Involuntary commitment links the healthcare, public health, and legislative systems to act as a “carceral health-service.” While masquerading as more humane and medicalized, such coercive modalities nevertheless further reinforce the systems, structures, practices, and policies of structural oppression and white supremacy. We argue that due to involuntary commitment’s inextricable connection to the carceral system, and a longer history of violent social control, this legal framework cannot and must not be held out as a viable alternative to (...) the criminal legal system responses to behavioral and mental health challenges. Instead, this article proposes true alternatives to incarceration that are centered on liberation that seeks to shrink the carceral system’s grasp on individuals’ and communities’ lives. In this, we draw inspiration from street-level praxis and action theory emanating from grassroots organizations and community organizers across the country under a Public Health Abolition framework. (shrink)

Utopian thought feeds on a speculative magnitude that has attracted sustained critiques and generated radical revisions. In the contemporary age, the advocates of utopia have been prompted to corroborate the effective agency of a predominantly abstract frame of mind. A response, which also serves as a rebuttal, entails illuminating how utopian projects have intervened in history and shaped societies by probing the most unyielding, unchangeable features of humankind. Understanding how utopias unfold proposals for the present involves recognizing that utopian writers (...) share a penchant for extrapolation: While perusing the present, they anticipate the future; in focusing their investigation on very specific historical... (shrink)

The general aim of this paper is to provide insight into the relevance of critical phenomenology for the study of the patient-provider relationship in health care systems in U.S. jails, prisons, and detention facilities. In particular, I utilize tools from the work of scholars studying phenomenological approaches to health care and structural forms of oppression to analyze several harms that arise from the provision of medical care under the punitive constraints of carceral facilities.

This article argues that criminal justice and health institutions under settler colonialism collude to create and sustain “truths” about First Nations lives that often render them as “bare life,” to use the term of Giorgio Agamben. First Nations peoples’ existence is stripped to its sheer biological fact of life and their humanity denied rights and dignity. First Nations people remain in a “state of exception” to the legal order and its standards of care. Zones of exception place First Nations (...) people in a separate and diminished legal order. Medical and health agencies have been instrumental in shaping colonial “biopower,” both in and beyond carceral settings to ensure that First Nations lives are managed in accordance with the colonial settler state project. This project is able both to threaten First Nations rights to live and to maintain settler self-perceptions of decency and care. We illustrate this discussion with reference to the tragic and unnecessary deaths in custody of twenty-two-year-old Yamatji woman Ms Dhu in 2014 in South Hedland Police Station, Western Australia, and twenty-six-year-old Dunghutti man David Dungay Jnr in Long Bay jail in Sydney, NSW, in 2015. Health professionals and police demonstrated callous disregard to Ms Dhu and Mr Dungay—treating them as “bare life.”. (shrink)

Medical schools, like all institutions, are conservative since they seek to maintain and expand on their accomplishments. Stakes are high in carceral medicine given the risks of replicating the inhumane social conditions that exist within prisons and allow prisons to exist. Given the increasing number of partnerships between state and municipal carceral systems with academic medical centers, medical schools must consider which guiding theory they will use to teach carceral medicine. The interdisciplinary theory of prison abolition is (...) best fit for the task of training medical students to think about the long term goals of societal change and public health. (shrink)

This chapter examines truthfulness, or veracity, in the context of health care services within prisons, jails, and detention facilities in the United States. Mainstream discussions of bioethics often highlight the general importance of veracity within the patient-provider relationship, including providers’ obligations and constraints with respect to telling the truth to their patients, and, to a lesser extent, patients’ responsibilities and concerns regarding truthful reporting to their providers. However, a great deal of this literature largely overlooks how structural barriers to (...) health care impact the functions of veracity in the provision of health care—including racist and sexist biases in clinical judgment, inadequate staffing, infrastructure, and accessibility in medical facilities, and institutionally specific constraints. Through an analysis of Assata Shakur’s political autobiography, this chapter focuses on such structural barriers to health care in carceral facilities with a focus on the institutionally specific constraints that arise through the punitive aims of carceral facilities. By focusing on the intersection between punishment and health, this chapter argues that bioethicists and clinicians alike would be better equipped to analyze structural barriers to health care that exist both within and beyond prison walls through a nonideal approach. (shrink)

