Death of terminally ill prisoner ‘inhuman and degrading’, says charity

Penal reform advocates have said the death of a terminally ill prisoner who died after repeatedly trying to access emergency medical attention could amount to inhuman and degrading treatment by the State.

A report into the death of Mr I, a 53-year-old inmate at the Midlands Prison, in June, 2018 was published by the Inspector of Prisons on Wednesday.

It criticised the manner in which his complaints of severe pain were dealt with by prison staff two days before his death, and said terminally ill prisoners should be spared the indignity of dying in custody.

Mr I was sent to prison in 1985 and had spent 33 years in custody. In 2017, he was transferred from the open Shelton Abbey prison to the Midlands Prison in order to improve his access to medical care.

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However, on the morning of June 12th, 2018, after Mr I had complained of "severe pain", an attending doctor said he required urgent medical attention and referred him to the Midlands Regional Hospital.

This was immediately communicated to prison management by a nurse but later, when no action was taken, a prison officer explained there was not enough staff to escort him to hospital. It was agreed he could attend the following day instead.

‘Distress and pain’

However, the report noted that the next morning Mr I sounded his alarm bell and was subsequently found lying on the floor beside the toilet “in distress and pain”.

“At this stage there was still no indication of anyone preparing to take him to hospital.”

He was then taken by ambulance to the Midlands Regional Hospital and later transferred to St James Hospital in Dublin where he died of an illness unspecified in the report.

Inspector of Prisons Patricia Gilheaney described the delay in transferring Mr I as a "major failing" and noted that "nobody appeared to treat [his case] with any degree of urgency".

Among her recommendations are that the Irish Prison Service (IPS) ensures there is no repeat of the incident.

“The IPS should review the application of its Compassionate Temporary Release Policy to ensure that prisoners who are terminally ill are appropriately released on licence in order to avoid the indignity of dying in prison,” the report found.

Responding to the case on Friday, the Irish Penal Reform Trust (IPRT) said the failings may have amounted to inhuman and degrading treatment based on Council of Europe guidance which includes that terminally-ill prisoner patients should be allowed to die in freedom and dignity, and without pain.

“The failure to bring a terminally-ill man in severe pain from Ireland’s biggest prison to a hospital across the road due to operational reasons is not acceptable,” said executive director Fíona Ní Chinnéide.

“It is absolutely paramount that the life, health and dignity of men and women in the custody of the State are the priority consideration.”

The IPRT pointed out that following its visit to Ireland in 2014, the European Committee for the Prevention of Torture (CPT) described healthcare in some Irish prisons as being "in a state of crisis" and highlighted services at the Midlands prison.

The IPS has acted on several recommendations set out in the report including the creation of an “email group” for nursing staff to communicate referrals, as well as a “referral to hospital form” introduced as policy.

“Communications have been improved between the Detail Office and Healthcare in relation to the expected timeframe for transfers which allows nursing staff to plan care,” an IPS document stated.

As regards temporary release, it said decisions are made on a case by case basis in accordance with legislation and taking multiple factors into account.