The purpose of this project is to explore the historical context and current state of prison hospice programs in the US. This objective was accomplished through an extensive review and synthesis of the relevant literature pertaining to prison hospice programs in the US. The historical increase of the incarceration rate beginning in America during the 1980’s has led to the development of more elderly prisoners than ever before in the US. As prisoners age in the US correctional system, they experience faster-than-average health decline. Mass incarceration has placed incredible strain on the correctional system to provide healthcare to the medically complex elderly inmate population. This project proposes that some of this systematic strain may be alleviated through the action of prison hospice programs. Prison hospices replace unnecessary industrial medical interventions with personalized comfort care measures and the unique service of inmate volunteers. This approach to medical care at the end of life has become the standard of care for the free population but is slower to emerge in the prison context. This project asserts that the dying US inmate population should be offered the right to a dignified death through equitable access to hospice services.

The emergence of COVID-19 has ravaged through the United States generally and prison facilities in particular. By reducing prison populations and protecting a facility's most vulnerable members, compassionate release is a means of mitigating the consequences of COVID-19 facing prison facilities across the country. This thesis will examine compassionate release requests for the months of March 2020 through May 2020 from minimum and low-security prison facilities within the Bureau of Prisons. By examining this data, the goal of this thesis will be to determine whether the Bureau’s use of compassionate release was conducted in a manner that would protect the well-being of incarcerated individuals in response to the emergence of COVID-19. Similarly, the data will be examined in order to identify any significant differences between prison facilities in their use of compassionate release and subsequent outcomes from COVID-19 infections and deaths. Lastly, this thesis will examine this data to determine whether the Bureau’s use of compassionate release was consistent with the general objective of reducing prison populations and overcrowding in response to COVID-19.