Nearly one in every 100 adults in the United States is in jail or prison today. In a period dominated by calls to roll back the government in all areas of social and economic policy, we have witnessed its massive expansion in the realm of penal policy since the 1970s. The U.S. incarceration rate is now more than 737 per 100,000 people, or five to 12 times the rate of Western European countries and Japan . The reach of the U.S. (...) carceral state extends far beyond the 2.2 million men and women currently in prison or jail in the United States. On any given day, over 7 million people__or 1 in every 32 adults__are incarcerated or on probation or parole . This rate of state supervision is unparalleled in U.S. history.These overall figures on incarceration belie the enormous and disproportionate impact that this bold and unprecedented social experiment has had on certain groups in U.S. society. If current trends continue, one in three black men and one in six Hispanic men are expected to spend some time in jail or prison during their lives . The number of incarcerated African_American men has grown so rapidly over the past quarter_century that today more black men are behind bars than enrolled in colleges and universities .[1]Some contend that growing public dismay over the crushing economic burden of incarcerating and monitoring so many people heralds the beginning of the end of the prison boom . As evidence, they point to recent penal developments in the states. Severe budget deficits prompted by the 2001 recession forced some states to close prisons and lay off guards. Dozens of states experimented with new sentencing formulas, mostly directed at nonviolent offenders.[2] Fiscally conservative Republicans previously known for being penal hard_liners championed some of these recent relaxations in penal policy. This fueled speculation that law_and_order Republicans, troubled by mounting costs, are well poised to roll back the carceral state, much as red_baiter Richard Nixon was ideally situated to breach the great political wall with China.We should be cautious, however, about assuming that fiscal pressures and the recent softening of public opinion sparked by the plummeting crime rate over the past decade will automatically forge a durable consensus that will dismantle the carceral state.[3] It was mistakenly assumed three decades ago that shared disillusionment on the right and the left with the rehabilitative ideal would shrink the prison population. Instead, it exploded. Criminal justice policies often confound conventional distinctions between left and right, particularly on issues related to crime victims. The relationship between political leaders, social movements, interest groups, and governing institutions is highly contingent and volatile in the case of penal policy because the left_right divide is more blurred and because of certain institutional features of the U.S. criminal justice system and welfare state.[4]While economic arguments against the carceral state are important and compelling, they have their limitations. If properly pitched, they can help forge a consensus to reverse the prison boom. But they can also be used to propel mean_spirited budget cuts that do not significantly reduce the size of the prison population__or save much money__ but do render life in prison and life after prison leaner and meaner. Criminal justice reform to reverse the prison boom is a highly fragile project that cannot be underwritten primarily by fiscal concerns. Without some broader vision and movement for change, the U.S. carceral state, trimmed down a little by a few modest sentencing and drug law reforms, will be here to stay. Such a movement is beginning to coalesce in the United States. Opponents have begun to portray the carceral state not only as a financial liability but also as a moral liability and a pressing civil and human rights issue that perverts cherished democratic institutions, like the right to vote. They have also begun to focus public attention on how the prison boom has exacerbated economic and social inequalities and is a growing menace to public health. (shrink)

The prison-industrial complex has historically operated as a mechanism for social control generally and as a tool to restrict women’s reproductive capacities specifically. Reproductive justice is a domain within the practice of health law. However, health law as currently practiced is ill-equipped to understand how the carceral state functions as a structural determinant of health or how legacies of oppression have facilitated the abridgment of incarcerated women’s reproductive capacities.

