Cruel Confinement: Abuse, discrimination and death within Alabama’s prisons

  An investigation by the Southern Poverty Law Center (SPLC) and Alabama Disabilities Advocacy Program (ADAP) has found that for many people incarcerated in Alabama’s state prisons, a sentence is more than a loss of freedom. Prisoners, including those with disabilities and serious physical and mental illnesses, are condemned to penitentiaries where systemic indifference, discrimination and dangerous – even life-threatening – conditions are the norm.

  The Alabama Department of Corrections (ADOC) is deliberately indifferent to the serious medical needs of the prisoners in its custody. Inspections of 15 Alabama prisons, interviews with well over 100 prisoners and a review of thousands of pages of medical records, depositions and media accounts – as well as the policies, contracts and reports of the department and two major contractors – lead to one inescapable conclusion: Alabama’s prisons violate federal law protecting people with disabilities and the U.S. Constitution’s ban on “cruel and unusual punishments.”

  This disregard for the law endangers the health and lives of prisoners. The ADOC’s actions demonstrate a valuing of cost over human life. The following are just a few examples of the consequences:

-A prisoner who had survived prostate cancer had a blood test indicating his cancer had probably returned, but no follow-up test was given until a year and a half later. By that time, the cancer had spread to his bones and was terminal. He died less than a year later, in February 2014.

-A prisoner undergoing dialysis died after he was given an injection of a substance that sent him into cardiac arrest in January 2014. Although there was a cart stocked with emergency medical equipment in the dialysis unit, no one present knew how to use it to save the man’s life.

-A prisoner who had undergone abdominal surgery died after complaining to the medical staff that he was bleeding from his rectum. Although the man had requested two new pairs of pants the day he died because he kept bleeding through his clothes, the medical staff offered him only an antacid.

-A prisoner incarcerated eight years ago after being shot in the groin had been told at the time of the shooting that he would have a catheter and a colostomy bag for six months before having surgery to repair damage from the gunshot. Almost a decade later, he has not had the surgery. He is in constant pain, sometimes urinating blood. He endures frequent infections from the catheter, often requiring hospitalization.

-Numerous prisoners have had toes, feet or portions of legs amputated as a result of poor diabetes care. Some diabetic prisoners have reported that they have not had their blood sugar measured in months.

-Psychiatric medication is often stopped or changed without any discussion between the psychiatrist and the patient.

-Numerous prisoners have been placed under “Do Not Resuscitate” or “Allow Natural Death” orders without their consent or even their knowledge.

  Prisoners with disabilities face many forms of discrimination. People in wheelchairs can’t access critical areas of facilities. At Kilby Correctional Facility, a wheelchair-bound prisoner is housed in a dormitory that has no wheelchair-accessible exits to the outside. The prisoner had no assistance when the facility was evacuated twice in May 2014, once for a fire and again for a gas leak. He had to struggle against the flow of evacuating prisoners to go farther into the prison to use a wheelchair-accessible exit.

  Prisoners wishing to receive medical care are expected to complete a written form to request it – a potential hurdle for those who are blind or have cognitive disabilities. Blind prisoners are routinely asked to sign documents that they cannot read. The SPLC and ADAP have learned of two blind prisoners who unknowingly signed “Do Not Resuscitate” orders.

  The state’s legal responsibilities are clear: Alabama has a constitutional obligation to provide adequate medical and mental health care to individuals in its custody. In 2011, the U.S. Supreme Court found in Brown v. Plata that depriving prisoners of adequate medical care “is incompatible with the concept of human dignity and has no place in civilized society.” Deliberate indifference to these medical needs constitutes “unnecessary and wanton infliction of pain” barred by the Eighth Amendment.

  Alabama also must ensure that its prisons, programs, activities and services are accessible to prisoners with disabilities under Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973. Instead, the ADOC systematically violates federal law, leaving people with disabilities isolated, unable to participate in prison programs and deprived of the medical care they need.

  Alabama illegally operates a corrections system that is little more than a network of human warehouses, a place where individuals caught in the criminal justice system are banished and forgotten.

  A conviction does not open the door for the state to engage in cruelty. Whenever Alabama determines a person must be incarcerated, it must accept the legal – and moral – responsibility that comes from imprisoning a human being.

  Read the full report (PDF).

  This article was published by the Southern Poverty Law Center.