Preventing Another Fifty Years of Mass Incarceration: How Bioethics Can Help.

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In the article "Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics," Sean Valles provides an important reminder of the consequences of mass incarceration in the United States and identifies potential roles for bioethicists in addressing this system. My limited view-that of a physician who conducts court-ordered investigations and monitoring of health services behind bars-is that the ongoing failure of most academic and professional organizations to be more effective in this much-ignored area stems from the lack of leaders and staff who have been directly impacted by mass incarceration. As conditions behind bars worsen, and a new war on drugs recoils the spring of mass incarceration, there is a pressing need to train, recruit, and promote people who know the realities of the criminal (and immigration) justice system and its impact on health and well-being. This step can bring a more powerful engagement of bioethics regarding housing, employment, and health care and policing, as well as the numerous and harmful elements of jails, prisons, and detention settings. I provide examples of partners I learn from in this arena, as well as some discrete and technical areas for possible investigation.