Mass incarceration and the aging prison population in the United States is an ethical crisis, understudied in empirical bioethics research. In this article, I share one woman’s narrative to illustrate how older Black women describe accessing healthcare while incarcerated and identify sites for bioethical exploration. I argue that, due to the punitive nature of prison healthcare interactions, wherein women are seen as inmates first and patients second, healthcare providers are caught in a trap of competing ethical commitments to their patients (...) and the state. As the prison population ages, these challenges will become more acute. Feminist bioethics has a critical role to play in imagining new possibilities for accessing, giving, and receiving care in the carceral context. (shrink)

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that (...) subjectivities are fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system. (shrink)

Polo‐like kinase 1 (PLK1) is a serine/threonine kinase that plays multiple and essential roles during the cell division cycle. Its inhibition in cultured cells leads to severe mitotic aberrancies and cell death. Whereas previous reports suggested that Plk1 depletion in mice leads to a non‐mitotic arrest in early embryos, we show here that the bi‐allelic Plk1 depletion in mice certainly results in embryonic lethality due to extensive mitotic aberrations at the morula stage, including multi‐ and mono‐polar spindles, impaired chromosome segregation (...) and cytokinesis failure. In addition, the conditional depletion of Plk1 during mid‐gestation leads also to severe mitotic aberrancies. Our data also confirms that Plk1 is completely dispensable for mitotic entry in vivo. On the other hand, Plk1 haploinsufficient mice are viable, and Plk1‐heterozygous fibroblasts do not harbor any cell cycle alterations. Plk1 is overexpressed in many human tumors, suggesting a therapeutic benefit of inhibiting Plk1, and specific small‐molecule inhibitors for this kinase are now being evaluated in clinical trials. Therefore, the different Plk1 mouse models here presented are a valuable tool to reexamine the relevance of the mitotic kinase Plk1 during mammalian development and animal physiology. (shrink)

Critics of mass culture often identify 1950s-style status competition as one of the central forces driving consumerism. Thomas Frank has challenged this view, arguing that countercultural rebellion now provides the primary source of consumerism in our society, and that ‘cool’ has become its central ideological expression. This paper provides a rearticulation and defense of Frank's thesis, first identifying consumerism as a type of collective action problem, then showing how the ‘hip consumer’ is one who adopts a free-rider strategy in this (...) context. (shrink)

Metaphors used to describe new technologies mediate public understanding of the innovations. Analyzing the linguistic, rhetorical, and affective aspects of these metaphors opens the range of issues available for bioethical scrutiny and increases public accountability. This article shows how such a multidisciplinary approach can be useful by looking at a set of texts about one issue, the use of a newly developed technique for genetic modification, CRISPRcas9.

Background COVID-19 has greatly impacted the health of incarcerated individuals in the US. The goal of this study was to examine perspectives of recently incarcerated individuals on greater restrictions on liberty to mitigate COVID-19 transmission.Methods We conducted semi-structured phone interviews from August through October 2021 with 21 people who had been incarcerated in Bureau of Prisons (BOP) facilities during the pandemic. Transcripts were coded and analyzed, using a thematic analysis approach.Results Many facilities implemented universal “lockdowns,” with time out of (...) the cell often limited to one hour per day, with participants reporting not being able to meet all essential needs such as showers and calling loved ones. Several study participants reported that repurposed spaces and tents created for quarantine and isolation provided “unlivable conditions.” Participants reported receiving no medical attention while in isolation, and staff using spaces designated for disciplinary purposes (e.g., solitary housing units) for public health isolation purposes. This resulted in the conflation of isolation and discipline, which discouraged symptom reporting. Some participants felt guilty over potentially causing another lockdown by not reporting their symptoms. Programming was frequently stopped or curtailed and communication with the outside was limited. Some participants relayed that staff threatened to punish noncompliance with masking and testing. Liberty restrictions were purportedly rationalized by staff with the idea that incarcerated people should not expect freedoms, while those incarcerated blamed staff for bringing COVID-19 into the facility.Conclusions Our results highlighted how actions by staff and administrators decreased the legitimacy of the facilities’ COVID-19 response and were sometimes counterproductive. Legitimacy is key in building trust and obtaining cooperation with otherwise unpleasant but necessary restrictive measures. To prepare for future outbreaks facilities must consider the impact of liberty-restricting decisions on residents and build legitimacy for these decisions by communicating justifications to the extent possible. (shrink)

