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What should Canadian prisons do when inmates who are suffering from a terminal illness request medical assistance in dying? That is the kind of question that Schulich School of Law Professor Adelina Iftene explores in her research. Her biggest projects to date have been around the aging population in prisons and the health problems and legal issues that can stem from institutions that aren’t responding appropriately.

“Prisons aren’t nursing homes,” says Iftene. “Consent to medical assistance in dying [MAiD] is a big issue in prisons. Can someone really meaningfully consent in prison? What if someone leaves prison to go to the community to receive MAiD and they change their mind? Will they be sent back to prison?”

Iftene believes dying prisoners should be released into the community to receive palliative care from their families, where possible, and a full health care team. When the prisoners are so physically and mentally debilitated by their disease or illness that they’re in a position to be granted MAiD, they pose no risk to society, she insists.

Understanding prisoners’ health-care needs

Iftene was busy this fall talking about her legal area of interest and expertise at conferences and workshops. In October, she spoke about parole as part of a panel at the first East Coast Prison Justice Society workshop, which was held at Dalhousie’s Macdonald Building and where Professor Sheila Wildeman also presented.

“It was great to find such a strong community of like-minded advocates who were waiting to talk about these issues,” says Iftene. “People are coming together from different fields and co-ordinating their efforts.”

Right now there are challenges in accessing parole, despite the significant greying of the prison population and the high rates of chronic and terminal diseases

In order to make legislation and policy changes, the mindsets of those in government, Corrections, parole boards, and the community have to change. “People need to understand who the prison population is and what they need,” says Iftene. “Right now there are challenges in accessing parole, despite the significant greying of the prison population and the high rates of chronic and terminal diseases. Also, when they are paroled, people do not receive the support they need to reintegrate into the community.”

In September, Iftene presented at the Second International Conference on End of Life Law, Ethics, Policy, and Practice, which was held in Halifax and co-hosted by the Schulich School of Law’s Health Law Institute. She spoke on a panel about end-of-life care in Canadian prisons with Crystal Dieleman, an assistant professor in Dal’s School of Occupational Therapy.

The day after the conference ended, Iftene facilitated a satellite meeting workshop that focused solely on end-of-life issues in prisons. The workshop brought together around 30 experts in different fields, from medical professionals and lawyers to academics. One of the experts was the Schulich School of Law’s Professor Jocelyn Downie, who talked about the current legal status of MAiD in Canada.

“We talked about what palliative care and end-of-life care should look like inside and outside prison and the issues around parole and compassionate release,” says Iftene. “The question isn’t if assisted dying should be available to prisoners, but how can assisted dying be implemented in correctional settings responsibly.”

‘The movement is growing and gaining momentum’

Iftene’s interest in legal reforms in prisons dates back to when she came to Canada from Romania to do her master’s and to study the impact of the Charter on the correctional system. She was disappointed to discover that there were only a handful of scholars and lawyers interested in what is going on behind prison walls, and that much work lay ahead.

“Once I started entering prisons, the motivation to continue this work was reinforced,” says Iftene. “Each one of the incarcerated people I met, either in my research or volunteer work – each of their stories and the injustices they suffered at the hands of the system gives me yet another reason to do this work.”

Each one of the incarcerated people I met, either in my research or volunteer work – each of their stories and the injustices they suffered at the hands of the system gives me yet another reason to do this work.

In September of 2018, the Schulich School of Law will partner with the Canadian Prison Law Association (CPLA) to host a national prison law conference at the law school; Iftene is on CPLA’s executive committee and will be directly involved in organizing the conference. The conference, which will be mainly for lawyers, legal academics, and law students, will look at where Canada should be headed in order to bolster access to justice for prisoners.

“Among other things, the conference will give us an opportunity to educate our students on these issues to give them a choice of specializing in this niche area,” says Iftene, who has proposed a Schulich Law seminar for next year called Imprisonment and Prison Policy in the Canadian Legal Context.

There’s no question that the changes that prison-reform advocates are working toward will take time to implement. “It’s going to take a few years to achieve meaningful change,” says Iftene. “These things don’t happen overnight, but the conversations have started. This movement is growing and gaining momentum.”