justice

Alexei Navalny

One day

My 16th February 2024 started out as a pretty standard Friday, doing my job as a doctor within the UK’s prison system. Sadly, it ended in tragedy with the unexpected death of one of my detained patients. After leaving the prison, I sat in my car for a while, thinking and praying for my late patient’s family. And as I drove out of the prison car park, I noticed two parked up police vehicles…

Investigation

Of course, the police were there because - whether expected or unexpected, self-inflicted, accidental or murderous - all UK deaths in custody are subject to extensive investigation by multiple agencies:-

In addition to all these measures, the Council of Europe’s Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), which is responsible for monitoring member states’ compliance with Article 3 of the European Convention on Human Rights, also takes a keen interest in deaths behind bars.

Two deaths

In the busyness of managing the immediate aftermath of my own detained patient’s death, I missed the breaking news about another custodial tragedy - that same day but thousands of miles away, in the frozen Artic Circle…

Prisoner Alexei Navalny, the fiercest and most enduring critic of President Putin, is dead.

Investigation?

  • He died just one day after being well enough to laugh and joke with his judge.

  • There is the usual confusion about the cause of his death and the location of his body,

  • The Investigative Committee of the Russian Federation, whose agency executive is (according to Wikipedia) a certain President Putin, is on the case.

  • And so it remains to be seen whether the United Nations has engaged in a spot of wishful thinking, in calling for his death to be rigorously investigated.

One judge

UK detainees are relatively blessed compared with those held in many other parts of the world. UK conditions of detention are regulated, monitored and - when found to fall short - investigated. Yes, I know full well that there are many problems behind my nation’s bars - and the CPT highlights these failings on a frequent basis. But compared with many places in the world, UK places of detention sit within a veritable Garden of Eden where the Rule of Law presides.

Yet viewed through the long lens of eternity, whether a free President in the Russian Federation or a detained person in the UK, one day every one of us will die and face judgement by the same Judge.

From His courtroom, He examines all the goings on in our world, with notable concern for detainees:-

The Lord looked down from His sanctuary on high, from heaven He viewed the earth, to hear the groans of the prisoners and release those condemned to death.
(Psalm 102:19-20)

And to those who ignore the visible suffering of others, yet alone those who cause it, He will say…

 Depart from me, you who are cursed, into the eternal fire… For I was hungry and you gave me nothing to eat… I was sick and in prison and you did not look after me…

Truly I tell you, whatever you did not do for one of the least of these, you did not do for me.
(Matthew 25:41-45)

The author is one of our spokespeople
Their views do not necessarily represent those of Integritas Healthcare

Will nitrogen enter the death arena?

So once again, death penalty demonstrators are gathering outside a USA prison. This time though, things are a bit different: the execution agent is gaseous, and the condemned man is a repeat attender…

Who and why?

Kenneth Smith is one of two assassins-for-hire who in 1988 killed Elizabeth Sennett, the wife of a pastor who hoped her life insurance could ease his financial troubles. Shortly after the killing though, the pastor killed himself - rather than face earthly justice.

A long 22 years later, in 2010, Kenneth’s partner-in-crime received the stiffest penalty meted out by the US Justice System - execution. And Kenneth himself is sentenced to the same punishment, yet he’s still on death row - at least until later today, 25th January 2024, when he is scheduled to become the first person in the USA to be executed through nitrogen asphyxiation.

Why gas and why now?

But why are the authorities using nitrogen gas rather than lethal injection, and why have they waited until now - almost 36 years after the murder - to execute him? Well the answers to these two questions are linked…

The USA’s capital punishment appeal system is notoriously slow and convoluted. It’s common for condemned people to spend around 20 years on death row. Some argue that this long wait for almost certain death is itself a form of psychological torture. And it’s not uncommon for death row prisoners to die of illness rather than by the executioner’s hand.

In Kenneth’s case, it was 33 years between conviction and the authorities first taking him to the death chamber in November 2022. But things didn’t go to plan…

As is common to many botched executions, his would-be executioners lacked sufficient skill in venous access to get the necessary needles into him. After several hours of trying, his death warrant expired and so they had to abandon the execution and return him to death row, his home for the previous three decades.

And in the aftermath of that debacle the authorities promised not to try to use lethal injection on him in the future.

So that is why Kenneth has been rescheduled to die - at another time and in another way.

Why worry?

Right now, more than the usual amount of last minute legal appeals are going on. And this is due to at least two key factors…

Firstly, no-one can reasonably deny that surviving a botched execution is a traumatising experience. And Kenneth’s legal team is arguing that it’s cruel to do this to him all over again.

