bed.

Many aging and sick federal prisoners die under horrid conditions—but they needn't. In 1984, Congress empowered the director of the Federal Bureau of Prisons (BOP) to petition for the early release of inmates in "extraordinary and compelling" circumstances. This power is formally called "compassionate release." It's perfectly legal and reasonably safe: Older prisoners seldom resume their criminal behavior upon release, and terminally ill prisoners almost never do.

Yet the BOP uses compassionate release sparingly. After being diagnosed with pancreatic cancer—which is often fatal when treated by even the country's finest physicians—Michael Hodge, who received a 20-year sentence for marijuana trafficking, asked to be allowed to die at home with his wife. He was denied without explanation.

For years, advocates on both the left and the right have begged the BOP to use compassionate release more often. In 2013, Justice Department Inspector General Michael E. Horowitz joined them, citing the astronomical cost of incarcerating and treating the elderly. By his office's calculations, prisons with older populations spend $10,114 on health care annually per prisoner, while facilities with younger populations spend just $1,916. In 2016, the U.S. Sentencing Commission expanded the criteria in hopes of addressing both the human and the financial costs of forcing aging drug war prisoners to spend their final days locked up.

While we don't know how many petitions the BOP denies each year, Human Rights Watch reports that it has granted, on average, less than two dozen annually since 1992.

That could soon change. In July, Sen. Richard Shelby (R–Ala.) ordered the BOP to explain in full how it administers this option, and asked for data on everything from who gets rejected and why to how many prisoners have died while waiting for the BOP to decide on their petitions.

Reformers have a long list of policies they'd like the Bureau of Prisons to change. Some would require completely rethinking how we incarcerate people. But allowing the sick and elderly to die with dignity should be a relatively easy call.

NEXT: Legal Marijuana Is Becoming the Norm

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  1. I've read similar articles over the years, and always somewhat surprised that human rights campaigners don't scream bloody murder about the capitalists turning compassionate release into a mere matter of dollars, that the government wants to release sick prisoners only to save money treating them. The cynic in me fully expects some kind of deal: you can release sick prisoners early if you still promise to pay for their health care.

    1. Most of these aging prisoners are going to be poor when (if) released. Therefore they'll end up on Medicaid and their health care will still be paid for by taxpayers.

      I think the nationwide average cost to house prisoners is something like $3000 a month. If you add in-prison health care for the aging/ill prisoner on top of that, it might be cheaper to kick them out of prison and put them in a $5000~$6000 a month private nursing home.

  2. So take someone who is too sick and old to work, has a high chance of having a crappy to non-existent support network, and call kicking them out on the street to fend for themselves compassionate. Yeah, sure, sounds like a great plan. I don't know if Reason knows this, but they don't always consult the prisoners on these release plans. When things start getting crowded they find any excuse to get some people out. Even when it's not what they want or what's best for them. Some people would rather serve their entire time than risk parole. Some people would rather spend their final years with a roof over their head and guaranteed three square meals a day, than trying to resume a life they left twenty/thirty years ago.

    I will only be for more use of compassionate release, if it is required that the prisoners agree to it.

    1. Ha! You're too gullible. Any prisoner who doesn't want early release can always find a convenient guard to attack, or smash up some dining tables. If they're too far gone to manage that, they probably don't even recognize the difference between prison and hospice.

      1. Not every prison is max security. If you are in a minimum security facility and try that, you get bumped up from spending time with non-violent well behaved offenders to a facility filled with rapist, murders, and generally violent folks.

    2. This rant was started because I know of a woman that has just been released on her third ten year parole attempt. Each time she is released she ends up violating parole on a technicality. If it weren't for the repeated paroles she would have been free and clear of her prison term five years ago. She knows this, and with only two years left in her prison term. She wants to stay in prison and finish her term instead of going on another ten year parole, with the constant threat of going back to prison again. One of these compassion for prisoners initiatives has just forced her out on parole again. Against her explicit will.

  3. Many of these prisoners suffer the same illnesses afflicting the elderly population in free America, from heart disease to Type 2 diabetes to cancer.

    Interesting; I thought the party line was that all those illnesses are due to the hedonistic lifestyle of eat, drink, and be fat. Please tell me that prisons do not allow that.

    1. No, each prisoner has a personal trainer and a carefully supervised diet prepared by the best chefs. /sarc

  4. "Many aging and sick federal prisoners die under horrid conditions?but they needn't. In 1984, Congres..."

    OK, I stopped there.

    In 1788, the people of the United States empowered the President of the United States to grant pardons and reprieves for offenses against the United States.

  5. How about we tax the pension funds of all the legislators, state and federal, who have voted for any mandatory minimum sentence laws? Maybe at 100%? Use those funds, and "mandatory contributions" from all political campaign accounts of 100% to provide the needed health care of these evil hardened criminals who pose such a risk to society.

    As a bonus, no one could afford all those nasty campaign ads.


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