by Steven H. Miles, MD
In 1986, guards were transporting Mr. Vinson Harris, a Black prisoner, from Mecklenburg County Jail to Butner Penitentiary in Lewisburg Pennsylvania He was forced to wear a painful hard black box around his wrists. Hands swell with that device—increasing the pain even more.
Mr. Harris would not be quiet. That annoyed the guards. When the bus got to the federal prison, they chained his waist into a chair, shackled his legs to the chair and handcuffed his wrist to the chair. A guard went to the infirmary and got an ace wrap that several of them wrapped around Mr. Harris’ head and secured with a piece of duct tape. They used a pocketknife to cut a small slit over his mouth. Soon Mr. Harris started seizing and then slumped to his side. Some of the guards laughed. They called the prison’s physician’s assistant who did not remove the head wrap and opined that Mr. Harris was faking his distress. Mr. Harris died. The prison staff kept their positions. No one was charged with the death that was recorded as a homicide. The licensing board did not even review the actions of the physician’s assistant. The federal government ignored the case.
The case achieved notoriety. It was the subject of extensive reporting in the Raleigh News and Observer. I saw an article in The Nation which I frankly did not believe. So I secured the primary documents, including the medical examiner’s report. I wrote an article about the failure of medical accountability in the medically assisted abuse of prisoners. It became the hardest paper to publish.
‘Not us’ said a journal of correctional health care, this is not a true reflection of our work.
‘Not us’ said three journals of medicine, this is rare and of no interest to the profession.
‘Not us’ said a major public health journal, this is not a public health problem.
‘Not us’ said two journals of medical ethics. We do not see this as a problem in clinical ethics.
Finally, the ACLU published it as ‘Health Professionals and a Preventable Death at Butner Federal Prison’ in the Journal of the National Prison Project in 1988.
In the wake of the deaths of George Floyd and Breonna Taylor and countless other Black people from police brutality, there was an uprising and lots of people getting woke. The Vinson Harris story was neither new nor rare in 1986. Mr. Harris was one of the many ancestors of George Floyd and Breonna Taylor. Mr. Harris was himself the descendent of the assassinations of the modern civil rights movement, the lynchings before that and slavery before that. It is impossible to even imagine the content or effect of medical ethics journals focusing on human rights,
Medical ethics, laser focused on the ICU, has rarely spoke to the inevitable public health consequences of our decrepit and unjust health institutions. Medical ethicists could have showed how the available data showing that identifiable physicians and drug distribution systems were just upstream health care problem that was sending opiates into our community. I have no doubt that reader of this article was personally touched by the grief for those deaths.
Focused on ICUs and clinical studies, ‘medical’ ethics was blindsided by the tidal wave of persons with COVID that blew into the ICUS when the cheap dams around our unjust prisons, slums, reservations and nursing homes gave way.
“I can’t breathe,” fentanyl overdoses and COVID took far more lives and caused infinitely more suffering in families and communities than was necessary. In the present reckoning of every aspect our society, medical ethicists have a choice between undertaking a serious internal structural reform that looks outward to everyday lives rather than inward to ICUs and laboratories or it can choose to slide further to academic obscurantism.