所有的希望都没有消失:“阿拉巴马-犹他模式”如何彻底改变监狱医疗保健服务的提供

Roger Antonio Tejada
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摘要

本文认为,司法强加的严格规则约束那些负责向被监禁者提供适当医疗保健的人的行为,不会改革监狱医疗保健。这在很大程度上是因为“定制和调整的需要使规则成为控制自由裁量权的无效手段”。相反,法官和政策制定者如果希望改善这些机构提供的医疗服务,就应该用持续监测和纠正这些机构的原则来取代有限的规则。第一部分简要介绍了美国的刑事法律制度以及美国监狱、拘留所和拘留中心的恶劣条件。第二部分调查了四个司法管辖区挑战不人道医疗保健规定的集体诉讼,每个司法管辖区使用不同的医疗保健提供模式。第三部分审查了如何根据提供儿童福利服务的阿拉巴马-犹他州模式所使用的原则,通过纳入不断监测和纠正系统来改善这些设施的体制系统和结构。最后,第四部分提供了一个简短的结论,并指出了对全国惩教设施可能产生的影响。
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All Hope is Not Lost: How the "Alabama-Utah Model" Can Revolutionize Prison Healthcare Service Provision
This Article argues judicially-imposed rigid rules governing the conduct of those responsible for providing adequate healthcare to the incarcerated will not reform prison healthcare. This is largely because the “need to customize and adapt makes rules an ineffective means of controlling discretion.” Instead, judges and policymakers should supplant limited rules with principles of ongoing monitoring and correction of these facilities if they hope to improve these facilities’ provision ofhealthcare. Part I quickly describes the United States’ criminal legal system and the dire conditions inside American prisons, jails, and detention centers. Part II surveys class-action litigation challenging inhumane healthcare provisions in four jurisdictions, each one using a different healthcare delivery model. Part III examines how institutional systems and structures at these facilities may be improved by incorporating systems of ongoing monitoring and correction, in line with the principles used in the Alabama-Utah model of child welfare service provision. Finally, Part IV offers a brief conclusion and notes possible implications for correctional facilities across the country.
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