OPINION: DOC's Medical Negligence and Dehumanization of Prisoners Must End

by Hannah Bolotin

On Jan. 14, 2021, the Office of the Corrections Ombuds (OCO) published a report summarizing numerous cases of delayed cancer diagnosis and treatment by the Washington State Department of Corrections (DOC), highlighting the ways in which DOC's negligence has led to several preventable prisoner deaths.

In yet another example of DOC's negligence, the Washington Corrections Center for Women (WCC-W) has been rebuffing a prisoner's requests for treatment for rapid development of potentially cancerous tumors for years. Several years ago, Patricia Teafatiller noticed a mass on her neck. A year and a half ago, a second lump developed along her spine. Patricia sought medical care and was told it was just a knot in her neck. She was subsequently informed she had degenerative disk disease to explain away the mass on her spine, saying nothing of her symptoms and masses in other locations. The lumps have continued to grow, more masses have appeared, and none have diminished. Her neck has grown increasingly stiff; she describes it as feeling like it is in a vice, with a grinding, popping sensation whenever she moves her chin towards her chest. The results of the ultrasound that was eventually ordered were inconclusive, warranting an MRI and/or biopsy to confirm whether the masses are benign or malignant — the standard of care in any medical practice.

One would think that the DOC's recent upsurge in bad publicity and legal jeopardy surrounding medical negligence — especially when it comes to negligent intervention for cancer treatment — would motivate them to, at minimum, follow the standard medical procedure in Patricia's case. They have not. Instead, they responded without haste to her attorney's call for necessary medical intervention with a cavalier mention that there is a "referral pending to see a specialist in the local orthopedic clinic" and blaming Patricia's invocation of religious beliefs for the delay. That is, they merely demonstrated a similar offhandedness and delay of intervention towards an unrelated medical issue — and are possibly violating the Religious Land Use and Institutionalized Persons Act (RLUIPA).

As if the glib responses to calls for life-or-death medical care aren't enough, the DOC cannot even be bothered to properly recall and spell Patricia's surname. In a recent email exchange with Post-Prison Education Program staff and attorneys, the DOC misspelled Patricia's last name throughout and, when notified of the error, offered no acknowledgement of the callousness it exemplifies. As Patricia's attorney tells the persistently unresponsive WCC-W health manager, "imagine that this was your loved one experiencing frightening and painful symptoms and being shown little regard for her medical condition, her pain, and her fear." It shouldn't be too much to ask for the DOC to treat her — to treat any prisoner — the way they would want their loved ones to be treated. But instead, they take their indifference a step further, desecrating Patricia's name as if to indicate just how little they care.

The radio silence with intermittent sleights of hand continue. Patricia's lumps and masses continue to grow, as do their accompanying pain and the fear of their malignancy. She is told to take Tylenol or "call a medical emergency," neither of which solve the underlying issues.

In their response to the January OCO report, the DOC stated, "It is not acceptable for those under our care to experience waits for diagnostics and treatments that could potentially impact their wellbeing." The response — or really, the lack of response — in Patricia's case suggests otherwise.

Patricia's struggle to receive adequate care and medical intervention — along with the many other cases of medical negligence that have recently come to light — point to a pervasive, systemic issue: the deprivation of basic human rights and dignity within Washington State prisons. In the Washington Supreme Court's Commissions' Symposium on June 2, numerous speakers poignantly discussed the inhuman medical treatment — and utter lack of treatment — they experienced while incarcerated. Renee Permenter spoke of the disregard and delay of medically necessary treatment she experienced as a transgender Woman of Color inside Washington DOC:

"In DOC, medical providers have said things that would be unthinkable for providers in the community to say. Being incarcerated doesn't make it somehow okay. It took months before I was allowed to see a mental health provider. Then more months of waiting before I could see a doctor who didn't know the basics of working with trans patients. Even after the decision-makers reviewed my case and determined that hormone replacement therapy was medically necessary for me, I still had to wait a couple more months before I actually received the medication. The delays I experienced were not atypical. In fact, they were less than what many of my peers have had to go through."

The DOC's apathy doesn't end there. In addition to delaying treatment and disregarding prisoners' medical needs, there is an overwhelming lack of basic compassion and empathy for individuals while they are incarcerated. Later in the symposium, social worker and advocate for incarcerated parents, Kimberly Mays, MPA, recounts the trauma she experienced when going into labor while incarcerated:

"I felt scared and was unsure what to expect … When the ambulance finally arrived, a male guard arrived to escort me, but he did not sit up in the front next to the driver. Instead, he rode in the back where I was being attended to by the paramedic. Here was this man, a male guard and not a medical professional, in the back of the ambulance with me, with the same view of my private areas as the attending paramedic. As a victim of sexual assault, it is hard to describe the violation, powerlessness, and degradation I felt.

"When I finally got into the delivery room … I asked if the male guard can please step out of the room … The guard refused … and just stood there across the room, again, in full view of my exposed private parts. I felt violated, humiliated, dehumanized, and worthless, like an animal giving birth in front of his human masters."

The Post-Prison Education Program is no stranger to the injustices that pervade the Washington penal system, and our staff work tirelessly to mitigate the gross mistreatment and deprivation of prisoners across the state. Prison is not meant to be a death sentence, and it is not meant to take away basic human rights and dignity. It is unjust and inhumane to let an individual like Patricia sit in her cell, day after day, week after week, in intolerable pain and crippling fear. We will continue to fight for the humanity of current and former prisoners. All those responsible for prisoners being traumatized by humiliating, dehumanizing practices and dying due to medical neglect must be held accountable.

Hannah Bolotin joined the Post-Prison Education Program as director of development and policy in June 2021 and was previously a volunteer grant writer for the program. Before joining the program, Hannah was a researcher at Boston College, Wesleyan University, and Yale University, where she studied criminal justice reform, racial bias in criminal proceedings, and the development of theories of punishment and justice across cultures.

Featured image is attributed to the Bureau of Land Management Oregon and Washington (under a Creative Commons, CC BY 2.0 license).