VARIATIONS IN ROUTINE
The sick--Prison hospitals--The removal of the sick to outside
hospitals--The wisdom of this course--The essential difference between
a prison and other public institutions--The treatment of refractory
prisoners--The folly of assuming that rules are more sacred than
persons--The position of the medical officer in relation to the
prisoner--The danger of divided responsibility--The untried
prisoner--His privileges--Civil prisoners--Imprisonment for contempt
of court--The convict--Short and long sentences.
The system makes no provision for individual differences between prisoners
and takes no account of the past training which has made them what they
are, but it recognises physical differences. It is the duty of the Medical
Officer to see that no one is overtaxed or underfed or insufficiently
clothed, and to attend to any sickness that occurs. If a prisoner is
insane he is removed to a lunatic asylum. If he is ill he is put under
treatment.
In the majority of cases the prison hospitals are simply larger and
better-lit cells. They are free from anything but the roughest imitation
of modern hospital appliances; but as there is no occasion for the
treatment in them of prisoners suffering from acute serious illness, they
are sufficient for the needs they are required to meet. What is required
for the treatment of such as are sick is not so much stone and lime as
flesh and blood. Not new hospitals, but trained nurses.
When a prisoner is reported sick or asks to see the doctor, he is
automatically freed from the ordinary rules. If the medical man decides
that there is nothing in his condition to warrant his being put on the
sick list he falls back under prison discipline. If, however, he requires
medical treatment, the Medical Officer may prescribe any regimen which he
considers applicable to the case, and the Governor has the instructions
carried out. It may broadly be stated that cases requiring the constant
attendance of a skilled nurse and those demanding serious operative
treatment do not need to be treated in Scottish prisons. Section 72 of the
Prisons (Scotland) Act, 1877, enables the Governor, in certain cases, to
petition the Sheriff for a warrant to remove sick prisoners to hospitals
outside. He must present two medical certificates to the effect that the
prisoner (1) is suffering from a disease which threatens immediate danger
to life and cannot be treated in prison, or (2) a disease which makes his
removal necessary for the health of the other inmates of the prison, or
(3) that continued confinement would endanger his life. This is one of the
wisest provisions in the Act. Cases might occur in which the treatment
required would be of such a character as to make it inadvisable to have it
carried out in prison.
Assuming that there is no difference in the experience and skill of the
prison doctors and their staff from that of the corresponding officials in
the general hospital, the conditions in prison are essentially different.
In a general hospital there are all sorts of people as patients, and their
friends have access to them; it is a public place compared with the
prison. The staff is subjected to continual criticism; not always
enlightened, and sometimes unfair, but it exercises a healthy effect on
their actions. There is no greater danger to the public than the
uncontrolled specialist; and it is a bad thing for him if he is led into
any belief either in the infallibility of his judgment, or in its
necessary applicability to the case with which he deals. He can perform no
operation without the consent of the patient or his friends, even though
he believe that operation is necessary to the saving of life. There are
cases in which this permission is refused in spite of all the persuasions
of the medical man; and in some of these cases, contrary to expectation,
the patient gets well. In others death takes place where life might have
been saved had consent to the necessary treatment been obtained; yet it
would be an intolerable condition of affairs if the medical man were to
have his patients placed at the discretion of his judgment; and no one
would propose that the inmates of a hospital should be compelled to submit
to any treatment that the doctors in their wisdom might see fit to
prescribe.
In a neighbouring country lately the question of compulsory treatment was
raised. All the information I have with regard to it has been obtained
from the statements, official and otherwise, which have been published.
These statements may have been imperfect, but only from them can the
public form an opinion, The statements contradict each other, and as they
refer to incidents which took place in a prison--a place to which ordinary
members of the public have no access--they are bound to leave an uneasy
feeling in the mind of the impartial observer.
Certain women, impelled by the desire to advance a political measure,
engaged in conduct which brought them into conflict with the authorities.