And crucially, the UN High Commissioner for Human Rights is alarmed at the prospect. Quoting an extract of their full statement:-

We have serious concerns that Smith’s execution in these circumstances could breach the prohibition on torture or other cruel, inhuman, or degrading treatment or punishment, as well as his right to effective remedies. These are rights set out in two International Human Rights treaties where the United States is bound by – the Covenant on Civil and Political Rights and the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment [CAT].

So, will the execution go ahead and - if so - will it go as ‘smoothly’ as the authorities hope? All eyes - and many hearts and prayers - are fixed on that death chamber right now. We’ll be updating you soon.

Dr Rachael Pickering is our Chief Medical Officer
Her views do not necessarily represent those of Integritas Healthcare

The Life Series: Nothing Less Will Suffice

We continue this series of a young doctor considering the health and justice interface as applied to long-term incarceration. In the first issue we considered IPP sentences. We now move on to the thorny issue of 'life means life' sentencing…

It has been almost a month now since I opened BBC News on my phone and saw the headline of former Police Constable Wayne Couzens being sentenced for the abduction, rape and murder of 33-year-old Sarah Everard. He received a whole life order. He will never be released. He will die in prison. 

I read various articles describing the tragic events of 3rd March 2021 - the violent, inexplicable acts against an innocent individual - and I wept. I wept for Sarah Everard and for what she had to suffer. She was a young woman living a life with many parallels to my own. I wept for her family, her friends and for all the other people caught up in this horrific crime. And I wept as I thought about all the other evil and injustice in our world. 

Then, out of my anger and sadness came a longing for justice. But what does justice really look like, in the face of such evil? Is a whole life prison sentence the answer? 

Whole life orders

Since the United Kingdom (UK) abolished capital punishment, a whole life order has been the most severe punishment available. It is reserved for only the most serious offences. The remarks from Mr Couzens’ sentencing hearing highlight the seriousness of whole life orders, stating they are rarely given out and should only be…

for the few exceptionally serious offences in which, after reflecting on all the features of aggravation and mitigation, the judge is satisfied that the element of just punishment and retribution requires the imposition of a whole life order. Nothing less will suffice.

(Lord Justice Fulford)

Whilst Mr Couzens’ crimes fell outside the list of offences that would normally qualify for a whole life order, Lord Justice Fulford stated that it is not a closed list and subsequently expounded on his sentencing decision. All the elements of kidnap, rape and murder were taken into account but particular emphasis was placed on Mr Couzens’ abuse of his position as a police officer. Lord Justice Fulford concluded that alongside other aggravating features, his misuse of his position and his undermining of public trust were deserving of lifelong imprisonment. 

The easy option would be to not question locking away those who kidnap, rape and murder. Such sentencing seems the obvious solution. But it is important to consider the function of imprisonment and to ask whether it truly achieves what we expect it to - the creation of a safer and fairer society.  

Public Protection

One function of imprisonment is public protection. When a violent crime is committed, we naturally want to prevent it from happening again. We can lock away those who pose a risk to society through their violence. Mr Couzens will never again drive a hire car down a South London street. By imprisoning him until he dies, we can take some comfort in knowing that he will never do to anyone else what he did to Sarah. 

There is a risk of reoffending at any age, but the risk of recidivism drops in older age - for certain types of crime at least. How do we know that Mr Couzens’ risk of reoffending will remain unacceptably high once twenty-five, thirty or forty years have passed? It also raises the question of whether lifelong imprisonment truly makes our streets safer. Coming just a couple of weeks before Mr Couzens was sentenced, the murder of yet another young female Londoner - this time 28-year-old primary school teacher Sabina Nessa - reminded us that the problem of violence against women was never going to be solved by locking away one man for the rest of his life.

What more can be done to create a safer, more just society?

Punishment

My gut response to Mr Couzens’ actions was that he must be punished and punished severely. Directly and indirectly, he has caused unthinkable harm: he inflicted sadistic, fatal harm on Sarah; and he carved agonising wounds into the hearts of her family and friends. He also damaged British society’s trust in the police. He may have pleaded guilty but so far has neither displayed regret nor expressed remorse.

In the old days he would have been in line for physically brutal punishment; as a supposedly forward-thinking, civilised society today we shudder at the thought of those historic punishments, characterised by public displays of physical violence and humiliation. Our modern-day punishments - locking people away for decades or even life - seem far more palatable. Offenders are hidden away behind heavy doors, removed from our public conscience.

