Ageing in Prison: The ‘other life sentence’?

James Ridgway’s recent piece in Mother Jones brings clearly into view the challenges faced by elderly inmates facing lengthy periods of incarceration. His article opens by describing the situation of William “Lefty” Gilday, who 

“had been in prison 40 years when the dementia began to set in. At 82, he was already suffering from advanced Parkinson’s disease and a host of other ailments, and his friends at MCI Shirley, a medium security prison in Massachusetts, tried to take care of him as best they could. Most of them were aging lifers like Lefty, facing the prospect of one day dying behind bars themselves, so they formed an ad hoc hospice team in their crowded ward. They bought special food from the commissary, heated it in an ancient microwave, and fed it to their friend. They helped him to the toilet and cleaned him up. Joe Labriola, 64, tried to see that Lefty got a little sunshine every day, wheeling his chair out into the yard and sitting with his arm around him to keep him from falling out.

But Lefty, who was serving life without parole for killing a police officer during a failed bank heist in 1970, slipped ever deeper into dementia. One day he threw an empty milk carton at a guard and was placed in a “medical bubble,” a kind of solitary confinement unit with a glass window that enables health care staffers to keep an eye on the prisoner. His friends were denied entrance, but Joe managed to slip in one day. He recalls an overpowering stench of piss and shit and a stack of unopened food containers—Lefty explained that he couldn’t open the tabs. Joe also noticed that the nurses in the adjoining observation room had blocked the glass with manila folders so they wouldn’t have to look at the old man.”

Ridgway goes on to note that as of 2010, state and federal prisons in the US housed more than 26,000 inmates aged 65 and older and nearly five times that number aged 55 and up, according to a recent Human Rights Watch report. He points out the significance of both numbers, since “long-term incarceration is said to add 10 years to a person’s physical age; in prison, 55 is old”. From 1995 to 2010, as America’s prison population grew 42 percent, the number of inmates over 55 grew at nearly seven times that rate. Today, roughly 1 in 12 state and federal prison inmates is 55 or older.

Ridgway’s work draws on themes explored by criminologist Azrini Wahidin in her work on the passage of prison time, and the sense of acceleration of ageing whilst in prison, and it also draws attention to the carceral ‘timespace’ of imprisonment, which I explore in a forthcoming paper in Geografiska Annaler B. By bringing debates over experiential time within human geography and criminology/prison sociology into dialogue with one another, this paper draws attention to the imperative of considering time in the geographical study of incarceration. Informed by an understanding of space and time which sees them as analytically inseparable from each other (‘TimeSpace’), it highlights overlapping temporalities in a carceral context, and in demonstrates both the significance of perceived control over time, and the experience of the lifecourse, when past, present and future are viewed through each successive ‘now’ in a context where (clock) time ‘moves on’ but space is fixed.

Ridgway’s piece highlights the specific challenges of incarceration for some elderly inmates, which emphasise the importance of considering the embodied experience of ageing in understanding the personal experience of imprisonment:

“Lifer John Feroli told the following story in one of his letters: “A guy in his 70s I knew personally was in the [solitary confinement] unit because he failed to stand for the afternoon count. He was on the third floor of the housing unit, he was partially paralyzed from a stroke and the batteries in his hearing aid were dead and he never heard the announcement for Count Time.” Another convicted murderer, 73-year-old Billy Barnoski, wrote me in April to report that he was in solitary after a younger cellmate jumped him and beat him up. His friends came to his aid, there was a melee, and four people were thrown in the hole. Barnoski suffers from a heart condition called atrial fibrillation, which is treated with a blood thinner called coumadin. He also has high blood pressure, high cholesterol, shingles, and severe arthritis in his back and neck. He takes 25 pills daily. “There have been many times, so many, that they simply say, ‘We haven’t got that med today,'” he writes. “Mind you it has been heart meds just last week. Locked in this hole without necessary meds is torture.”

With ever longer sentences and increasing incarceration rates, the number of elderly inmates is rising, Ridgway’s article also asks whether the US can afford to incarcerate persons with the particular needs described above. However, as he also points out, there are few prison hospices nor immediate plans to build any. “By 2020, according to the state’s DOC Master Plan, Massachusetts will need three “new specialized facilities” to house an estimated 1,270 prisoners with medical or mental health issues that would preclude them being housed in “regular” prisons. “We don’t have have a position on compassionate, geriatric, or any other type of release,” a DOC spokeswoman told me via email. “That’s up to the Legislature.””

