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Dying in prison can be cruel

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Over the past two years, dozens of Maryland prisoners have died at the hospital on the grounds of the former Maryland House of Correction in Jessup. The causes of death ranged from cancer to heart, liver and renal diseases to hepatitis to simple wear and tear on bodies damaged by decades of alcohol and drug abuse. Maladies, in other words, that warranted hospice care.

But these men died scared and alone. No friends or family could sit vigil with them; no hospice volunteers offered them comfort. Granted, these men committed crimes against the people of Maryland, so they were where they were as a result of their own actions. But American justice forbids cruel punishment. It is cruel to make a man face death alone.

Staff members who know my concern for these men occasionally allow me to visit them. I have witnessed their fear.

Lonnie, who served nearly 30 years for murder, lay dying of cancer. His despair over what he perceived to be his abandonment by his family and fellow prisoners made him all the more pitiful. "I’m scared of dying," he said. "I’m all alone and afraid.... I don’t understand."

Charlie, a friend of 28 years, became confused, telling me that his relatives had never visited, even though a prison clergyman said they had been there recently when he celebrated a Mass for the family. Ten days later, Charlie died without anyone at his bedside.

Saddest for me was Willie, a fellow lifer (I’m serving two life sentences for homicide) with more than 25 years in. He and I shared a ward at the hospital while I was there for knee surgery and a hip replacement. Cancer was rapidly killing him. Bewildered as a lost child, this former boxer nonetheless fought for life, but his body failed. After succumbing to dementia, he was transferred to an outside facility.

Before his transfer, I sat holding Willie’s hand. I let him know I loved him and that he was deeply respected by many. "I’m not afraid to die," he said, "I’m just scared of the loneliness." But he died alone, handcuffed to a bed in accordance with a state policy for outside hospitals that makes no exception for the dying.

Willie’s words led me to action. I proposed to Jessup Correctional Institution Warden John Wolfe, a progressive penologist by Maryland standards, that his institution establish a prison hospice. To bring this about, Maryland need only follow the lead of Burl Cain, the warden at the notorious Louisiana State Penitentiary in Angola. In the 1990s, Cain read in the newspaper about hospice and knew that his thousands of lifers would benefit. Angola’s hospice unit opened in 1998, and two years later the prison was honoured for the program with the American Hospital Association’s Circle of Life Award.

Others states have followed suit. Why not Maryland? The state’s "tough on crime" policies have increased the length of sentences, and a general disdain for releasing offenders on parole has led to the graying of the inmate population. Long-term incarceration has left our nation’s correctional system with two basic alternatives to the status quo: Build geriatric prisons with hospice units, where costs are lower due to the reduced need for security and other factors, or start letting harmless old, dying people go free. I think the latter is unlikely.

I’m 61, and I recently suffered a health scare when a prison doctor suspected I had throat cancer. Thankfully, a biopsy came back benign, but the experience made me think about a time when I may be in Lonnie, Charlie and Willie’s place.

I know many readers will be at peace with that image, but I would argue that the notion of hospice gets at a fundamental question: What do we want for those who are incarcerated for long periods — in many cases, for the remainder of their lives?

Prison hospice is not just for dying prisoners. At Angola, observers have seen the profound effect the program has on the prisoners who serve as hospice volunteers, supporting and caring for others in the final stages of incurable illness. For me, merely visiting with dying prisoners has brought me face to face with the shock, despair and horror of death. It has helped me to better understand the losses I caused, and this empathetic bridge with all victims wracks my soul with an unending remorse. My prayers go out to my victims and their families.

Those of us living behind bars become shadows of humanity. In life, we are greatly diminished. When death beckons, the specter of fear takes hold. I ask that you allow us the simple dignity of hospice care so that we don’t have to face that fear alone.


Larry Bratt is serving two life terms at Jessup Correctional Institution in Jessup, Md. He is a founder and director of the Extra Legalese Group prisoners organization.


—The Washington Post


For a Canadian perspective on this topic, see the Canadian Medical Association Journal article "Integrating prison health care into public health care: the global view" at

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