But lifelong imprisonment is an immensely heavy punishment. To be deprived of your liberty and enclosed in a cell for the majority of your waking hours (often 23 hours or more per day, as he is a prisoner of notoriety and so will likely need to be segregated for his own protection) with no hope of release is a desolate place in which to be. Whilst we may not be punishing his body directly, as was once the custom, such incarceration will take its physical toll indirectly. Certainly it will be punishing his mind. And the same punishment extends its reach beyond a sentenced individual. Often there is a family left behind. Children, wives and mothers can all become branded by the same hopelessness.

Clearly Mr Couzens’ actions were unacceptable and cannot be ignored. My own initial thirst for punishment came not from a longing for justice but out of a desire for vengeance. What do we seek from his punishment? What motivates us to punish any other human being who has erred? We must ask ourselves whether a just society is ever right to condemn an individual to an unending punishment. We must protect ourselves from the tyranny of becoming cruel and vindictive, whether as individuals or collectively as a society. Regardless of what someone has done, we must treat one another humanely. To repay darkness with darkness will in no way bring healing. 

Deterrent

In addition to public protection and punishment, many view heavy sentencing as an effective deterrent to reduce further incidences of violent crime.

The relationship between sentencing length and crime rates has been long studied and there is much detailed research on the topic that is beyond the scope of these ponderings. The United States of America has 2 million people locked up - that’s a 500% increase over the course of just one generation. Whilst crime rates have fallen, it is widely agreed that this cannot be solely attributed to mass incarceration and that the increase in imprisonment plays only a small part. Similarly, UK prisoner numbers are expected to rise by 25% (that’s approximately 20,000 people) over the next five years as the government looks to pass and implement the Police, Crime, Sentencing and Courts (PCSC) Bill, which will deploy more police officers and expand the prison system.

It is most telling that this bill’s own impact assessment reveals a lack of evidence for the measures deterring offenders or reduce crime rates. The threat of punishment is not an effective deterrent.

Rehabilitation

The final role of prison is rehabilitation, helping prisoners to process their actions and to receive support as they return to society. In the USA this is referred to as ‘correction’.

A whole life order implies that a prisoner is beyond redemption or rehabilitation. The sentence says, ‘You will never be fit to return to society’. At the time of his sentencing, Mr Couzens had offered no form of apology. Some people never reach a point of rehabilitation in which they seek repentance and genuinely wish for inner change. For others it does happen - but very slowly.  A whole life sentence removes any incentive for repentance and reconciliation. Moreover, there is nothing to lose so bad behaviour in prison cannot be sanctioned much beyond the removal of privileges and intermittent stays in segregation. After all, what is worse than a whole life order? Nothing that the UK’s criminal justice system offers, that’s for sure.

To leave someone in prison for the rest of their life with no expectation of any apology or positive change seems tragically futile. To me, the impossibility of rehabilitation implies that the main focus of a whole life order is pure and simple punishment. 

We must also wrestle with the question of whether there is ever a role for forgiveness in cases of abhorrent wrongdoing. To forgive is not to forget, condone or minimise what has been done. These actions have inflicted deep wounds on a family and, to a lesser extent, wider British society. These wounds will leave permanent, painful scars. Sarah’s loved ones, and society in general, may neither be able to forgive Mr Couzens nor feel that it is appropriate to consider doing so. Yet we must be wary of the destructive nature of resentment and bitterness. In order to bring more justice and peace to this world, we must each be the caretaker of our own heart.

Could anything else suffice?

The question of whole life imprisonment is a weighty one with no easy answers. The process of reflecting upon these issues has been somewhat distressing for me, and perhaps you have found this an upsetting read. Regardless of our society’s myriad opinions on these matters, surely we can all agree that even the severest sentence imposed upon an offender can never make up for the loss of his victim’s life. That equation just will not balance.

Yes, there must be a response to injustice. No, we should not tolerate violent crime in others. Still, for ourselves, let us seek to live justly and compassionately in our day-to-day thoughts, words and deeds.

Dr Elinor Webb is one of our Health & Justice Fellows

If you have appreciated this article and would like to support our anti-torture & ill-treatment work, we welcome donations towards the Gerry Serrano Centre.

Price of Pandemic on Prisoners

A startling report was published by HM Inspectorate of Prisons on February 11th 2021 about the effects of restrictions imposed on prisoners in England since the start of the COVID-19 pandemic. Prisoners have had to spend 22 hours in a cell every day and have been unable to attend work, education, rehabilitation interventions or gyms, in an attempt to stop the spread of the virus. Visits from relatives and friends have also been suspended or highly restricted.

