Leveraging Compassionate Release Reform to Advance Palliative Care for Seriously Ill Prisoners

Jail and prison healthcare services are responsible for treating a disproportionately growing number of seriously ill patients. However, correctional palliative care has focused almost exclusively on the important development of prison-based hospices, which are available to a relatively small proportion of seriously ill prisoners. Palliative care across the spectrum of serious illness has been largely absent from most correctional health care systems. Simultaneously, a national drive to address mass incarceration and enhance criminal justice reform has led to a renewed interest in compassionate release policies for seriously ill prisoners. These policies, which allow some seriously ill prisoners to die outside of prison, are often ineffective, primarily because (1) few clinicians have the palliative care knowledge needed to identify prisoners with serious illness, and (2) the policies rarely incorporate a palliative care framework and therefore fail to account for the realities of serious illness. The rapidly growing number of older and seriously ill prisoners, coupled with a national drive to advance criminal justice reform, has opened up an extraordinary opportunity to leverage the national interest in improving compassionate release policies to integrate key palliative care concepts into correctional healthcare for seriously ill prisoners. The ultimate goal of this project is to infuse correctional health care services and compassionate release policies, and the clinicians who enact them, with the palliative care knowledge needed to ensure appropriate and effective care for seriously ill prisoners.