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Humanize From Discovery Institute's Center on Human Exceptionalism
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Court Wrong to Okay Refusal of Life-Saving Medication to Prisoners

Originally published at National Review
Categories
Patient Care

This is outrageous. Kentucky denied a prisoner with hepatitis a life-saving drug that always works — because of the expense. Now, a court of appeals ruling finds that the move is constitutional. From the Courier Journal story:

A federal appeals court has ruled the Kentucky Department of Corrections can deny a life-saving medication for inmates with hepatitis C because it is expensive — a decision a dissenting judge says will condemn hundreds of prisoners to long-term organ damage and suffering.

In a 2-1 ruling, the 6th U.S. Circuit Court of Appeals panel said Tuesday the department can deny the treatment, which cures nearly 100% of patients but costs $13,000 to $32,000.

The majority found that denying it to most of Kentucky’s 1,200 inmates with hepatitis C does not constitute cruel and unusual punishment in violation of the Eighth Amendment.

I am with the dissent on this:

In a sharply worded dissent, Judge Jane Stranch of Nashville said by “flouting the recognized standard of care,” the Corrections Department “consigns thousands of prisoners with symptomatic, chronic HCV to years of additional suffering and irreversible liver scarring.”

She said by withholding medical treatment until the damage caused by an inmate’s chronic hepatitis C infection has progressed too far to be reversible, Kentucky’s rationing plan “shocks the conscience” and is fundamentally unfair…

Stranch noted in her dissent the Centers for Disease Controls, the Centers for Medicare & Medicaid Services, the Veteran’s Administration and many state Medicaid systems — including Kentucky’s — recommend treatment with DAAs regardless of the degree of fibrosis.

I tend to be a law and order kind of guy. But prisoners don’t lose their intrinsic human dignity because they are incarcerated. Clear, generally provided, and immediately needed life-saving or serious disease-curing care should not be denied solely on the basis of cost, or indeed, for any other reason that I can think of. Not if it is truly non-elective care. And this drug would seem to qualify as non-elective.

Yes, I know that allowing prisoners open access to any treatment the ask for could bust the bank. But surely a legal distinction can be drawn between procedures prisoners want, and those they need to stay alive or avoid irreversible physical harm to their health or prevent death. I hope the Supreme Court grants certiorari.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.