Torture is something that we seem to have difficulty defining, especially when it comes to act of torture committed on ‘our’ behalf; thus, the United States commits acts of torture against enemies and defends them, while it would be furious if another nation was doing that sort of thing to US citizens. Except, of course, if you’re talking about the United States doing it to its own prisoners, who aren’t counted as full citizens and full human beings, and thus can be subjected to inhumane, abusive, and sometimes actively torturous conditions.
Access to medical treatment in the US prison system is very hit and miss, and in some cases, it is clearly being used as a tool for power and control. Not just that, but as a method for directly torturing inmates, whether for pleasure, discipline, or information-gathering. Just as torture is used in the outside world, torture in prisons becomes a powerful tool in the hands of those in power who want a method for terrifying their subjects. An awareness that torture occurs can be enough to keep people in check, because they fervently fear being the next victims and want to avoid it at all costs.
Ostensibly, prisoners must be provided with routine medical care, because they are under the jurisdiction of the state. Since they are in prison, they cannot exactly seek medical treatment independently, and they rely on the prison to provide it, whether this involves visiting an infirmary, being transported to a medical facility, or being provided with care in a cell. Prisoners also deserve appropriate followup care, including provision of medications, bandage changes, and other treatments that may be necessary to help them fully recover, or to help them manage chronic illnesses.
Prisons charge the state for the provision of medical services, and it can actually be a substantial part of a prison’s budget. Those services, though, don’t reach all prisoners. Mental health care in particular is very poor in the prison system, but access to treatment for physical conditions can be equally hard to come by. Prisoners may be ignored when they report health problems, or told that they need to wait for treatment. They may not be given their medications, or the prison might choose not to pay for expensive treatments on the grounds that it thinks they are not necessary; see, for example, the refusal to provide hormone replacement therapy to many transgender prisoners.
And sometimes, that care is deliberately and conscientiously denied. I would argue that this is a form of torture. The goal is to make the prisoner experience pain and suffering for the purpose of frightening or manipulating the prisoner into doing, or not doing, something. Perhaps a prisoner is considered a discipline problem, so guards withhold needed medication to punish the prisoner. Maybe a prisoner is refusing to provide information pertaining to an internal investigation, so prison officials decide to stop offering the prisoner regular psychiatric care. Perhaps guards simply want to torment a prisoner for whatever reason, and they decide to turn medication delivery into a game where the prisoner is forced to perform to get lifesaving drugs.
Denying medical care to prisoners can have a fatal impact. Patients may develop severe complications as a result of untreated medical conditions, for example, or may die because care isn’t provided in time in an emergency. Prisoners bleed out in their cells, die from severe head injuries, and miscarry because guards decide to deny them needed medical treatment. If prisoners manage to survive when guards leave them to suffer, they have few avenues to pursue when it comes to getting any kind of compensation, or fighting to protect other prisoners.
Because prisoners have no value to most of society, and thus it’s hard to mobilise people to support prisoners and lobby for better access to medical care in prisons. Determining that denial of medical care is a form of torture would not necessarily further the cause, because many people seem very comfortable with the idea of torturing prisoners; they feel that prisoners deserve it, or have signed their human rights away by entering the walls of correctional institutions. Thus, there’s little interest in creating humane conditions in prison, let alone questioning the system as a whole.
Guards should be investigated and punished for engaging in this kind of behaviour, which endangers medically needy prisoners as well as the rest of the prison population and some of the guards as well. Instead, administrators often leave guards largely unsupervised, with minimal attempt at keeping order and making sure guards behave ethically and appropriately when they manage the prison. The consequence is a dangerous world for prisoners and guards alike, one where torture of many forms is commonplace and the consequences for such are few and far between. Guards operate in awareness of the fact that, if anything, they might be praised for withholding medical care because it saves the prison money, and might just get rid of some pesky and unwanted members of the prison population known for their rabblerousing.
It is troubling indeed that a sentence to prison can become a death sentence for so many, and that prisons do not take their responsibility to provide health care very seriously. This should be a source of national shame and embarrassment, instead of an unspoken secret. How can the United States take the high moral ground on torture when it sanctions and sometimes even promotes torture of its prisoners, and regularly uses torture as part of the war on terrorism?