The right to be free of inhumane denial of medical care as well as the provision of medical care in a cruel and inhumane manner are addressed by numerous international human rights treaties including:
“article 25 (1) of the Universal Declaration of Human Rights (UDHR); article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR); article 24 of the Convention on the Rights of the Child (CRC); article 12 of the Convention on the Elimination of All Convention for the Protection of Human Rights and Fundamental Freedoms and its protocols. The right to health is also enshrined in over 110 national constitutions.”CENTER FOR HUMAN RIGHTS & HUMANITARIAN LAW, A n t i – To r t u re I n i t i a t i v e
Torture in Healthcare Settings: Reflections on the Special Rapporteur on Torture’s 2013 Thematic Report
According the above report, the United Nations long ago adopted principles prohibiting “cruel, inhuman and degrading punishment” of prisoners. In doing so, the 1982 UN General Assembly declared rightly that refusal to provide needed medical care and/or cruel, inhuman and degrading provision of medical services to prisoners constitutes not just a gross violation of medical ethics but a violation of international law. In short, provision of medical care in such as fashion is by international standards considered torture.
Likewise, the U.S. Supreme Court barred cruel and inhumane medical care or lack thereof in the 1976 case of Estelle v. Gamble. The U.S. Supreme Court does not use the term torture, but the behavior described and prohibited would very likely fall within the definitions set forth under international law.
United Nations’ Examples of Cruel and Inhumane Medical Care
The Report gives examples of behavior that would fit into the international definition of torture including “unsanitary pre-trial detention and prison facilities, lack of medical care, and death of prisoners and detainees as a result of defective medical assistance”.
These examples clearly describe New Mexico prisons under the New Mexico Corrections Department (NMCD) and the contractors that hire to provide medical care. Sadly, our firm alone Collins & Collins, P.C. can provide horrifying examples of each in NMCD with just the cases upon which we have filed lawsuits. Basic math will tell you that if our small firm has encountered numerous situations involving deaths and permanent severe physical injuries resulting from the intentional, deliberately cruel and inhumane denial of basic and what should be routine medical care, then there are many more cases out there of which we are not aware.
Examples from New Mexico Prisons
The medical care or more accurately, the lack of medical care in NMCD facilities most definitely fits the parameters of international definition of torture.
To illustrate, the best place to start here is with our firm’s prison spinal osteomyelitis cases. Osteomyelitis is an infection that gets into the bones. Spinal osteomyelitis is an infection that gets into the spine. Osteomyelitis is a rather slow moving infection. In other words, it takes quite some time for an infection to spread into and invade the bones, including the spine. Once it gets into the bones, it is still very easily treated with even minimally competent medical care. Like any infection, it can very readily and effectively be treated with antibiotics.
However, in NMCD facilities, it is not treated at all in many cases. It is not a matter of simple medical error or oversight. The refusal to treat what begin as very trivial infections until such time as they are life-threatening is a deliberate choice made by NMCD and its medical contractor. Refusal to treat osteomyelitis is cruel and inhumane to the nth degree in the case of NMCD.
Common Spinal Infection Fact Pattern in NMCD Facilities
Collins & Collins, P.C. has seen the same fact pattern in multiple cases that the firm has filed. These are the facts that recur repeatedly:
An inmate will have a minor infection, it could be a scratch, a pimple, a cut or some internal infection. The infection will begin to grow causing as infections do increasing levels of pain. The inmate will ask to have the infection checked out and for treatment. The inmate is told there is nothing wrong and is given ibuprofen. No lab tests are conducted to determine whether there is an infection despite the rampant rate of infections that prevails in prison environments.
The infection continues to grow for weeks and months with repeated requests for medical care, and repeated denials. During this time, the inmate reports increasingly severe pain. Due to the utter failure of the medical providers to provide basic care, the inmate will file medical grievances. Nothing happens, there is still no medical care and the grievances are either ignored completely or denied summarily by non-medical NMCD personnel.
The spinal infection continues to grow. The inmate conditions continues to worsen as the infection takes to the bones. Still, there are no lab tests conducted. Still there are no antibiotics. Still the inmate is given ibuprofen at told there is nothing wrong. Still there is no referral to a local emergency department to arrest the growing and now emergent spinal infection.
The infection continues to grow due to lack of basic antibiotic treatment. No lab tests are conducted, no antibiotics are prescribed, ibuprofen is the cure-all for the emergent infection and the crippling pain that ensues.
This exercise continues over and over and over until the inmate can no longer walk, care for himself, use the bathroom, shower, clothe himself or get to the dining room without help from fellow inmates. In one tragic case, the inmate went into a coma before he was finally transferred for treatment. Ultimately the result in this case was death because osteomyelitis and sepsis had destroyed his spine and full system failure from the sepsis had resulted.
And this is what it takes to get medical care for what are easily preventable spinal infections. Literally, it took a coma to get medical attention. In other cases, it comes close with full system failure imminent before the inmate is transferred for treatment.
Is this Medical Torture
At the risk of stating the obvious, of course it is, at least by international standards. Of course, as blue as it is, New Mexico by way of NMCD and the other powers that be, do not view it as such.
Let’s do a little thought experiment. Think of a time when you had a cut that began to get infected. Think of how that cut begins to throb and burn. Its painful most would agree. Now imagine that the infection continues to grow and grow. The infection now moves into your bones, lets say a finger. Now you have bone infection. If you have never had a bone infection, which few people have, you will now have to imagine what that bone infection might feel like. Now lets imagine that bone infection is allowed to continue to grow and with it the pain gets worse and worse. The infection still is allowed to grow now doing damage to the bone. The infection creates pus pockets in the bone creating enormous pain. Consider now that you go a urgent care or the emergency room and the doctor tells you that you are not in pain, that you are faking and sends you home with ibuprofen. Now consider this occurs time and time again until finally you are transported by ambulance to the hospital because you can no longer drive yourself. Consider that you are now in the hospital for weeks or months with multiple painful surgeries and painful invasive antibiotic treatment.
Finally, consider that all of this could have easily been prevented had the doctor behaved in a humane and professional manner.
Is it torture? Given that this is done deliberately and repeatedly to inmates, one would be hard-pressed to argue that it is not, at least again under international norms. NMCD norms could only call it typical.
Why Should You (the Taxpayer) Care
The math is not difficult here. Basic medical care could prevent the spinal infection at nominal costs to the prison medical contractor. This costs has already been paid to the medical contractor by the terms of the contract with NMCD. The contract itself exceeds $40 million in the first year alone. The contract increases by the millions each successive year. Taxpayers have already paid for basic healthcare for the inmates. The medical contractor for any number of reasons, upon which I will allow you to speculate, decides not to provide this medical care. The medical contractor does this knowing that if the infection goes untreated, the inmate will likely at best to need weeks or months of hospitalization to cure the untreated infection. Some as with our client mentioned above will die, in that case after months of hospitalization.
Who pays for the extended hospitalizations? You would be justified to guess that the medical contractor would pay for its gross reckless and deliberately inhumane medical neglect for which it alone is responsible. You would be wrong if you guessed this to be the case. In fact, it is you the taxpayer that pays. Once the inmate is in the hospital for 24 hours, New Mexico Medicaid picks up the tab. And New Mexico Medicaid is New Mexico taxpayers.
If you are a concerned taxpayer, Contact your legislator to tell him or her to stop medical tortue in New Mexico prisons.
If you or a loved one has seen this same fact pattern in your own medical care while in the custody of NMCD, contact Collins & Collins, P.C.