It was claimed on their behalf that they had committed a political
offence, and in that respect differed from other criminals; but all
offences are political offences. Whether a woman strikes a man because she
is angry with him, or because she is angry with a Cabinet Minister whom
she does not know, she commits an assault which is a crime in the eyes of
the law. Her motive may differ in the one case from the other, but its
issue has no difference; and in both cases, in so far as the State takes
notice of it, it is a political offence. Distinctions between offences can
only end in confusion; distinctions between offenders have never been
sufficiently recognised; and no real progress can ever be made in the
treatment of the criminal until the differences between one person and
another are taken into account. There can be no question that in
character, in training, and in their previous history, these women
differed widely from the ordinary prisoner, and all the trouble which
resulted was due to the failure of those in authority to act upon their
knowledge of this fact. That the conduct for which many of the women were
sent to prison was unreasonable, few will deny; but it was no more
unreasonable than the treatment they received. If they behaved like mad
people, so did the officials.
The only way in which one person can show greater wisdom than another is
by conduct. If the women were hysterical, the officials did not exactly
shine as examples of calmness. The highly strung person who glories in
what she believes to be martyrdom, who sees everything in the light of her
own ideals, is not likely to be brought to another frame of mind by
receiving the treatment which she regards as persecution. These women had
made it necessary that they should be restrained from annoying others by
their conduct; but it mattered nothing to the public that they should be
restrained in a certain way; what did matter was that the nuisance should
be effectively stopped. That the method of dealing with them increased the
trouble is beyond question; and there is no justification for interference
with anybody except in so far as the method adopted has the result
desired.
It is folly, if not worse, to enter upon any course that cannot be carried
on indefinitely. If your treatment fails to achieve the end aimed at, that
is bad; if it results in the person with whom you are dealing beating you,
that is worse. The law attempted to frighten the women, and the women, by
their continued resistance, frightened the administrators of the law.
Which presented the most sorry spectacle it is hard to say.
The trouble seems to have begun through the refusal on the part of the
authorities to allow the women to wear their own clothing. What harm it
would have done to anybody to grant this permission it is difficult to
see. If they had fed themselves and clothed themselves it would have saved
expense to the public. They believed that the clothing was intended to
degrade them; and they might have asked, if that was not the intention,
why was the proceeding insisted on? Of course, to permit them to save the
State the expense of keeping them while they were in custody would have
upset the system; but the system is far from being considered by those who
are responsible for its administration to be anything approaching
perfection, for it is a fashionable thing amongst them to ask for its
improvement, and to justify changes, when they make them, on the ground
that they were required. Opposition grew with repression; unreason
provoked unreason, and the public heard with considerable uneasiness that
a hunger strike was taking place, and that the strikers were being
artificially fed.
In certain physical diseases resort to artificial feeding may be
necessary, but prisoners suffering from these diseases are not fit for
prison discipline and should be treated in a hospital outside. Among the
insane are those who obstinately refuse to take food, and therefore
require to be fed; but an insane person differs from a prisoner in this
important respect, that in the eyes of the law he is free from
responsibility and has no will of his own. His friends are permitted
access to him. They may, and sometimes do, interfere with the discretion
of the medical attendant, and in any case his actions are within their
supervision and criticism.
Medical men assume that self-preservation is a primal instinct, and that
the person who deliberately sets out to maim himself or to destroy his
life is insane, even although intellectually he may appear to be quite
sound. If a man become possessed by religious zeal and set out to convert
his neighbours to his views, he may incidentally be a considerable
nuisance to them. He may stand at street corners and annoy the surrounding
inhabitants by his exhortation; but, in Glasgow at any rate, they put up
with this on account of the good intention they ascribe to him. If,
however, he gives up his business, and prevents other people from
attending to theirs by calling on them and arguing with them, people begin
to suspect his sanity; and the man who would throw a brick into another's
office at the risk of hurting some of the people employed there, in order
to convince their principal that if he did not accept the religion the
missionary preached he would go to hell, would probably be dealt with as a
lunatic. The conduct of some of the women was quite as eccentric, but
people may do insane-like things without being insane. That, however, is
no reason for disregarding their eccentricities, which should be taken
into account when dealing with them. If the women required to be fed
artificially, it by no means follows that it was a proper thing to do so
in prison. It certainly was indiscreet, and it is difficult to see how, if
it was justifiable to resort to this measure in order to save the life of
a prisoner, it could be argued that a medical officer would not be equally
justified in cutting off the injured or diseased arm of a prisoner, in
spite of his protestations, in order to save his life. It is one thing to
place the liberties of men, and another thing altogether to place their
lives in the hands of officials.
