I can concur with what Dr. Shaw mentioned, and I suspect that some of the stories come directly from what we were able to gather.
The problem, as I said, is threefold. There has to be a statutory obligation to refer the cases so that my office becomes aware; there needs to be oversight in this business. The second one is that the service must investigate like it does for every single death dealing with a person who is incarcerated. Then there should be a clear prohibition that the procedure should not happen in penitentiaries—period—no if and buts. It should not happen.
What I think is really important to stress in a prison situation is to try to be extremely proactive and get the people who are palliative, terminally ill, have chronic diseases, where death is just a question of time, outside the penitentiary so they can make the decision there without the fear of dying in prison, and the coercion that can be either perceived or real. I think that's my wish.
With respect to phase two, or the expansion of it, given the high prevalence of people with significant mental illness who live in conditions of confinement, especially some of the people who are severely mentally ill, it's to give them a way out of prison with death, because they're struggling with mental illness and are in such poor conditions of confinement.
I can tell you that people with mental illness in corrections tend to be housed in higher-security institutions, maximum security. They're overrepresented in those structured intervention units, which are the new regime in administrative segregation.
Absolutely, this should have added oversight and some rigour if you're going to expand it. It's not only that they're suffering and they want the suffering to end, possibly, but also because the added suffering because of the conditions of confinement may taint their...so absolutely this should be done very thoughtfully.