Saving lives

When the first lockdown was implemented back in March 2020, radical changes had to be made within the prison system as it was estimated that 2,000 prisoners could die from COVID-19. To an extent the measures have worked: the numbers of deaths has remained low thanks to the precautions.

The prisoners, made aware of the restrictions in the community, not only understood the necessity of prison lockdowns but also felt largely safe from the virus. As time has stretched on though, their mental strength to endure their restrictions has worn thin. Many desire the resumption of activities to make their lives meaningful again.

Price paid

The lasting psychological, physical and emotional impacts are already starting to show, with prisoners reporting an increase in self-harming behaviours, drug misuse, and deterioration in physical and mental health.

HM Chief Inspector of Prisons, Charlie Taylor, commented

‘The cumulative effect of such prolonged and severe restrictions on prisoners’ mental health and well-being is profound. The lack of support to reduce reoffending and help prisoners address their risk of serious harm to the public does not fill me with hope for the longer term […] Locking prisoners up in prolonged isolation has never been a feature of a healthy prison.’

The conditions many are faced with are not those you would wish upon anyone: eating meals in the same room as an unlidded toilet, inadequate ventilation, and often sitting alongside a cellmate. Those housed in single cells may not have the difficulty of being cramped in with another, but instead suffer the psychological impact of isolation and loneliness. These descriptions sounds more like those found in the detention centres of a low or middle income country, not the United Kingdom.

When allowed out of their cells for the daily activities of showering and exercise, there is a strict time limit. Many are frustrated that they don’t have long enough to complete these tasks.

Although the report does state that inter-prisoner violence has decreased, due to the reduction in face-to-face contact between prisoners, bullying and intimidation have increased.

And many prisoners have remarked on how underprepared they are for release into the outside world; without access to rehabilitation programmes or meaningful work, their chance of re-offending is far higher.

The solution?

The introduction of video calling and in-cell telephones have allowed some prisoners to remain in contact with their support networks. This may even be a post-pandemic solution for many isolated prisoners of the future.

The end of January saw eligible prisoners in England being offered vaccines, in line with the community rollout. This sparked some public debate as elderly & certain ill offenders will now be receiving vaccination before their (perhaps younger or fitter) victims in the community. That said, prisoners are not the only ones at risk within the prison system: prison staff are at risk and their representative bodies feel that both they and their prisoners should be higher up the vaccination queue.

Whilst individuals may disagree as to who should go to the top of the queue, there is common ground in the knowledge that we cannot fight this virus whilst fighting each other. We must act as a team to stop the spread and save lives.

The future

The longer-term impact of the restrictions imposed on prisoners is yet to fully come to light. However, this report has shown that - unless we act soon - many offenders are at risk of serious mental and physical deterioration. It is too soon to lift the restrictions without putting thousands of lives at risk. So, in order to emerge from this pandemic safely, we must look to vaccination as the way forward - in prisons as in the community.

If not now, then when?

Following his inauguration last week, President Biden has not wasted time in signing a number of executive orders. Two days ago, this included ordering the Department for Justice to end contracts with private prisons.

This order could be seen as a step forward to ensure more humane settings of detention. It may also be a move towards racial equity. But others see this as a purely political statement that does not solve the myriad underlying problems within American’s criminal justice system. For example, it does not benefit immigration detention centres; there is no news as to when action might be taken to improve their conditions.

We continue to hope that the new administration will act on capital punishment. As of yet though, no post-inauguration mention has been made of ending the execution of prisoners who may have committed their crimes whilst seriously mentally unwell. Mr President, we urge you to consider the mental, emotional and lethal consequences of putting off this decision.

For media enquiries, please phone our Medical Director or email our European office.

Integritas calls for new POTUS to act on capital punishment

Today the world has its eyes on Washington DC. We wait to see what might happen during and after President-elect Biden's inauguration. And we wonder which executive orders the new POTUS (President Of The United States) will sign as he eases himself into his Oval Office chair.

Particular things that Integritas Healthcare, the medical non-government organisation with a heart for detainees, wants to know are...

Will President Biden act decisively to end his nation's record of executing prisoners who may have committed their crimes whilst seriously mentally unwell? And will he move to end the decades of solitary confinement, which could be said to amount to psychological and environmental torture, endured habitually by many death row prisoners?

We wait with expectation. But regardless of whether President Biden acts on this matter soon, within the next few months or never, the international appetite for change grows ever stronger.

