Care in Custody: An Ethnography of Illness and End of Life in Prison

Abstract

This thesis presents an ethnographic study of the experiences of men living with and dying from serious illness in prison, with a particular focus on the kinds of care they receive and the ways in which they experience that care. The dissertation draws on extensive ethnographic fieldwork conducted over two years in U.S. state prisons in Maine, presented in three standalone papers. The first paper outlines how the prison and its health care system shape the illness experiences of older and ageing prisoners and asks, what does it mean when the lives of prisoners collide with contracted for-profit medical care and how might their lives be constituted as unworthy of care? The stakes lie in applied policy and practical solutions for custodial services. The second paper explores the experience of caring and being cared for in the context of a prison hospice program, in which incarcerated men provide care to peers who are ill or dying. Through tracing one man’s end of life journey, this chapter considers how hospice caring makes and remakes death and life in prison, and the ways in which this “nefarious” form of escape from disciplinary power translates in the repressive penal regime. The final paper has its roots in sensory ethnography and the emerging field of sensory penality. This is a reflexive piece in which I probe my sensorial subjectivity and particularly touch as a medium of inquiry to explore the sensations of life, death, and dis/connection experienced in a prison infirmary. The observed feel of life and death illuminates new ways of understanding care in custody as a space of simultaneous brutality, beauty, indignity and intimacy. Taken together, the papers shed light on constellations of care in prison, the contingency of relations and personhood, and points of friction between care and custody.