There is no official and no number of officials--by whatever name
called--good enough to be entrusted, unchecked by public observation, with
the lives of their fellow-citizens; and there is no criminal bad enough to
be immured from the public gaze and placed wholly under the control of
anyone. It is not that the officials are bad; they are no worse than
unofficial persons and no better, and there is far more danger from those
who have gained a reputation for humanity and for enlightened opinions,
even when they have deserved the reputation, than from the others, because
the former are likely to be left more to themselves on account of their
good name. Few who read this could be trusted to do as good a day's work
at the end of the year as they did at the beginning, if there were not
someone to check and criticise them.
Here and there, now and then, there are violent outcry and excitement
because of some administrative scandal, and there is seldom much in it;
but there is no continued and intelligent interest in administration on
the part of the public. If a man do not fulfil his contract his employer
may accept an excuse once or even twice; but if his failure continue he
will find himself out of a job, and someone less incompetent or
unfortunate will be sought and put in his place. In the public service
excuses and exceptions are so much the rule that it would be easy to form
a library of blue books containing them, printed and paid for at the
public expense.
Only ordinary cases of domestic sickness need be treated in prison, and
such ailments or injuries as are dealt with in the outdoor department of a
general hospital. In Scotland there is little inducement to prisoners to
feign sickness, as there is no automatic change in their diet or location
as a result of their being placed on the sick list. The doctor may or may
not remove them from their cells and alter their diet. So far as the Act
of Parliament is concerned the treatment of the sick lies wholly in his
discretion, and there is no power granted to any authority to interfere
with or overturn his decision. He may be questioned as to the reason for
his conduct; and if foolish enough or weak enough to be persuaded into
altering it, in order to please some higher official, he may do so; but
the Act of Parliament is absolutely specific in the matter, and refers the
sick not to the Commissioners, but to the surgeon of the prison.
It is much easier for a man to carry out an instruction received from
above, than to assert and act on the powers conferred on him by statute;
but it is not right to do so, and in so far as he is subservient he is
unfaithful to his trust. Patients cannot be treated by correspondence. No
man, however highly placed, is infallible. Better that the man on the
spot should accept his responsibilities frankly, even though he do make
mistakes, than that he should look to someone who is not present to direct
him in a case of difficulty. No medical man need want for help from his
neighbours, and he can easily get someone of approved skill to assist him
in the diagnosis or treatment of a difficult case. It is quite proper that
his actions should be scrutinised, but it is quite wrong that the scrutiny
should take place in private. The statute has recognised this principle,
and has ordered that a public enquiry should take place on the occasion of
the death of any prisoner in prison. The relatives of the prisoner are
there entitled to put any questions to the officials, personally or
through an agent; and the Sheriff has to be satisfied that all reasonable
care and skill have been exercised in the case.
Private official enquiries give opportunity for petty persecution on the
part of any Jack-in-office who fancies his abilities are equal to his
position, and whose spleen may be raised against better men than himself.
No man eminent in his profession would be likely to be guilty of such
conduct, but the occupation of some positions does not necessarily imply
professional eminence, though it may infer social influence.
The Medical Officer has not an arduous task in treating the sick. His work
practically consists of patching up old offenders, in the knowledge that
he is prolonging their lives and their uselessness, to the injury of the
public. Many of them would have been dead long ago as the result of their
excesses had they not been interfered with. It is well that their lives
should be prolonged and their health improved, but only if some security
is taken that they use their powers to better purpose in the future than
they have done in the past. There is no sense in the State doing anything
for anybody without a reasonable guarantee that the person benefited will
not use the benefit to the injury of the community. Many are cured of
diseases in various public institutions, and turned loose to live on
others for the rest of their lives. There is an increasing number of young
people who, having suffered from some serious illness, have been saved
from death, but have been left permanently crippled to some extent in one
or other of their organs. They are not fit for the work they once engaged
in, but they are fit for some work, and so far as can be seen, they have
no intention of performing any. A number of them drift to the prison and
on the strength of their infirmity try to get special treatment. The
special treatment they require cannot be had there, nor is there any place
at present where it can be had.