Please Mr President, such actions would be the start of a much needed improvement in the treatment of detainees on your country's soil. We hope for the day when leaders of smaller nations set on improving their human rights records are able to look up to the United States of America and pledge to emulate your statesmanship in this matter.

For media enquiries, please phone our Medical Director or email our European office.

Integritas responds to the execution of Lisa Montgomery

Further to our recent campaigning, we were saddened though not surprised to hear that Lisa Montgomery was executed this morning after her last-minute stay of execution was overturned by the United States of America’s Supreme Court. Our thoughts and prayers are with her victim’s family, with Lisa’s own family, and with all those who have been involved professionally in her case.

Whether or not you agree with the death penalty, Lisa’s execution is a sobering, sentinel moment. It will be remembered for arguments hinged around the fate of those who commit a serious crime whilst severely mentally unwell. Could better social services & healthcare during her formative years have prevented her crime? And could more or better forensic psychiatric assessment whilst on remand have prevented her being given a capital sentence?

Those who commit heinous crimes are often themselves victims of horrendous abuse and substandard care. It is for this reason that a gold standard forensic psychiatry system needs to exist alongside an effective criminal justice system. And so we must continue to advocate for certain detainees within the criminal justice system who, because of mental illness, are especially vulnerable.

This case has been highly emotive. Therefore we will be pausing to reflect before releasing further commentary in due course.

For media enquiries, please phone our Medical Director or email our European office.

Death to the Inequality of Justice Part 1: Letter to POTUS

On 12th January 2021 the US government plans to kill Lisa Montgomery by lethal injection; she will be the first woman since 1953 to receive the federal death penalty in the USA. She was arrested in 2004 after she strangled a pregnant woman, cut her unborn baby from her abdomen, and then kidnapped the child to pass it off as her own.

TRAUMATIC CHILDHOOD AND MENTAL HEALTH

However abhorrent her crime might be, it must be placed into the context of her tragic and traumatic life. Lisa’s parents were alcoholics and she was raised in a deprived and violent household. Reported to have suffered brain damage as a child, she was a victim of sex trafficking and physical abuse, has a genetic predisposition to mental health problems, and has since been diagnosed with bipolar disorder, complex post-traumatic stress disorder and dissociative personality disorder. Yet all this mental strain went unrecognised and her mental health un-investigated - until after she was arrested and detained.

Lisa has taken full responsibility for her crime. Since being in prison she has been able to receive the help she needed in the first place, to begin to stabilise her mental health. Yet psychological reports, which stated that she was psychotic when she committed the murder and that her childhood trauma could explain her behaviour as an adult, were ridiculed in court. Her legal team’s attempts to have these arguments weighed in her sentencing were dismissed as ‘abuse excuse’. Instead her poor personal hygiene and unkempt home were used to degrade her character - as a person and as a mother.

As for the ‘abuse excuse’ accusation: examining a suspect’s mental health history and unfortunate background is the very opposite of looking for an ‘excuse’. No, it is a search for a partial ‘explanation’ at least.

Capital punishment is a divisive subject. Lisa’s crime was abhorrent. But regardless of what one believes about capital punishment, surely it isn’t right to execute someone who committed their crime whilst seriously mentally ill?

With less than 24 hours to go until Lisa is executed, we appeal to President Trump:-

Mr President

Sir, your administration has permitted Lisa Montgomery - a woman who committed a heinous crime whilst chronically mentally ill after a lifetime of severe social injustice - to be put forward for execution during the closing, supposedly ‘lame duck days’ of your presidency.

We would suggest that the death penalty is unnecessarily politicised in the USA and we feel that this scheduling is suggestive of political manoeuvring. Yet, reaching far beyond mere suggestion, the last few days have demonstrated solidly that passions boil over, people over-reach themselves, and allegiances switch - in politics and in personal lives.

Compassion is not the weakened motions of a lame duck - rather it is the decisive stroke of a strong man. Our Lord Jesus Christ, the Saviour in who you profess faith, commanded us so: ‘Do not judge, and you will not be judged. Do not condemn, and you will not be condemned. Forgive, and you will be forgiven. Give, and it will be given to you’ (Luke 1:37-38).

For the next few hours Lisa is still alive and for the next few days you are still the most powerful man on Earth. When we stand up in God’s court room, we will all need forgiveness. I will. Lisa will. You will too.

So Sir, please do the strong thing.

Yours respectfully

Dr Rachael Pickering (Prison doctor) & her colleagues at Integritas Healthcare