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Patient or Prisoner

Ji Seon Song
92 Geo. Wash. L. Rev. 1

Carceral power expands into many institutions vital to social life. This Article focuses on one such important institution: the hospital in the free world. Hospitals outside of carceral institutions routinely treat, diagnose, screen, and discharge people under law enforcement and correctional control. Just as hospitals serve an important function for society as a whole, hospitals are indispensable to the United States’s system of policing and incarceration. Hospitals take up the slack for inadequate correctional health care by treating injured or sick people in police custody and provide critical support in criminal investigations and incarceration.

The use of hospitals by police and correctional institutions, however, is more than incidental or situational. The Article argues that hospitals have become part of the infrastructure of mass incarceration. Despite popular conceptions of the hospital as a place of care, this Article posits that hospitals perform functions essential to the operations of mass incarceration by identifying criminals, helping build criminal cases, preparing people for incarceration, and certifying that arrested and incarcerated people are fit for imprisonment. Law enforcement and correctional actors alter the complex, structured, and regulated hospital workplace through their immense formal and informal powers. Their rules and norms on security, isolation, and control trump hospital regulations, practices, and ethics on patient privacy, autonomy, and dignity. This Article articulates this deference to and incorporation of carceral rules and practices as an expansion of the modalities of policing and custodial practices. Further evidence of hospitals inclusion in carceral infrastructure can be seen in how hospitals perpetuate problems of mass incarceration, such as racial and class-based subordination and loyalty to carceral logic of “public safety.”

Highlighting the role of hospitals in mass incarceration is particularly important now when public health and care-based institutions and solutions are offered as alternatives to incarceration and policing, and abortion criminalization brings further attention to the intersection of law enforcement and health care. Close scrutiny of this intersection is also important not just to expose the problems, but because the indispensability of hospitals presents us with an opportunity. The exposure of correctional and law enforcement practices to the outside world through hospitals breaches the divide between the too-often unaccountable correctional environments. These outside institutions therefore have an opportunity to reimagine a different kind of patient prisoner care. The Article concludes by proposing ways to do so through institutional, regulatory, and doctrinal measures.

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