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Prisoners Have No Constitutional Rights to Outside Medical Care

When the Eighth Amendment to the United States Constitution was drafted, the American draftsmen borrowed from the English the phrasing of the Eighth Amendment to prohibit “tortures” and other “barbarous” methods of punishment. Gregg v. Georgia, 428 U.S. 153 (1976).  In early cases, the U.S. Supreme Court was concerned with “particular methods of execution to determine whether they were too cruel to pass constitutional muster.”  Id. 

However, the Court has not stuck to historical issues, but has interpreted the Amendment’s prohibition against “cruel and unusual punishment” “in a flexible and dynamic manner.”  Therefore, the Court declared in Estelle v. Gamble, 429 U.S. 97 (1976), that the prohibition against cruel and unusual punishment included a prohibition against deliberate indifference to serious medical needs. The Court rationalized that the government has an “obligation to provide medical care for those whom it is punishing by incarceration. An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met.” The Court stressed that in the worst scenarios, the failure to provide medical care could produce physical torture or a lingering death.  Id.  “In less serious cases, denial of medical care may result in pain and suffering which no one suggests would serve any penological purpose.”  Id.  Therefore, the Court found that “deliberate indifference to serious medical needs of prisoners constitutes the ‘unnecessary and wanton infliction of pain,’”, citing Gregg v. Georgia, supra, whether that indifference is by “prison doctors in their response to the prisoner’s needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed.”  Estelle, supra.

The Court in Estelle stressed that an inadvertent failure to provide adequate medical care cannot be said to constitute “an unnecessary and wanton infliction of pain” or to be “repugnant to the conscience of mankind.” Therefore, negligence in “diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth Amendment.”  The Court further explained that “[m]edical malpractice does not become a constitutional violation merely because the victim is a prisoner. In order to state a cognizable claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs. It is only such indifference that can offend “evolving standards of decency” in violation of the Eighth Amendment.  Estelle.  

Through the evolution of these constitutional standards, the courts have held that a prison inmate has no independent constitutional right to outside medical care additional and supplemental to the medical care provided by the prison staff within the institution. Roberts v. Spalding, 783 F.2d 867, 870 (9th Cir. Wash. 1986), cert denied 479 U.S. 930 (1986).  The courts have further explained that an inmate has no absolute right to a particular course of treatment, and doctors can use their own medical judgment.  There is no right to be seen by a specialist. Prisoners cannot demand a right to a particular course of treatment under the Constitution.  Boomer v. De Perio, 405 F. Supp. 2d 259, 264 (W.D.N.Y. 2005).  Indeed, in  Green v. McKaskle, 788 F.2d 1116 (5th Cir. 1986) the Court held that “the mere claim that he was not afforded a doctor who specialized in the treatment of paraplegia or a trained physical therapist does not, of itself, state a claim of deliberate indifference.”

Therefore, no matter how inmates demand access to outside specialists, specialty testing, and outside treatments and opinions, they do not have constitutional access to same unless to deny them that medical treatment would be deliberately indifferent to a serious medical need.