Literature Review

Incarceration and quality of cancer careJAMA Network Open; by Oluwadamilola T. Oladeru, Ilana B. Richman, Jenerius A. Aminawung, Jason Weinstein, Lisa B. Puglisi, Rajni Mehta, Hsiu-Ju Lin, Emily A. Wang, Cary P. Gross; 10/25The incarcerated population in the US is aging, and an estimated 15% of incarcerated adults, or approximately 175,000 individuals, are now 55 years or older. With this demographic shift, diseases of aging have become more prevalent, and cancer now ranks as the most common cause of death among people who are incarcerated in the US. Despite the growing prevalence, cancer outcomes among those incarcerated lag behind those with no history of incarceration. Individuals diagnosed with cancer while incarcerated or immediately following release have an approximate 2-fold increase in cancer-related mortality compared with the general population, even after adjusting for stage at diagnosis. Along with other published literature, this work suggests that gaps in quality of care may contribute to observed disparities in outcomes.Assistant Editor's note: Most of us cannot imagine what it would be like to be in prison. With cancer. And perhaps even dying there. Steven Garner knows. He spent many decades as an inmate at a state penitentiary. While there, he became a hospice volunteer supporting dying inmates, training other volunteers, and he served to pioneer Hospice in Corrections programs throughout the US. Steven is out of prison now, living his best life in Colorado and consulting around the nation about ways to improve end of life care for incarcerated persons. Oprah Winfrey was involved in sharing Steven's story in a Netflix documentary called Serving Life. NPR published an article about Steven in February 2024. Additionally, Hospice Analytics has posted a link to a 20-minute video about Steven's life and work in prison: Angola Prison Hospice: Opening the Door. And finally, if you'd like more information, Steven Garner has a website. 

Living with injustice: Gary Tyler had his life taken away, yet managed to claw it back. The Progressive Magazine; by Bill Lueders; 10/6/25 Just as I sat down to write this review of former death row inmate Gary Tyler’s memoir, I noticed that its publication date is the fifty-first anniversary of the day that upended his life: October 7, 1974. This undoubtedly deliberate timing, like the book itself, serves to help close the circle around Tyler’s remarkable—at times, almost unbelievable—life journey. That was the day Tyler, then a sixteen-year-old Black youth, was arrested for the shooting death of a thirteen-year-old white boy at their high school in Destrehan, Louisiana, about twenty-five miles from New Orleans. He was taken into custody and beaten so severely that he was left with permanent physical scars, as well as psychological ones. Police and prosecutors ignored and withheld evidence of his innocence, and suborned perjury by threatening witnesses. One witness, Natalie Blanks, was told she would be charged as an accessory to murder and miss out on her baby’s life if she didn’t falsely testify that she saw Tyler fire a gun from inside a bus. Stitching Freedom: A True Story of Injustice, Defiance, and Hope in Angola Prison is, for much of its first half especially, an intensely bleak book.Editor's Note: See previous significant posts in our newsletter about Gary Tyler and this transformative hospice program at Angola Prison.

Hospice was meant to offer dignity in death — but it fails the most marginalized. We need hospice programs that go to the streets, into shelters, behind barsSTAT; by Christopher M. Smith; 8/26/25I’ve spent more than a decade in hospice care, sitting at the bedsides of people facing the final days of their lives. I’ve held hands in hospital rooms, in tents, in prison cells, and in homes that barely qualify as such. And over time, I’ve come to see that dying in America is not just a medical event — it’s a mirror. It reflects everything we’ve failed to do for the living. Hospice was created to bring dignity to the dying — to manage pain, provide emotional and spiritual support, and ease the final passage for people with terminal illness. But the systems surrounding hospice care are riddled with inequity. The very people most in need of compassion — the unhoused, the incarcerated, people of color, LGBTQ+ individuals, and people with disabilities — are systematically excluded, underserved, or erased. Access to a good death is too often reserved for the privileged, while everyone else is left to navigate a system that wasn’t built for them — or worse, actively works against them... The truth is, hospice care cannot achieve its mission unless it actively addresses the inequities built into the structures around it. We need hospice programs that go to the streets, into shelters, behind bars. We need training rooted in cultural humility, in antiracism, in trauma-informed care. We need to reimagine what it means to offer dignity to someone whose life has been defined by abandonment... Because dying is universal. But justice, even at the end of life, is still not.Publisher's note: STAT also references Dr. Ira Byock's article "The hospice industry needs major reforms. It should start with apologies, 8/22/23".