Prisoners in Medical Research: Consent, Incentive and the Confined Body

Many thanks to Ebru Ustundag for alerting me to this recent paper arising from a national study led by Dr. Flora I. Matheson, a research scientist at St. Michael’s Hospital’s Centre for Research on Inner City Health, Toronto, Canada. The paper, published in the American Journal of Public Health, draws attention to the use of prisoners in Canada’s correctional system for medical and behavioural research, and in particular to the variety of policies and practices which surround the use of incentives for prisoners to take part in such research.

The paper points out that although prisoners are considered a vulnerable population in Canada, there is no specific regulation for ethical considerations for research involving prisoners, in terms of the use of incentives (anything offered to participants, monetary or otherwise, for participation in research). The authors point out the complications in offering incentives to prisoners: i.e. that for some, incentives could act as an undue inducement which could affect the voluntariness of consent; that offering incentives to nonoffenders but not to offenders could be seen as discriminatory; that some could argue that since prisoners are being ‘punished’ for breaking the law, they should not be ‘rewarded’ in any way for participation in research; and that providing incentives to offenders who meet research eligibility criteria (e.g. age, gender) but not to those who are not eligible, could create resentment within the prison environment. The paper concludes by suggesting ways forward for policy development in Canada to ensure effective and equitable engagement between researchers and the prison population, and an improved code of ethics for this population.

Whilst drawing attention to a particular issue of incentives and consent, this paper highlights in a broader sense the potential effects of confinement of the prisoner body; i.e. that confinement of the body places the body in a vulnerable position in relation to those who have a use to which it can be put. As the authors point out, ‘in history, offenders have been used in a variety of medical and behavioural studies without a properly informed consent process, often with little choice over their participation’ (Matheson et al 2012, 1438). Extreme examples, of course, include Nazi experimentation on thousands of concentration camp prisoners without their consent, and the recent revelations that American PoWs in Japan were apparently dissected alive. The bodies of dead prisoners have commonly been utilised for dissection and anatomical research: a 2007 Japanese study into the sources of cadavers for dissection by medical students found that in the mid Edo era, the bodies of executed prisoners were used to study internal body parts. Later, unclaimed bodies, including those from prisons, were used for dissection.

The disenfranchisement of prisoners apparently extended to the use of their bodies after death; according to research conducted by Ross Jones, in 1862, when the first Australian medical school was established in Melbourne, corpses were in such short supply that the Victorian Parliament passed the Anatomy Act to legalise the collection and dissection of cadavers. At the time, the inmates of the main benevolent asylum in North Melbourne feared that after they died, their bodies would be taken, without consent and used by medical students. They set up a petition against the Act demanding their bodies not be sent to the university but their concerns were ignored. In the same year, the Electoral Act  disenfranchised any person receiving charity in a public institution, and from then on, inmates had effectively no say in the disposal of their bodies. Although many advocates agitated about this inequity and argued for institutionalised Australians to be given the same rights as other citizens, the provision wasn’t discarded in Victoria until 1975.

This gory history of live experimentation and cadaver dissection is a backdrop to contemporary debates about the embodiment of imprisonment. Criminologist Azrini Wahidin‘s work explores the embodied nature of imprisonment, considering the particular ways in which prison time is inscribed upon the ageing imprisoned body, and the ways in which prisoners seek to deploy agency to resist the carceral control of the prison. For carceral geographers, considering imprisonment in this way opens a space for conceptualising  the experience of imprisonment as inherently embodied, drawing on scholarship in feminist geography which recognises both the mutually constitutive relationship between bodies and spaces, and a variety of bodily subjectivities (e.g. Johnson 2008). Bodies are understood as sites of  ‘textual inscription’  which shapes identities and social relations as well as the conceptual and actual spaces in which bodies move. The body, always in the process of becoming through the experiences of embodiment, is corporeally inscribed by imprisonment, in that the corporeal inscriptions acquired during incarceration act to construct bodily subjectivities which can stigmatise and disadvantage prisoners both during confinement and after release.

Returning to the Canadian example, participation in medical and behavioural research to which prisoners may consent, and for which they may or may not be offered incentives, could be viewed as enabled or encouraged by the carceral prism in which prisoners’ bodies are held during confinement, and also as a form of corporeal inscription of incarceration. Thankfully ethical regulations governing research in prisons are strict, and access procedures include detailed discussion of issues of consent, incentive and dissemination of information to participants. However, the thorny methodological and ethical issue of what constitutes ‘informed consent’ in a prison context remains, whether the research in question involves potentially risky medical research, or apparently benign questionnaire survey…