Literature on mass incarceration is vast and increasing, but Minimal Standards is the first book tracing the history of medical care in U.S. prisons. General accounts of the rise of U.S. prisons indicate that health services have long been provided in carceral institutions but offer scant detail about how and why those services changed over time. A limited number of sources regarding medical treatment at particular prisons show that clinicians could generally use their own discretion when determining which treatments should be administered, and they had much freedom to abuse imprisoned people. That work relates to important studies on the ethics of prison health care and involving vulnerable populations – including incarcerated men and women – as research subjects in scientific studies. It also connects with research by legal scholars, who have offered rich analyses of how and when people in prisons won crucial rights, including access to medical care. Recent scholarship on prison activism underscores that incarcerated individuals have hardly been silent bystanders; they have long struggled for rights and mobilized against inhumane treatment.
Historically-oriented research about prison medical services offers important context for twenty-first century understandings of relationships between incarceration and health. Mass incarceration, public health researchers note, threatens the well-being of communities and exacerbates health disparities. Inside of prisons, incarcerated people are more likely to have HIV/AIDS, Hepatitis C, tuberculosis, and sexually transmitted diseases than their non-incarcerated counterparts. Peer-reviewed literature, news reports, and legal claims highlight egregious shortfalls in prison medical services.
Building upon research about health consequences of incarceration and the history of health and prisons, Minimal Standards explores questions related to so-called routine medical care. It analyzes the legal decisions and amorphous standards that influenced prison-based care in the post-World War II years, and how incarcerated men and women experienced medical services. Minimal Standards also assesses prison health activism, paying special attention to its connection with the civil rights movement and a rash of litigation in the 1960s and 1970s that indicted entire prison systems as unconstitutional. It shows that, in the wake of such lawsuits, professional organizations like the American Medical Association articulated standards for service provision even as prisons became more prevalent, bureaucratized, privatized, and openly punitive. The book ends with the recognition that more than forty years after Supreme Court Justice John Paul Stevens maintained that the government must “provide the persons in its custody with a health care system which meets minimal standards of adequacy,” major legal and ethical questions regarding the medical rights of incarcerated people – and reports of abuses of those rights – abound.