The Commonwealth of Pennsylvania is in the middle of a tremendous reform of criminal justice policy: for the first time in forty years, there is momentum behind commutations of life sentences. People who have served decades behind prison walls are being granted clemency and released back into society. Simultaneously, a new interpretation of the U.S. Constitution’s protections against cruel and unusual punishment is allowing hundreds of juvenile “lifers” to be resentenced and often released. We argue that it is in the state’s interest to capitalize on these lifers’ hard-won wisdom and experience. Years of isolation, deprivation, brokenness, and self-reflection—while living outside the law and while incarcerated—have put these citizens in a unique position to understand and intervene in cycles of violence that still afflict our communities. For that matter, those rehabilitated lifers who remain in prison also have important contributions to make. This article offers a blueprint for a role the formerly or currently incarcerated can play in decarceration and public safety by helping to create and operate a reintegration hub in Pittsburgh.

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama , the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama , which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

Amendments to the compassionate release provisions of the federal First Step Act and Second Chance Acts provide some opportunity for release for elderly and infirm federal inmates. This article examines the reentry successes of three Pennsylvania state inmates, all convicted of homicide, who won their release as re-sentenced juvenile lifers or through commutation. The author came to know them through a reentry group affiliated with a Pittsburgh university. Their success and scholarship about the low recidivism rates for violent offenders over the age fifty suggest that the criminal justice system should abolish the imposition of life sentences. More than avoid recidivism, each of these returning citizens has made positive contributions to their communities, both in and out of prison. They are working, obtaining educations, engaging in charitable work and political advocacy, and writing about their experiences. Their example and their description of many similarly-situated older inmates still in prison teach that society should not rest the argument for their release solely on compassion and pity. Rather, older inmates have learned coping skills that can help restore the communities that their crimes harmed and that they were taken from during their incarceration. For these reasons, the author suggests that prison sentences generally should provide for release after an inmate serves twenty-five years and attains the age of fifty.

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

The COVID-19 pandemic has opened our eyes to the myriad vulnerabilities in the prison health care system. We need only record the number of pandemic-related deaths of federal inmates to grasp that the prison health care system is profoundly ill-equipped to handle the needs of inmates during a public health crisis. Currently, prisoner infection rates outpace those of the general, unincarcerated population by more than 150%, and prisoners are dying four times as often as prison staff who test positive. Results are far worse for elderly inmates. While COVID-19 afflicts people of all health profiles, its grip on the elderly is the most arresting. Though some effort has been exerted, federal prison officials fail to adequately protect the rights of the imprisoned elderly. It cannot be ignored that prison officials owe basic duties of care to the incarcerated, chief among them, the responsibility to provide adequate health care. However, prisons, by their very nature, are unable to care for an old and ailing population. This glaring deficiency is rendered indisputable by the novel coronavirus pandemic. For this reason, vulnerable inmates, especially the elderly, should be released to home confinement forthwith. Anything less is profoundly inhumane and represents a colossal miscarriage of justice.