Inmate serving life for murdering Lancaster County woman in 2015 seeks compassionate release Fox 43, Lancaster County, PA; by Keith Schweigert; 8/8/25 A state prison inmate serving a life sentence for killing a Lancaster County woman after she ended their relationship in 2015 has filed a petition asking for a compassionate release so that he can die at home, according to court records. Randall Shriner, 68, has less than six months left to live due to stage-five kidney disease, according to an emergency petition filed by his attorney on July 30. ... According to the Pennsylvania Institutional Law Project, the statute allows courts to grant a compassionate release under two circumstances:

SCI Waymart meets needs of aging incarcerated population by training inmates in hospice care PBS WVIA News, NPR, Pittston, PA; by Lydia McFarlane; 6/8/25 Nurses and their inmate aides care for hospice patients. Some are bedridden, needing help with eating, changing and using the bathroom. The patients have recently signed do-not-resuscitate (DNR) forms. Some have just a few more months to live. The medium security prison's hospice unit looks like a nursing home. SCI Waymart is one of two prisons, along w ith SCI Laurel Highlands, in the Commonwealth that has a personal care unit. Waymart receives medical transfers from institutions across the state, making its population older than most of Pennsylvania’s state prisons. The average age of a Waymart inmate is 45.5, according to SCI Waymart’s superintendent, Mark Wahl. About 36% of inmates are over the age of 50, and 10% are over 65 out of a total of 1,122 as of April of this year, he said. Wahl said SCI Waymart averages one death per month.

New inmate comfort care program launched for terminally ill patients ABC WTXL 27, Tallahassee, FL; by Tier Wootson; 6/6/25 The Leon County Sheriff's Office and Big Bend Hospice are teaming up for a new Inmate Comfort Care Program for Terminally Ill Patients. In the press release, LCSO says that due to this new partnership, there will now be an inpatient hospice room within the Leon County Detention Facility. They say this has been developed over the last year with collaboration between LCSO leadership, healthcare leaders from YesCare, and representatives from Big Bend Hospice. ... The program is for inmates who have less than one week to live. While in hospice care, family members will be able to visit loved ones in a "peaceful and private environment."

Johnson champions Eddie's Law to bring dignity to end-of-life-care in Illinois Public, Springfield, IL; News Release; 5/22/25 After an incarcerated man named Eddie Thomas died alone in a prison infirmary without receiving any end-of-life care, State Senator Adriane Johnson is championing legislation to bring dignity, compassion, and transparency to hospice and palliative care services in Illinois correctional facilities. "This bill is about basic human dignity," said Johnson (D-Buffalo Grove). "No one should die in pain, in isolation or without the comfort of care - no matter who they are or where they live. House Bill 2397 brings transparency to a system that too often leaves people to suffer silently." ... House Bill 2397 would require the Illinois Department of Corrections to prepare and publish an annual report detailing its hospice and palliative care programs. The bill aims to provide lawmakers with data that can guide future policy decisions on compassionate and medically appropriate end-of-life care for people incarcerated in Illinois. 

Illinois plan calls for annual report on hospice, palliative care for prisoners WAND TV News, Springfield, IL; by Mike Miletich; 5/8/25 The Illinois House Restorative Justice & Public Safety Committee passed a bill Thursday [5/8] to require the Illinois Department of Corrections report data on hospice care available for prisoners. Over 1,000 Illinois prisoners are 65 or older, and a growing number of those people are in need of end-of-life care and support services. The Department of Corrections does not have a formal hospice program, as end-of-life care is provided on a prison-by-prison basis. Although, sponsors and advocates said this has led to inconsistent care for prisoners diagnosed with terminal illnesses or who are expected to reach the end of their life.

