Dying inmates don’t need to be in jail

It’s no wonde r that state legislators aren’t anxious to establish a way to release prison inmates who are dying or severely incapacitated. What politician wants to be on record expressing sympathy for criminals, even grievously ill ones?

But that’s how legislation under consideration on Beacon Hill has been framed in public discussion: as a “compassionate release” law. It’s a key reason why the bill, in various incarnations, has languished.

Take compassion out of the equation, however, and the proposal appears practical and fiscally smart. The state already spends about $100 million annually on inmate health care. With prisons overcrowded and their populations aging, that figure is increasing every month.

A small percentage of those inmates have a terminal disease, are so disabled they can barely function, or require regular treatment — such as dialysis — outside of jail. If they were instead released to a hospital, hospice, nursing home, or family member, state spending on inmates’ health care could be reduced: Those allowed out, under what proponents call “medical placement,” could qualify for MassHealth insurance coverage, which is partially subsidized by the federal government. The likelihood of anyone in such a weakened condition posing a danger is extremely low.

“The goals are protecting public safety, saving money, and offering incarcerated people a chance to die with dignity,” said Senator Patricia D. Jehlen, a Somerville Democrat and a sponsor of the bill, which received a hearing earlier this month. Massachusetts is one of just five states lacking such a release mechanism.


The bill has its obvious backers, like the not-for-profit group Prisoners’ Legal Services of Massachusetts, whose website features a “Compassionate Release” page. But support comes from some law enforcement officials, too, including Middlesex County Sheriff Peter J. Koutoujian. During the 2015 fiscal year, he said, it cost his department $1.2 million to provide treatment and medicine for inmates and pretrial detainees, most of them held at the Middlesex Jail and House of Correction in Billerica. That amounted to about 10 percent of Koutoujian’s budget. Each prisoner needing outside care must be accompanied by two corrections officers, which contributes significantly to the expense — hospital trips required $900,000 in overtime during the last fiscal year alone.


Often, prisoners haven’t received regular medical care prior to arriving at a jail, so diagnosis sometimes comes only after incarceration. That was the case with a female inmate at the state prison for women in Framingham who was found to have advanced breast cancer.

Another obstacle to the bill’s passage is the perception that scores of violent criminals will be set loose. Not likely, since the legislation permits only the transfer of terminally ill or “permanently incapacitated” inmates to approved locations. And, as Jehlen noted, “There are many nonviolent people in prison.”

The legislation details a rigorous set of procedures for release that includes a doctor’s review and culminates with a judge’s ruling. Conditions might include electronic monitoring bracelets, and permission to receive outside care could be revoked at any time.

There is much to be worked out before the Massachusetts bill can move to a vote. But elected representatives who can’t muster empathy for dying criminals should be able to recognize the benefits of medical placement and push for passage. Even when an issue is as emotional as this one, they need to act based on reason.