Criminal Procedure

To prisoners at the Washington Corrections Center for Women, he is known as Dr. Yank. A dentist with a thing for extractions, Dr. Yank is known among inmates for going on sadistic "power trips" that have led to unnecessary procedures, severe infections, and additional drastic surgeries as a consequence of his treatment. Yet he wears his nickname with pride. Dr. Yank has admitted under oath that his car's vanity plate reads: DR YANK. In response to stories like these , legal agencies in both California and Washington pursued two class-action suits in the mid-1990s, hoping to improve the quality of life for women serving sentences in the state prison systems. How much the settlements in those cases have improved care is up for debate. Meanwhile, women in both states have testified that prison health care is so inadequate that it threatens their lives and constitutes cruel and unusual punishment.

The fundamental deficiencies cited by women inmates generally fall into two broad categories: Denial of adequate medication for chronic disease and crucial delays in treatment of acute health problems. When they doreceive care, say prisoners, they often suffer humiliating or abusive treatment at the hands of medical staff. Yet, prison officials contend they are doing the best they can, given the mushrooming prison population of women with diverse medical needs.

The 1995 California case of Shumate vs. Wilson accused prison administrators and medical staff at both the Central California Women's Facility in Chowchilla and the California Institute for Women in Frontera of cruel and unusual punishment and charged them with "deliberate indifference" to the health needs of inmates. Among the cases at the center of the Shumate lawsuit were instances of untreated or poorly treated pulmonary and cardiac problems, hypertension, sickle-cell anemia, and cancer. Attorneys also attributed at least two prison deaths to the poor quality of health care, including the case of a mentally ill woman with gastrointestinal problems. Confined naked to a prison cell, the woman ingested her own body waste and eventually died of untreated pancreatitis and starvation.

That suit ended in a settlement in 1997, in which the state of California agreed to improve its overall prison health care system. The settlement allowed for the state to avoid admitting any wrongdoing. Changes in the prison system are being monitored by an independent investigation team whose findings later this summer will determine whether the state has adequately fulfilled its obligation. If the improvements are found to be incomplete, the suit will go back to trial.

In Washington state, attorneys achieved a far-reaching judgment in the 1995 class action suit Hallett vs. Payne, just months after a 41-year-old female inmate died from a misdiagnosed and improperly treated ulcer. On the order of a federal judge, the settlement required that prison administrators for the Washington Corrections Center for Women in Gig Harbor dramatically improve the delivery of medical, dental, and mental health services.

But four years after the settlement of Hallett vs. Payne and two years into the monitoring phase of Shumate vs. Wilson, these and other lawsuits -- along with campaigns of prison activists -- continue to raise serious questions about the health care provided to women doing time.