Imprisonment may sometimes be a justified form of punishment. Yet the U.S. carceral system suffers from appalling problems of justice—in who is put into prisons, in how imprisoned people are treated, and in downstream personal and community health impacts. Medical personnel working in prisons and jails take on risky work for highly vulnerable and underserved patients. They are to be lauded for their professional commitments. Yet at the same time, prison care undercuts the ability of medical personnel to (...) uphold their own professional standards and sometimes fails in even basic health protection. Doctors in prisons are stuck between their commitment to vulnerable patients and complicity in a system that requires their participation to uphold its constitutionality. Medical ethics is frayed in prisons, and the problem deserves our attention. (shrink)

Reflecting on Smith (2021) in this issue, this commentary extends our consideration of issues in carceral health and questions the dehumanizing language we sometimes use—including in public health and public health ethics—to talk about persons held in incarceration. Even the language we use for the carceral system itself (such as ‘criminal justice system’) is fraught: it casts a laudatory light on the system and papers over its role in compounding racial health inequities and in (...) sustaining colonialism. A host of issues call out for ethical analysis, using lenses that can encompass the tensions and contradictions experienced by people within the system who deliver healthcare and those within the system trying to access that care. Beyond access to health care (promotion, prevention, treatment and palliation), the societal commitment to dealing with social issues by depriving people of many key social determinants of health is at the heart of many of these tensions and contradictions. (shrink)

Abstract:This article analyzes the pervasive practice in US carceral institutions of shackling incarcerated pregnant women during childbirth and postpartum. After a review of bioethical, civil, and human rights norms, which widely condemn the practice, I advance an interpretation of the social meaning of shackling imprisoned pregnant women and its persistence despite widespread normative consensus in favor of its abolition. Two arguments regarding the persistence of the practice are considered: (1) that it stems from the unthinking exportation of prison rules (...) to a hospital setting and (2) that it is the product of an androcentric approach to punishment and carceral health care ill-adapted to women’s needs. I argue that these explanatory frameworks are inattentive to the intersecting genealogies of race and gender that are constitutive of the practice. As a result, the prescriptive horizons that these frameworks delineate are inadequate to the race- and gender-specific task of redress. Drawing from Black feminist theory and Nietzsche, I argue that the practice of shackling imprisoned pregnant women, like many ostensibly race-neutral facets of American mass incarceration, is a sedimentation of slavery that impacts all incarcerated women. The practice is symptomatic of the persistent anti-Blackness of the criminal legal system and the unfinished project of American abolition. (shrink)

This article analyzes the pervasive practice in US carceral institutions of shackling incarcerated pregnant women during childbirth and postpartum. After a review of bioethical, civil, and human rights norms, which widely condemn the practice, I advance an interpretation of the social meaning of shackling imprisoned pregnant women and its persistence despite widespread normative consensus in favor of its abolition. Two arguments regarding the persistence of the practice are considered: that it stems from the unthinking exportation of prison rules to (...) a hospital setting and that it is the product of an androcentric approach to punishment and carceral health care ill-adapted to women’s needs. I argue that these explanatory frameworks are inattentive to the intersecting genealogies of race and gender that are constitutive of the practice. As a result, the prescriptive horizons that these frameworks delineate are inad­equate to the race- and gender-specific task of redress. Drawing from Black feminist theory and Nietzsche, I argue that the practice of shackling impris­oned pregnant women, like many ostensibly race-neutral facets of American mass incarceration, is a sedimentation of slavery that impacts all incarcerated women. The practice is symptomatic of the persistent anti-Blackness of the criminal legal system and the unfinished project of American abolition. (shrink)

