Vanderbilt Law Review

First Page



Most Americans have little knowledge or concern about what hap- pens inside this Nation's prisons.' Unless prisoners riot, they generally are far removed from the popular consciousness. Members of society beyond prison walls hear about only the most severe and exceptional cases of prisoner suffering. When prisoners do not receive adequate medical treatment, however, they may suffer harm beyond the segregation from society and loss of liberty contemplated by incarceration. A discussion of the medical care that prisoners receive must begin, therefore, with a recognition of the paradox of taking care of individuals about whom very few people in society care.

The issue of the adequacy of prison health care is very important today. The deprivation of adequate medical care frequently is a basis for lawsuits filed by prisoners in the United States. Prison health care delivery today fails to measure up to acceptable standards. While commentators agree that reform of health care delivery systems in this Nation's prisons remains necessary," the problem of inadequate prison health care is considerably more difficult to remedy than it is to ac- knowledge. The quality, quantity, accessibility, continuity, and efficiency of prison medical services all draw criticism. Furthermore, direct and unequivocal statements from courts and commentators concerning prison health care are very rare. This vagueness produces inaction and indecision that, combined with public apathy and the political powerlessness of prisoners, has served only to exacerbate problems in the delivery of prison health care.