Dying inside: deaths from natural causes in prison culture, regimes and relationships

This thesis considers what happens when a prisoner in England dies from natural causes. It explores the impact of deaths from natural causes on prison regimes, culture and relationships and demonstrates what determines the responses of prison regimes and personnel to dying prisoners. It is significant because to date there have been no studies of these deaths which considers their impact on the prison as an institution. Data collected using ethnographic methods in two prisons in the north of England in 2017 and 2018 shows how staff and prisoners understand the carceral geography of death and dying, construct the identity of the dying prisoner and define quality end of life care. The thesis concludes that, within limits, deaths from natural causes in prison custody soften the usual distinctions between what is expected or not expected, permitted or not permitted, between ‘inside’ and ‘outside’ prison. This is both tangible and intangible in prison regimes, culture and relationships and informs the responses of prison regimes and personnel to dying prisoners. The thesis challenges existing literature by demonstrating care quietly permeating through prison culture. It considers palliative care in prisons more holistically than existing studies, which are often limited to the medical care of terminally ill prisoners. It argues that in the perception of prisoners and staff, prison changes death, and death changes prison.