The Associated Press got a sneak preview of a new study that found the medical ethics of healthcare workers on Rikers Island are seriously compromised — especially when they are involved in placing inmates in solitary confinement:
The two-year study at New York’s sprawling Rikers Island jail complex concluded with a bold recommendation to remove health workers entirely from the most contentious issue they face — whether to put an inmate in solitary. That’s because many doctors believe the confinement, which involves 23-hour stretches of isolation, could harm inmates.
Additionally, over 90% of health workers reported they treated an inmate for what was filed as a fight with another inmate, when in fact the inmate claimed to have been assaulted by guards. 16% had “heard of or seen” guards beating inmates at the health clinic. Many acknowledged concern over retaliation if they reported guard-on-inmate violence.
Unfortunately, the report’s central recommendation to remove healthcare workers from the placement process for solitary confinement directly contradicts the new rules adopted by the Board of Correction this past January.
In establishing the new super-isolation facility known as the Enhanced Supervision Housing Unit (ESHU), the Board made mental health workers an essential part of the placement process. According to the new rules, mental health staff “shall be permitted to review ESH placements and participate in placement review hearings” and have the power to “determine that the inmate shall be barred from ESH placement or shall be moved from ESH to a more appropriate housing unit.”
These measures were adopted in a conscious effort to shift power away from notoriously abusive corrections officers, whose radical use of solitary confinement was one of the original drivers of reform. With medical staff evaluating inmates, the thinking went, the DOC could divert people who were identified as too severely mentally or physically ill from the ESHU and punitive segregation, and into specialized ‘therapeutic’ housing units.
This may sound like a good idea, but in reality it is asking mental health workers to participate in a dangerous Catch-22: they are technically the best-equipped for the job, but are also automatically disqualified from recommending anyone without violating medical ethics. As the authors of the study write, “Whatever the security reasoning for placement in such units, the participation of health staff in this process is cumbersome, time intensive, of questionable value and does not reflect a patient-health provider interaction that is in the patient’s best interest.”
Additionally, medical staff must work alongside guards that are often violent and vindictive, and may find difficulty reconciling the need for ‘security’ with inmate health needs. They might also feel pressured in this atmosphere and feel they are unable to report abuse or mismanagement by those guards out of fear of retaliation.
On top of it all, many of these healthcare workers come from the infamously negligent inmate medical contractor, Corizon Health Services, which is alleged to have been directly responsible for multiple deaths and mutilations in solitary units on Rikers Island.
The ESHU was doomed from the start because something as inherently harmful as solitary confinement can’t be reformed. No matter how much we tinker with the protocols, there will never be a safe or rehabilitative way of isolating someone. If NYC really wanted to be a leader in prison reform, it would have made plans to end solitary confinement altogether.
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