The untried prisoner is permitted to wear his own clothing, provided it is
clean and that he can have it changed with sufficient frequency. He may
hire furniture and pay for the cleaning of his cell. He may have visits
from those of his friends he desires to see; and he may correspond with
them, provided that in the conversation and correspondence there is
nothing said or written regarding the charge against him. All letters to
and from him are read and censored on behalf of the Governor. Prisoners
are not allowed to see and converse with their friends without the
presence of a prison official. The prisoner is put in a box with a
latticed front, and his visitor is placed in another box opposite. Between
the two boxes there is space for a warder to move. He can see the
occupants of both boxes, each of whom can only see the person in the box
opposite. When a number of prisoners are having visitors at the same time,
there is a shouting and gabbling that makes conversation difficult.
Convicted prisoners and convicts of the first class may receive a letter
and a visit from a friend once in three months, provided their conduct and
industry have been satisfactory. Before their entry into the first class
convicts may receive one, two, or three letters and visits in the year,
according to the class they have reached. After being a year in the first
class they may be placed in a special class, receiving a letter and a
visit once in two months.
The prisoner sees his agent in view of but outwith the hearing of the
warder. He may have his food sent in to him by his friends, provided it is
sufficient in quality and amount, but he may not have part of a meal sent
in. He may also receive newspapers, magazines, or books. Any or all of
these privileges may be granted or withdrawn at the discretion of the
Visiting Committee. It is questionable whether it is right that they
should be granted as privileges. The man is, in the eyes of the law,
presumed to be innocent of the offence charged against him; and his
detention is only justifiable on the ground that he might fail to appear
at court for trial. That being so, he ought not to require permission from
any committee or official before he is allowed to feed, clothe, and amuse
himself; and he should only be prevented from doing so if his act is
detrimental to his own health or that of the other inmates of the prison.
This might cause more trouble to the officials concerned, but the primary
object of the system ought not to be the saving them trouble.
The untried prisoner may have a pint of wine or a pint of beer daily, but
on no account is he permitted to smoke. This is a curious restriction
nowadays, and there is not the faintest show of reason for its exercise.
The proper attitude towards the untried prisoner is not that implied in
the question "Why should he be allowed to do this?" The question ought
always to be "Why should he not be allowed to do what he wishes?" and this
would be the question if the theory that presumes an untried prisoner's
innocence were put in practice. He is detained for the convenience of the
public, not for his own, and his liberty should be curtailed as little as
possible consistent with good order.
There are very few civil prisoners in Scotland. Failure to pay aliment may
entail on a prisoner imprisonment, at the instance and expense of his
creditor, for a period of six weeks. At the end of that time the prisoner
is free from similar proceedings for six months, but the costs are added
to his original debt. He has some of the privileges of an untried
prisoner. Failure to pay taxes may cause a man to be imprisoned under
similar conditions. Persons sent to prison for failing to have their
children vaccinated are treated by the same rule, and persons condemned to
indefinite imprisonment for contempt of court.
In Scotland we claim that we do not imprison for debt other than aliment,
rates, or taxes; but the rule is evaded by process of law, and the Prison
Commissioners are used as debt collectors in some cases. Technically this
is not so, but in practice it occurs. X 31, a woman, has obtained
jewellery on the hire-purchase system. She is the wife of a labouring man,
and there is room for the suspicion that she has been tempted by the
seller. A number of payments are made, then the husband loses his
employment, and she is not only cut off from the means of paying her
instalments, but has not money to get food. She pawns or otherwise
disposes of the jewellery, and is called upon either to pay for it or
return it. Her intention may be to pay, but she is not able. She is
summoned to appear at Court, and fails to do so. In her absence a decree
is granted ordaining her to deliver the jewellery to the person from whom
she obtained it, in terms of the contract made between them. Failing to do
this, she is seized and carried off to prison, on a warrant obtained for
Contempt of Court, inasmuch as she had not obeyed its decree. All her
friends become alarmed, and by their united efforts the money to satisfy
the creditor may be obtained. If this is not done she may be kept in
prison for an indefinite period at his expense. Had she contracted a debt
with the grocer for food, or with a dressmaker for clothing, they could
not have imprisoned her if she did not pay them, even though they desired
to do so. They are thus at a serious disadvantage, so far as the exercise
of pressure is concerned, compared with the hire-purchase trader; but the
ingenious among them who regret the abolition of imprisonment for debt may
revive it in effect by selling groceries and clothes on a hire-purchase
contract.
