Sociology and Criminology-Open Access
Open Access

The Effects of Expecting Investigations after a Death from Natural Causes in Prison Custody

Robinson D^{* *}Correspondence: Robinson D, Department of Sociology, University of Winchester, Sparkford Rd, Winchester SO22 4NR, United Kingdom, Email:

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Introduction

Deaths in prison custody occur for several reasons, including suicide or, very rarely, homicide, but the bulk result from natural causes. Understanding influences on the standard of end-of-life care in prison is therefore important. Deaths from natural causes accounted for 56% of the 286 deaths in prison custody in England and Wales within the year to March 2020. There have been 1.9 deaths from natural causes per 1000 prisoners during this period, a rise from 0.94 deaths from natural causes per 1000 prisoners in 2000. Some deaths from natural causes are sudden. When a death results from natural causes and is predicted, there's the chance to analyse how the anticipation of an investigation affects the delivery of palliative care and therefore the behaviour of prison staff towards the prisoner, and to think about whether the consequences are necessarily those desired by the investigating bodies.

Drawing on data collected in two prisons within the north of England, the anticipation of an investigation are going to be shown to possess direct consequences for the standard of look after dying prisoners and their families. These arise both from prison staff expectations of the problems which will form the main target of the investigation but also from the anticipated process of the investigation itself. The PPOs investigation and subsequent report was mentioned by prison staff during a sort of roles, including governors, officers and healthcare professionals, and is restricted to the prison setting. The article will suggest that the consequences of anticipating an investigation aren't always those expected. Rather, while the anticipation of an investigation can motivate efforts to supply additional support for dying prisoners, the actions taken in anticipation of the method of the investigation also can potentially undermine look after prisoners, their families and staff.

When any death occurs in prison custody in England and Wales the prison is required to tell three organisations: the police, the coroner and therefore the PPO. All three organisations have responsibility for investigating the circumstances of the death. These investigations are a part of fulfilling the State’s duties under Article 2 (the right to life) of the ecu Convention on Human Rights (ECHR) and are undertaken no matter any preliminary assessment of the explanation for the death. When the deaths investigated are the results of a terminal diagnosis, concerning conditions like cancers, organ diseases or degenerative illnesses, the individual may are considered dying for weeks or months before their death occurs. A key component of the investigations is an assessment of the care they, and where relevant, their family, received during this era.

Regardless of the wants for an investigation, dying from natural causes in prison isn't an equivalent as dying from natural causes in other settings. The difficulties of developing and delivering good palliative care in prison, although the prisons have began to explore how palliative care provision for prisoners might be improved. Where age may be a factor, older prisoners are generally in poorer health than their peers outside of the prison and have less access to hospital services. In 2018, a House of Commons Health and Social Care Committee’s report on Prison Health found deaths from natural causes in prison often reflect the poor physical health of the prison population which prisoners sometimes experience long delays in getting their health concerns addressed. Conspicuous to the committee, the charity INQUEST showed prisoners in England have a death rate 50% above the overall public.

The PPO is an independent body, funded by the govt but with no statutory powers, whose role in fatal incidents is meant to satisfy the obligations for investigation arising from Article 2 of the ECHR. Its investigations are breaking away those of the coroner, which must also happen whenever a death in custody occurs. It’s the responsibility of the coroner, not the PPO, to work out the explanation for death and of the police to undertake criminal investigations where relevant. The remit of the PPO is to determine the circumstances of the death, particularly how the deceased was managed by the relevant authorities, and to look at whether operational practices or policy should be changed to stop a future death. Their remit includes assessing clinical care and a clinical reviewer, independent of the prison’s healthcare provider, is appointed to assess clinical issues associated with the death.

The PPO is remitted to figure with the coroner ‘to ensure as far as possible that the complete facts are delivered to light and any relevant failing is exposed, any commendable action or practice is identified, and any lessons from the death are made clear’. Their findings are presented to key stakeholders, including the prison governor, the prison’s head of healthcare, the family of the deceased, and therefore the coroner.

The data presented here are a part of a bigger study examining how the growing number of deaths from natural causes in prisons in England and Wales impacts on prison regimes, culture and relationships. The study also considered what factors determine how prison regimes and personnel answer dying prisoners and deaths from natural causes. It’s during this context that the influence of anticipating an investigation became apparent.

Using participant observation, semi-structured interviews and documentary analysis, fieldwork was conducted in two prisons within the north of England. One among these prisons was within the future and High Security Estate (LTHSE), accommodating men sentenced for the foremost serious crimes and sometimes serving very lengthy sentences. The opposite was a ‘Category B’ local prison, housing medium-risk male prisoners and people on remand. Each prison had some on-site healthcare provision. These prisons were selected because that they had experienced a comparatively high number of prisoner deaths from natural causes within the 5 years before the research: 13 within the ‘Category B’ prison and 33 within the LTHSE prison, the second highest in England and Wales. The mean number of deaths per prison in England and Wales during this period of time was five, and therefore the median was three. In all, 108 prisons recorded a minimum of one death from natural causes therein 5-year period, but only 31 prisons recorded quite 10 deaths.