The case of Scott Ortiz: a clash between criminal justice and public health

Homer D Venters,Asiya M Razvi,Maria S Tobia,Ernest Drucker

doi:10.1186/1477-7517-3-21

Homer D Venters, Asiya M Razvi + Show 2 more

Open Access

https://doi.org/10.1186/1477-7517-3-21

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Abstract

The criminal justice system creates particular challenges for persons with HIV and Hepatitis C, many of whom have a history of injection drug use. The case of Scott Ortiz, taken from public trial and sentencing transcripts, reveals the manner in which incarceration may delay learning of important health problems such as Hepatitis C infection. In addition, the case of Mr. Ortiz suggests the bias in sentencing that a former injection drug user may face. Collaboration between the Montefiore Medical Center residency in Social Medicine and a Bronx legal services agency, Bronx Defenders, yielded the discovery that a decade after diagnosis with HIV and after long term incarceration, Mr. Ortiz was infected with Hepatitis C. Mr. Ortiz only became aware of his advanced Hepatitis C and liver damage during his trial. The second important aspect of this case centers on the justification for lengthy sentence for a burglary conviction. The presiding Judge in Mr. Ortiz's case acknowledged that because of his advanced illness, Mr. Ortiz posed no threat to society as a burglar (the crime for which he was convicted). But the Judge elected to use his discretion to sentence Mr. Ortiz to a term of 15 years to life (as opposed to a minimum of two to four years) based on the idea that the public health would be served by preventing Mr. Ortiz from returning to the life of a street addict, sharing dirty needles with others. Mr. Ortiz reports distant injection drug use, no evidence of current or recent drug use was presented during Mr. Ortiz's trial and he reports no injection drug use for over a decade. In this case, bias against a former injection drug user, masquerading as concern for public health, is used to justify a lengthier sentence. Mr. Ortiz's lack of awareness of his Hepatitis C infection despite long term incarceration, combined with the justification for his dramatically increased sentence, provide examples of how persons within the criminal justice system may face particular challenges to their health.

Highlights

Involvement in the criminal justice system (CJS) creates particular difficulties for persons with HIV and Hepatitis C, many of whom have histories of injection drug use (IDU) and substantial criminal records [1]
Mr Ortiz reports having used IV drugs 10–15 years prior to his recent trial which is consistent with the observation that approximately 70% of person's co-infected with HIV and Hepatitis C become infected via IVDU [5]
With regard to Mr Ortiz not knowing that he had hepatitis C, one can imagine multiple scenarios

Summary

Background

Involvement in the criminal justice system (CJS) creates particular difficulties for persons with HIV and Hepatitis C, many of whom have histories of injection drug use (IDU) and substantial criminal records [1]. Harm Reduction Journal 2006, 3:21 http://www.harmreductionjournal.com/content/3/1/21 case illustrates how the health care of such an individual may suffer when they are in hands of the CJS, in this instance in the guise of protecting the public not from crime, but from infectious disease This case report flows from a new collaboration between Bronx Defenders (a public defender organization) and Montefiore Medical Center's residency program in Social Internal Medicine, in which medical, social work and legal professionals work together to understand the interface of law and health and advocate for better client outcomes. The Judge concluded that incarceration in a state prison would provide "a setting that will ensure that he takes his medications on schedule, and without resort to the use and sharing of dirty needles" [7]

Conclusion

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