School of Human and Health Sciences, University of Huddersfield, UK.
Faculty of Health and Social Care, Edge Hill University, UK.
Soc Sci Med. 2018 Sep;212:161-167. doi: 10.1016/j.socscimed.2018.07.009. Epub 2018 Jul 9.
Prison populations across the world are increasing. In the United Kingdom, numbers have doubled in the last two decades, and older prisoners now constitute the fastest growing section of the prison population. One key reason for this shifting prisoner demographic is the growing numbers of men convicted of 'historic' sexual offences, many of whom are imprisoned for the first time in old age, and housed in prisons not suited to their needs. These demographic changes have profound consequences, including increased demand for health and social care in prison, and rising numbers of anticipated deaths in custody. Using the findings from a recently completed study of palliative care in prison, this paper proposes that older prisoners face a 'double burden' when incarcerated. This double burden means that as well as being deprived of their liberty, older people experience additional suffering by not having their health and wellbeing needs met. For some, this double burden includes a 'de facto life sentence', whereby because of their advanced age and the likelihood that they will die in prison, they effectively receive a life sentence for a crime that would not normally carry a life sentence. There has been little popular or academic debate concerning the ethical and justice questions that this double burden raises. Drawing on the work of Wacquant and others, the paper proposes that these changes are best understood as unplanned but reasonably foreseeable consequences of neoliberal penal policies. Although the paper focuses on the UK (which by comparison with other European countries has high rates of imprisonment), many of the challenges discussed are emerging in other countries across the world. This paper illustrates starkly how neoliberal policies and discourses have shaped the expansion and composition of the prison population with its consequent implications for health and justice.
全球的监狱人口都在增加。在英国,监狱人口数量在过去 20 年中翻了一番,而老年囚犯现在构成了监狱人口增长最快的部分。这种囚犯人口结构变化的一个关键原因是被判定犯有“历史性”性犯罪的人数不断增加,其中许多人是在老年时首次入狱,而他们被关押在不符合其需求的监狱中。这些人口结构的变化产生了深远的影响,包括监狱中对医疗和社会保健的需求增加,以及预计在押期间死亡人数的增加。本文利用最近完成的一项关于监狱姑息治疗的研究结果,提出老年囚犯在入狱时面临“双重负担”。这种双重负担意味着,除了被剥夺自由之外,老年人由于其健康和福利需求得不到满足,还会遭受额外的痛苦。对一些人来说,这种双重负担包括“事实上的无期徒刑”,由于他们年龄较大,而且很可能在狱中去世,他们实际上因一项通常不会被判无期徒刑的罪行而被判无期徒刑。关于这一双重负担所引发的伦理和司法问题,几乎没有引起公众或学术界的辩论。本文借鉴了 Wacquant 等人的工作,提出这些变化最好被理解为新自由主义刑罚政策的意外但可合理预见的后果。尽管本文重点关注英国(与其他欧洲国家相比,英国的监禁率较高),但讨论的许多挑战正在世界其他国家出现。本文鲜明地说明了新自由主义政策和话语如何塑造了监狱人口的扩张和构成,以及随之对健康和司法产生的影响。