Mass incarceration is an ethical crisis. Yet it is not only the magnitude of the system that is troubling. Mass incarceration has been created and sustained by racism, classism, and ableism, and the problems of the criminal legal system will not be solved without meaningfully intervening upon these forms of oppression. Beyond that, incarceration itself—whether of one person or 2 million—represents a moral failing. To punish and control, rather than invest in community and healing, is antithetical to the values of (...) the field of bioethics. This commentary, which responds to the article “Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics,” by Sean Valles, considers abolition as a crucial form of justice that must be centered in the work of bioethics. Abolition is both an antiracist intervention and a means of considering the ways health care broadly and bioethics specifically have allowed for the perpetuation of carcerality in the United States. (shrink)

Low-income women and, disproportionately low-income women of color seeking reproductive and pregnancy care are increasingly subject to what this article terms carceral care – care compromised by its’ proximity to punishment systems. This article identifies the legal and health care practice mechanisms leading to carceral care and proposes solutions designed to stop criminalization at the bedside.

The number of older adults incarcerated in prisons is growing significantly, and there is a great need for legal authority, processes, and resources to mitigate individual and social burdens of elder neglect and abuse within these settings. Older adults in prison may be particularly vulnerable to abuse, neglect, or exploitation. They are dependent on the carceral system for basic resources, are at risk for retaliatory actions for reporting mistreatment, and bear disproportionately high health burdens. This essay first considers (...) standards and resources for mitigating elder mistreatment in the community and residential‐care settings in contrast to the available resources in prisons. Arguing that a conceptual model of elder abuse tailored to the prison population is needed, the essay proposes a research agenda through which such a model could be developed. The model could then be used in the creation of policy for detecting and mitigating elder mistreatment of incarcerated people. The essay concludes with a call to action to address the rift in legal protections and processes that leave older adults in prison at increased risk of abuse and neglect without a clear pathway for recourse. (shrink)

Applying Foucault’s concepts of disciplinary power and technologies of the self to the ex-periences of social work academics in English universities, this articles reveals their carceral existences, arguing that social work academics and their students exist within a “carceral network” which controls and normalises behaviour by simultaneously trapping them with-in and excluding them from succeeding in academic practices. While social work academics become “docile bodies” as they are shaped and trained by competing norms of neoliberal higher education and (...) professional social practice, their position as insiders and outsiders to both can also enable them to resist certain disciplinary expectations. The findings of the qualitative study discussed in this article support Foucault’s analysis of powerful institu-tions but problematise binary positions of docility or resistance to disciplinary power with-in them. Lived experiences of ‘becoming academic’ in English social work education reveal how normalising judgements and hierarchical observation intersect with neoliberal forms of responsibilisation to create a carcerality rooted in “incompetence”; how “technologies of relationships” are used to mediate individual forms of responsibilisation, and how having to negotiate multiple disciplinary regimes can create opportunities for resistance to each. (shrink)

Most mainstream feminist anti-rape scholarship and activism may be described as carceral feminism, insofar as it fails to engage with critiques of the criminal punishment system and endorses law-and-order responses to sexual and gendered violence. Mainstream feminist anti-rape scholars and activists often view increased conviction rates and longer sentences as a political goal—or, at the very least, are willing to collaborate with police and lament cases where perpetrators of sexual violence are given “light” or non-custodial sentences. Prison abolitionists, on (...) the other hand, have tended to insist that most lawbreakers are non-violent and that the “dangerous” are “few”, thus avoiding serious engagement with the widespread phenomenon of sexual violence. Despite the prevalence of carceral feminism, to my knowledge no feminist scholar has explicitly embraced this label, and the closest I have found to a defense of carceral feminism is feminist legal scholar Lise Gotell’s “critique of the critique of carceral feminism”. For this reason, it is with Gotell’s article that I primarily engage in defending anti-carceral feminism and prison abolitionism even in the difficult case of sexual assault. (shrink)

