Case Study #1

Steven Jenkins


HMGT 495

07 April 2022

An Overview of Estelle v. Gamble and how the 1976 Supreme Court Ruling Pertains to the Provision of Intimate Healthcare

The Supreme Court’s Estelle v. Gamble case of 1976 was considered the foundation in terms of consideration of the type of proof that is important in confirming the violation of the prisoner’s Eighth Amendment rights. In this case, Gamble who is involved in the case against the curt unloaded cotton bales from a truck as per the labor as part of the daily routines in the prison. Unfortunately, he suffered injury after the bale fell onto his back. He never stopped working despite the condition of his back and this led to the severity of the injury ad was later examined and sent back to the cell (Nowotny et al., 2018). The pain increased ad he later found himself in the prison hospital where he was ultimately examined by the doctor and given pain medications.

Months later, he was in and out of the hospital as a result of the nonstable severe pain and the migraine. He could endure the pain and sometimes refused to take part in the daily routines within the prison. He found himself on the wrong hand after he refused to work in the farm and was even denied the chance to access the doctor for about three days. He later drafted a prosecutor complaint with no legal representation as he alleged that the prison had violated his eighth amendment right (Nowotny et al., 2018). His argument about the prison’s failure to sufficiently initiate the treatment of his back constituted a cruel and unusual form of punishment. The case ended up in the Supreme Court of the United States.

The ruling is based on the principle of equivalence that is present in the jurisprudence associated t the care of the prisoners. Following the ruling, it is acknowledged that the rights of the prisoners to be provided with healthcare are enshrined in the eighth amendment of the constitution (Nowotny et al., 2018). The principle of equivalence is indirectly included in the rights of the prisoners towards access to healthcare.

The challenges encountered during the delivery of healthcare services within the correctional environment

The challenges in the provision of healthcare in the prison are associated with the barriers to healthcare. The perceptions expressed by the healthcare providers and other correctional staff are considered to be barriers. There are healthcare providers who are resistant to engaging in advance care planning (ACP) discussions due to the worry about the possibility of triggering the fears of death amongst the inmates. Others are opposed to this because it means an increase in the workload and learning of the new processes. Trust is absent among the prisoners toward healthcare providers and other staff hence affecting the activities aimed at promoting the ACP (Macleod et al., 2020). The absence of trust presumed by the healthcare providers is associated with the fears that ACP discussions are approaches used by the state to ensure a speedy dying process.

The challenges faced when offering healthcare services to the female inmates that might be lacking in the male prisons

Women offenders often have particular health needs that are associated with risky sexual behaviors, drug use behaviors before imprisonment, and the risk of infectious diseases like HIV, tuberculosis, and other breathing illnesses. The female offenders are at high risk of suffering from health issues. There is limited access to treatment for drug-related health issues. Currently, the majority of females receive fewer healthcare services compared to their male counterparts. The type of healthcare services provided to female offenders can be described as mediocre (Tsegaye, 2020). The reports that have been received from the female offenders indicate that the medical professionals offering services to them are under-skilled and most of the time withhold medical care and fail to show concern or care for their specific needs. This deficiency in the accessibility to healthcare services is an indication of the severe healthcare needs of the female offenders compared to the male offenders.

At present, the correctional facilities that host women offer prenatal and postpartum treatment. Nevertheless, these services are not typically needed and are provided based on the request of the inmates or when there is a clinical indication (Ekaireb et al., 2018,). The shortcomings in the response to pregnancy-associated health problems are common in female prions.

The framework to be applied in strategic planning

The prison institution always limits the availability of healthcare and in many prisons, women have to wait for long in lines under strenuous conditions caused by their health. Therefore, the policy framework is focused on ensuring that women offenders are accommodated in place physically separate from the accommodation for the male inmates. It is also important to ensure that there are gender-responsive policies (Tsegaye, 2020). The prisons must develop such policies to ensure that the specific needs of the female inmates are addressed. The policies should also be developed based on the consideration of the necessity to have all the aspects of healthcare for example mental ad physical health.


Ekaireb, R., Ahalt, C., Sudore, R., Metzger, L., & Williams, B. (2018). “We take care of patients, but we don’t advocate for them”: advance care planning in prison or jail. Journal of the American Geriatrics Society66(12), 2382–2388. .

Macleod, A., Nair, D., Ilbahar, E., Sellars, M., & Nolte, L. (2020). Identifying barriers and facilitators to implementing advance care planning in prisons: a rapid literature review. Health & justice8(1), 1-11.

Nowotny, K. M., & Kuptsevych‐Timmer, A. (2018). Health and justice: framing incarceration as a social determinant of health for Black men in the United States. Sociology Compass12(3), e12566.

Tsegaye, T. (2020). What Are the Challenges of Women in Incarceration? The Case of Dessie Correctional Center, Amhara Region, Ethiopia. GRIN Verlag.

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