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The Controversy regarding treatment for Jason Reihana

Garth made the following comment in an article in the Dominion Post on Monday July 9th 2007, regarding the treatment of Jason Reihana for leukaemia at an estimated cost of one million dollars, shortly after he had been convicted of murdering his former partner and her new boyfriend.
The Herald story on this matter is here
This was then the subject of extensive discussion on the Herald messageboard here

Sensible Sentencing Trust spokesman Garth McVicar said Reihana did not deserve the treatment. "There has to be a balance. The poor old taxpayer has to pour huge amounts of money into looking after these criminals."

This prompted the following reaction from Glen Oliver

This week’s revelation that a convicted double murderer is to receive a million dollar operation has stirred a great deal of community anger. The Department of Correction has announced that Jason Reihana, jailed in June with a non-parole period of 21 years for killing the mother of his children and her new partner, has leukaemia and will receive a state-funded bone marrow transplant. Arriving on the heels of other incidents such as compensation payments to mistreated prisoners, this issue has reignited the debate on the rights of inmates inside the Corrections system.

The family’s reaction, understandably, has been one of outrage. Few can relate to having a family member taken from them in such a manner. It was, without doubt, a brutal attack with tragic consequences. However, any suggestion that Reihana be denied treatment cannot be countenanced further.

Whatever a person’s view on the nature of the crime, denying Reihana a life saving operation would likely impose a death sentence. New Zealand formally abolished capital punishment many years ago, and rightly so. Any suggestion of actions to the contrary would fly in the face of New Zealand’s proudly held values. Comments implying that money targeted for this procedure should be diverted to other health system ends are ill-considered and do not add to rational debate.

A fundamental tenet of this country’s legal system is that the courts apply the appropriate penalty to any crime committed under the law. Reihana was convicted of his crimes under the law, and has subsequently been given a punishment seen by the courts as commensurate with those crimes. The punishment handed down, appropriately, did not include inhumane directives that medical treatment was to be withheld. Concern around the length of the sentence imposed must be addressed through the legal appeals process, not the health system. Any medical procedure must be seen independent of the justice system, and the Department of Corrections cannot independently decide to add to that punishment by withholding medical treatment. Indeed, there are grave implications for the legal system if additional punishment was to be imposed post-sentencing.

One argument is that Reihana has, through his actions, abdicated his rights to medical care that he could reasonably expect be available if he was not incarcerated. This leads to a slippery slope with a murky end. Following this logic, one could argue that an inmate not be allowed to receive anything which would require state funding - medical care, heating or even appropriate nutrition. Clearly, this old fashioned “throw away the key” approach runs counter to modern best practice objectives of punishing, rehabilitating and eventually reintegrating inmates back into society.

The state has, and must continue to have, a duty of care to any person resident within the Corrections system. Anything less is simply not an option for a civilised nation.

This engendered the following response from our webmaster Peter Jenkins

This whole debate regarding Reihana and his treatment for leukaemia springs from the underlying assumption behind many of the changes in our justice system and our society in the last 50 years - that those convicted of serious violent/sexual offences have the same rights as law-abiding citizens and worse, their victims and/or victim's families.

That is the core problem.

And that is what we must address. Most of the problems that victims and the rest of law abiding society experience with the criminal justice system arise from this assumption. Instead we must reform the system - and ultimately society - starting from a different assumption, that there is a hierarchy of rights with victims receiving first priority, closely followed by the rest of society, with convicted criminals coming last, so that those who show no respect for the basic human rights of the vulnerable, the poor and more or less law abiding citizens in general forfeit their rights in proportion to the extent of the consequences of their actions. Note here the word convicted.

Where exactly people will fall within this hierarchy will depend on their track record and the nature of their offences etc etc. Under such a system someone who has committed only one or two relatively minor offences should not have their rights abrogated significantly, whereas someone with a long history of serious offending will find themselves severely disadvantaged, which is as it should be. Situations do of course arise where a "victim" turns out to be as much if not more an offender, and there will need to be flexibility to account for this. Such situations will need to be handled on a case by case basis.

I was heartened to see that a number of people who posted their views in the Herald debate and in other forums pinpointed this core problem from which this issue arose (as I noted when I posted there myself). Many of them did however set about blaming this Government, which is not entirely fair, as they did not create this situation, although they have done nothing to remedy it either. It arose over many years under both Labour and National Governments, and the previous National government did nothing about it either regrettably, a mistake I hope they will not repeat upon next gaining power.

As to what to do in this particular instance, it has to be said that we cannot deny Reihana treatment, regardless of what he has done. However that treatment, like any finite resource, should be prioritised. He should be placed upon a waiting list,, at the bottom, just like many other far more deserving individuals. And then, as other more urgent and more deserving cases enter the system they should receive priority. That way he is not being denied treatment, it will simply postponed until other higher priority cases are dealt with first. This is consistent with the principle enumerated above, that the more deserving are prioritised.

Where I disagree in particular with Glen Oliver is in his statement that " Comments implying that money targeted for this procedure should be diverted to other health system ends are ill-considered and do not add to rational debate.". This as I have said above is exactly what we should do. In fact, not dissimilar practices already exist within the health system, where doctors make the assessment that liver transplants for heavy drinkers who refuse to stop may not be worthwhile, and similarly heavy smokers and/ or the grossly obese are told they will need to change their lifestyle in order to qualify for heart transplants or surgery. There have been cases where treatment has been withheld and death has resulted - remember Rau Williams.

On what grounds Greg can possibly say that the comments about prioritisation of resources do not add to rational debate? The comments on this particular aspect of the Reihana issue were well-considered by and large, and this is a debate that we as a society need to be having.