This paper uses a materialist feminist discourse analysis to examine how women’s movement organizations, liberal Democrats, and conservative Republican legislators shaped the Violence Against Women Act and the consequences for intersectional and carceral feminism. Drawing on qualitative analysis of Congressional hearings, published feminist and conservative discussion of VAWA, and accounts of feminist mobilization around VAWA, I first show how a multi-issue coalition led by feminists shaped VAWA. Second, I show how discourses of crime intermixed with feminism into a polysemic (...) gendered crime frame that facilitated cross-ideological support. Third, I show how, in contrast, intersectional issues that activists understood as central to violence against women were discursively and structurally separated from gendered crime in Congress. Although a multi-issue movement coalition advocated for expansions in VAWA dealing with immigrants, unmarried partners, same-sex partners, transgender people, and Native Americans, these issues were understood in Congress through more controversial single-issue discourses and often considered in administratively separate Congressional committees. Fourth, I show how VAWA’s outcomes played out in terms of carceral and intersectional feminist goals. (shrink)

Contesting Carceral Logic provides an innovative and cutting-edge analysis of how carceral logic is embedded within contemporary society, emphasizing international perspectives, the harms and critiques of using carceral logic to respond to human wrongdoing, and exploring penal abolition thought. With chapters from scholars across many disciplines, people in prison, as well as penal abolition activists, the book explores what a future without carceral logic would look like, as well as how such a future is to be (...) developed. The book is also an exploration of penal abolition thought as it is developing in the twenty-first century. Diverse geographical, cultural, identity and experiential frames inform the book's themes of analysing carceral logic as it harms disparate people in disparate places, creating anti-carceral knowledge, exploring case studies pointing to radical alternatives, and to contesting carceral logic from below. Ultimately, Contesting Carceral Logic provides the reader with an alternative and critical perspective from which to reflect on carceral logic, the punitive state and the criminalizing systems that almost exclusively dominate across the world. Finally, it raises the questions of how we are to build communities as well as transform our response to human wrongdoing in ways that are not defined by racism/ethnocentrism, class war and heteropatriarchy. Contesting Carceral Logic will be of great interest to not only scholars and activists, but also provides an introduction to key carceral issues and debates for students of penology, criminology, social policy, geography, politics, philosophy, social work and social history programmes in countries all around the world. (shrink)

How can Christian ethics make a significant contribution to health care ethics in today's Western, pluralistic society? Robin Gill examines the 'moral gaps' in secular accounts of health care ethics and the tensions within specifically theological accounts. He explores the healing stories in the Synoptic Gospels, identifying four core virtues present within them - compassion, care, faith and humility - that might bring greater depth to a purely secular interpretation of health care ethics. Each of these virtues (...) is examined in turn, using a range of topical issues including health care rationing, genetics, HIV/AIDS, withholding/withdrawing nutrition from PVS patients, and the empirical evidence which suggests a connection between religion and health. Professor Gill also argues that these four virtues are shared by other major religious and humanistic traditions and that, together with secular principles, they can enrich health care ethics even in a pluralistic society. (shrink)

This article explores the effect that communications technology has on hegemonic power. The first section establishes a theoretical framework combining Foucault’s carceral archipelago theory with Chiara Bottici’s concept of the social imaginal describing the medium through which inter- and trans-subjective imagination occurs. The remainder employs this framework to examine how four technological innovations (print media, radio, television and Internet) impact the (re)production of discursive hegemonic ideology, integrating a variety of historical and contemporary theories on public discourse and ideological dominance. (...) I conclude by arguing that each case demonstrates a dialectic pattern that explains the techno-social evolution of the carceral archipelago. (shrink)

This commentary reflects on recent instances of anti-Asian violence and state responses to redress violence through data-driven strategies. Data collection often presents itself as an appealing strategy, due to impacted communities’ desires for evidence and metrics to substantiate political claims. Yet, data collection can bolster the carceral state. This commentary takes an antagonistic approach to policing, including the ongoing creation of data infrastructures by—and for—law enforcement through hate crimes legislation. We critically discuss the challenges and possibilities in building towards (...) anti-carceral responses amidst ongoing racial violence and crisis. (shrink)