Giving Compass' Take:

• In this story from the AMA Journal of Ethics, authors Andreas Mitchell and Brie Williams argue for compassionate release of prisoners with serious progressive and terminal illnesses.

• What is barring prisons from releasing prisoners even when compassionate release laws apply?

• To learn about some possible next steps to prison reform, click here.

A rapidly aging correctional population has led to an increasing number of patients with serious progressive and terminal illnesses in correctional settings. “Compassionate release” describes a range of policies offering early release or parole to incarcerated patients with serious or debilitating illnesses. However, in many states that have compassionate release policies, few patients are actually granted release. We describe how the continued incarceration of patients with serious or debilitating illness can constitute a violation of human dignity if appropriate palliative care is unavailable. We argue that, given the importance in medical ethics of upholding dignity, physicians should advocate for the appropriate application and use of compassionate release.

For humanitarian, practical, and economic reasons, 47 states and the District of Columbia have some form of early release mechanism for seriously ill or disabled incarcerated patients. “Compassionate release” is a broad term used to describe a range of these types of policies (including medical parole, emergency parole, and medical release). Most, if not all, share the requirement for a physician to determine medical eligibility for potential candidates, although medical eligibility differs by jurisdiction.

Compassionate release policies are designed in recognition of the fact that an appropriate level of care for patients with severe or debilitating illnesses is difficult, and sometimes impossible, to achieve in the correctional setting. For instance, the community standard for end-of-life care is to offer patients hospice; however, prison hospices are available only at 69 of 1,719 state correctional facilities, and they often require patients to move farther away from family or friends at a time when maintaining social connections is a core component of quality care.

Read the full article about compassionate release by Andreas Mitchell and Brie Williams, MD, MS, at the AMA Journal of Ethics