Controversy Surrounds Shackling of Dying and Comatose Prisoners in UK

by Matt Clarke

Authorities at Great Britain’s HM Prison Frankland pledged to change the way ill and dying prisoners are shackled in the aftermath of a scathing report by the UK’s prison ombudsman concerning a prisoner who died while chained to a guard because prison officials twice refused requests by medical staff to have the restraints removed.

“This was inhumane,” wrote Nigel Newcomen, the Prisons and Probation Ombudsman, in a January 2014 report that noted the failure of authorities to authorize the removal of shackles from Paul Culshaw, 45, violated a ruling by Britain’s High Court that required medical recommendations be considered in the use of restraints on prisoners judged to be a low risk of escape.

Culshaw, who was serving a mandatory life sentence for murder and had been incarcerated since 2004, died on February 6, 2013 of a heart attack. Other than the refusal of prison officials to authorize the removal of shackles, Newcomen’s investigation found no irregularities in the response of prison staff to Culshaw’s medical condition, nor his treatment at the hospital.

“It is wholly unacceptable that the restraints were not removed until after the man had died,” Newcomen said. “The risk assessment did not take into account the guidance of the High Court so that medical opinion was considered and the assessment was not appropriately reviewed as the man’s condition changed.”

Further, he added, the circumstances surrounding Culshaw’s death were not isolated.

“We have made recommendations to the Governor of Frankland three other times in the last 18 months about similar issues,” Newcomen wrote. “Although the prison has accepted the previous recommendations, it does not seem that this is being translated into appropriate action.”

The report noted that the shackling of ill and dying prisoners was not unique to HM Prison Frankland.

“This is also apparent in investigations at other high secure prisons,” Newcomen said. His report called on Britain’s Deputy Director of Custody for High Security Prisons to “ensure that there are appropriate arrangements and guidance in all high secure prisons which ensure risk assessments for escorts fully take into account the medical condition of the prisoner and are based on the actual risk the prisoner represents at the time.”

Scores of other examples were reported in the Learning Lessons Bulletin, which examined the use of restraints by prison staff over a five-year period. For example, a 67-year-old prisoner was chained to a guard as he lay in a hospital dying of liver cancer. He had been convicted of manslaughter in 1969 and was unable to move without help.

Guards reapplied restraints to another prisoner, who was in his 70s and bedridden at a hospice, even though the restraints had been ordered removed earlier.

Yet another prisoner, who was serving a life sentence and considered a significant escape risk, was shackled for four days while in a medically-induced coma. He suffered from terminal cancer and had just undergone a medical procedure. He had been escorted to the hospital by three guards and required to wear double shackles.

The incidents were among 51 such cases reported in the Bulletin in which prison officials used what critics complained were inappropriate restraint levels on ill and dying prisoners during the previous five years. The cases involved one-tenth of all prisoners who died of natural causes in UK prisons during the same time period.

Newcomen, who investigates all prisoner deaths, criticized the HM Prison Service for being excessively harsh in its treatment of dying and seriously ill prisoners.

“There is, inevitably, a balance to be struck between decency and security. However, our investigations have shown that the correct balance is not consistently being achieved. Too often, an overly risk-adverse approach is taken when frail, immobile or even unconscious prisoners remain restrained,” he said.

“Some of the cases outlined in this bulletin are truly shocking,” added Andrew Neilson, director of campaigns at the Howard League for Penal Reform. “Prisoners who are seriously ill or dying are amongst the most vulnerable people in society and it beggars belief that even being in a medically-induced coma cannot excuse you from restraint.”

“No one is talking about luxury or special treatment here,” said Juliet Lyon, director of the Prison Reform Trust. “But, in the interests of common humanity and decency, justice and health ministers must now review the treatment of increasing numbers of elderly people and those dying in prison.”

In the wake of Newcomen’s report and recommendations following Culshaw’s death, Britain’s Deputy Director of Custody for High Security Prisons announced procedural changes at HM Prison Frankland designed to prevent similar incidents.

“A new risk assessment process, which includes a revised management checklist, was introduced following the death of the man to ensure that risk assessments for prisoners taken to hospital are based on a consideration of the individual’s circumstances and the actual risk the prisoner presents at the time,” according to the Deputy Director.

There is mounting concern in Britain about the aging of its prison population and the greatly increased costs of caring for geriatric and ailing offenders. Prisoners over 60 years of age are the fastest growing segment of the UK prison population. According to Inquest, a charitable organization that focuses on deaths in custody, there were 141 deaths from natural causes in UK’s prison system in 2014, up almost 15% from the year before. There were also 83 suicides, three homicides and one death due to restraint by prison staff.

The shackling of ill and dying prisoners is not unique to Great Britain. Prisoners in the United States who require medical treatment are routinely shackled, including pregnant women before and immediately after giving birth. [See: PLN, Dec. 2014, p.30].

Sources: www.corspecops.com, www.ppo.gov.uk, www.independent.co.uk, www.inquest.org.uk

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