Penny Stamps speaker Gary Tyler shares his wrongful conviction story, empowers communities through artThe Michigan Daily; by Talia Varsano; 3/17/25At 5:30 p.m. in the Michigan Theater Thursday night, nearly every seat was full as the audience welcomed Gary Tyler, a falsely convicted felon of first-degree murder turned artist, performer, youth mentor and community leader. ... On October 7, 1974, Tyler was framed and wrongfully convicted by an all-white jury of first-degree murder and sentenced to death at 16 years old. ... At the event, Tyler spoke about his experience as an inmate at the Louisiana State Penitentiary in Angola for nearly 42 years before his release in 2016. Tyler said the trajectory of his life was completely shifted by his wrongful imprisonment. ... [Tyler's story of imprisonment continues.] Tyler began quilting while incarcerated to raise money for the hospice program at Angola, which provided end-of-life care for Louisiana State Penitentiary inmates. Tyler said he was inspired by his mother and grandmother, who were also quilters, as well as the communities surrounding him. ... Tyler said. “When I do quilts, I try to pull everything around me, because I try to build, I try to put everything that I feel, that someone would identify, someone would recognize, understand, in my quilt.” ... Tyler volunteered for the Angola Prison Hospice program for more than 17 years while incarcerated.Editor's note: Pair this with Death and redemption in American prison," posted 2/19/24 about Gary's friend and fellow quilter at Angola Prison Hospice program, Stephen Garner. 

Engaging the hospice community in end-of-life care in prisons (Part 2)ehospice; by Barry R. Ashpole; 1/21/25Part 1 offered a broad overview of the potential role community hospices can play to improve end-of-life care (EoLC) for a particularly vulnerable and underserved population. As has been widely acknowledged, prisons and correctional facilities are caught between the proverbial “rock and a hard place,” between issues of security and public safety and the civil rights of the prison inmates to healthcare comparable to what is available to the populace-at-large. Part 2 takes a closer look at specific initiatives by some community hospices to support prison inmates towards the end of life. Prior to conducting research for its 2020 report, ‘Dying Behind Bars: How can we better support people in prison at the end-of-life,’ Hospice UK had only anecdotal evidence of the important work that some hospices were engaged in to support prison inmates at the end of life. The scope of this support had not been established at a national level. After conducting a survey of hospice services across England, researchers found that 25 hospices – representing approximately 15% of hospices in the country – are indeed providing this care and support, working with 34 different prisons.Publisher's note: Also see: Engaging the hospice community in end-of-life care in prisons (Part 1) that was also discussed in Hospice News' Global challenges persist in bringing hospice care to incarcerated populations.

Bill would require prisons to notify families of inmate deaths Henry Herald, Washington, DC; by Staff; 12/18/24 U.S. Sen. Jon Ossoff, D-Georgia, recently announced the introduction of a bipartisan bill aimed at helping ensure family members are notified in a timely and compassionate manner in the event of the death or serious illness or injury of a loved one in custody. Ossoff and U.S. Sen. John Kennedy, R-La., recently introduced the bipartisan Family Notification of Death, Injury, or Illness in Custody Act. U.S. Rep. Sydney Kamlager-Dove, D-Calif., is leading the companion bill in the U.S. House of Representatives.

New fellowship will help imprisoned women plan for end of life Washington State University - WSU Insider; by Scott Swybright; 12/9/24 Incarcerated individuals have few personal rights, but one they do retain is the ability to create advance directive plans for their health care. Unfortunately, few know that this is the case. A new project led by a Washington State University graduate student will educate more incarcerated people about their options as they approach the end of their lives. “When folks are incarcerated, they lose most of their bodily autonomy and basically become property of the government,” said Tosha Big Eagle, a doctoral student in WSU’s prevention science program at the WSU Vancouver campus. “Advance directives are one outlier, but nobody tells them about that right.” To help educate prisoners, Big Eagle recently received a fellowship from The Order of the Good Death, a group helping all people face end-of-life concerns, fears, and legalities. Big Eagle’s project will focus on ensuring incarcerated people at the Washington Corrections Center for Women (WCCW) have access to end-of-life resources.