Deliberate Indifference

The Matter of Honor

In my recently published novel, The Matter of Honor, attorney Alan Gold faces in 1979 what seems like an insurmountable obstacle to winning his case. A Supreme Court decision requires him to prove that jailers were "deliberately indifferent" to the serious medical needs of a prisoner who died while awaiting trial. The 1976 decision opened a tiny crack in the wall of immunity protection given to jailers across the country. It was based constitutionally on the Eighth Amendment protection against cruel and unusual punishment. Gold has to dig up evidence to show much more than mere negligence.

Legal History

The law was less than three years old when Honor took place. In 1979, Justice Rehnquist, in another case (Bell v. Wolfish, 441 U.S. 520 (1979), not mentioned in the novel, ruled that the presumption of innocence is still the law for purposes of proving guilt in a courtroom, "but it has no application to a determination of the rights of a pre-trial detainee during confinement before his trial has even begun."

After Wolfish, protecting against medical maltreatment of those confined awaiting trial continued to be nearly impossible. Courts refused to take into consideration either of two circumstances: that in our local jails, almost all inmates are people who have not been convicted of the charges that brought them into custody and that something seems constitutionally amiss when those who cannot make bond are treated the same as those who are being punished.

Finally, Some Movement

The state of the law remained basically unchanged for nearly 40 years. Recently, Ryan Kost of the Marshall Project (Dec 4, 2024), in partnership with Kentucky Center for Investigative Reporting, reported the remarkable efforts of a Kentucky lawyer who has made a difference. His story will help you understand not only the change in the law concerning medical care for pre-trial detainees but will open the window into how our laws change due to the tireless efforts of some trial lawyers.

Greg Belzley, Country Lawyer

Greg Belzley is officially a country lawyer living in Prospect, Ky. Before that, he was a corporate lawyer in Cincinnati, where he began taking a smidgeon of prisoner cases, which, after a few victories, began to grow until he left the firm to work from his front room, mostly on prisoner cases.

Helphenstine, Deceased Pre-Trial Detainee

Christopher Helphenstine was arrested in rural Kentucky for allegedly selling small amounts of heroin to police informants. While in jail, he began suffering severe drug withdrawal symptoms. Five days later, he was dead. As far as Belzley could tell, the jailers had done little to save the man's life.

Case Dismissed

The trial judge dismissed Helphenstine’s widow's suit against the county, an on-call doctor, law enforcement officials and several jail staffers without a trial. In lawsuits over medical care in prisons and jails, proving negligence is not enough. Belzley had failed to prove "deliberate indifference" to Helphenstine's "serious medical needs."

Game over? Not for Belzley. He was aware of a Supreme Court case (Kingsley) in 2015 that found jailers who tasered a pre-trial detainee while lying on his bunk handcuffed used excessive force that violated his constitutional rights. That case became pivotal because the plaintiff didn't rely on the "cruel and unusual punishment" Amendment. Instead, he based his claim on a violation of his right to due process under the 14th Amendment. The court agreed.

The Kingsley Standard

The Kingsley standard was whether the jailers' actions were "objectively unreasonable." Well, you don't have to be a legal scholar to realize that proving "unreasonableness" is much easier than proving "deliberate indifference." In medical cases, Belzley contended that people awaiting trial shouldn't have to argue that jailers deliberately ignored their health needs, only that jailers should have known about those needs and ignored them.

Victory

He took the case to the Sixth Circuit Court of Appeals in Cincinnati, where in 2023, the court agreed. Defendants' further appeals, including to the Supreme Court, failed. Helphenstine is now good law in the Sixth Circuit, including Oh, Ky, Tenn, and Michigan.

Conclusion

This decision, seemingly based on mere legal technicalities, could start a significant change for prisoners needing medical care. Well done, Mr. Belzley.