The routine treatment to which the convict is subjected is much more
severe than that which is applied to the ordinary prisoner, and it does as
little good.[3] It is a system of repression mainly; a sitting on the
safety-valve that is apt to provoke outbursts of temper and violence
resulting in assault. These may be punished with the lash. A power which
is not possessed by the Judges of the High Court is granted to the Prison
Commissioners. It is considered necessary in order to maintain the system,
but as no one claims that the system is in any degree reformatory, it
becomes a question whether it is worth maintaining.
[3] The diet for convicts is more generous than that for ordinary
prisoners, however. Male convicts whose conduct and industry have been
satisfactory may be liberated on license when three-fourths of their
sentence has been served. Female convicts in like circumstances may be
liberated on license after serving two-thirds of their sentence.
The same man who is at one time a convicted prisoner in an ordinary prison
may at another time be undergoing penal servitude. While he is in an
ordinary prison there is neither power nor occasion to order him the
severe punishments which may be inflicted on convicts. If he need the lash
when he is sent to penal servitude, there is at least the presumption that
the cause lies as much in the character of the life he is compelled to
lead as in the character of the man. The more punishment inflicted on
prisoners in a prison the stronger the probability is that the place is
badly managed. Repression is necessary, no doubt, but repressive powers
should only co-exist with power to reward. Even a donkey will go further
after a carrot than when driven by a stick. It never does any good to a
man to treat him as a machine, and the tendency to do so under the name of
discipline is a root vice of the system. In the convict prison, as in the
ordinary prison, during the last few years the grinding mechanical routine
has been relaxed, and the amazing discovery has been made that it is
easier and better to manage men if you recognise that they are men than to
regard them as mere numbers. There has even been talk of reformation
resulting from the changes that have taken place, and to judge by some
magazine and newspaper articles from the pens of enthusiastic and ignorant
visitors, one would think the prison had become a kind of paradise.
That other men's behaviour towards us will largely be determined on our
behaviour towards them is no new discovery, and that more considerate
treatment by officials should result in better conduct on the part of
prisoners need surprise no one; but that this better conduct necessarily
implies that they will live in conformity with the laws when liberated
does not follow at all. You may improve a man's conduct in prison as you
may improve his mental condition in a lunatic asylum, but you never know
how he will behave outside until you put him there; and if we acted on the
knowledge of this fact we should see that persons liberated from any
institution are placed in proper positions outside--that they should be
guided and helped in so far as they need guidance and help--so that there
would be less excuse for their recurring to their old habits and conduct,
and less chance of their relapse into the condition and actions for which
we have dealt with them.
Of late years short sentences have been generally denounced on the ground
that there is no time to reform a prisoner who is only under the influence
of the system for a few days. This would be a reasonable objection if
those who are sent to prison for long periods were thereby made better,
but that is precisely what cannot be shown; for the longer a person is in
prison the less fit he is on liberation to take his place in the
community. So that if short sentences are bad, long sentences are worse,
from the standpoint of the reformer. A person sent to prison for a few
days is usually the cleaner for his experience. Imprisonment has kept him
off the streets for a time. It has also caused him to lose his job, and,
as usually the short-time prisoner is not a person of means, his position
is worse after his imprisonment than it was before. He has to earn his
living by his work, if he would avoid coming into conflict with the law;
and if he has no means of livelihood it is easy to see that he will find
it difficult to avoid recommittal.
In this respect the long-sentence prisoner resembles him, but in addition
he has acquired habits in prison that are a hindrance to him outside.