The Iranian authorities are committing shocking violations of the right to life by deliberately denying ailing prisoners lifesaving healthcare. The deadly cruelty has involved both blocking or delaying prisoners’ access to emergency hospitalization, and denying prisoners access to adequate healthcare throughout their imprisonment, which leads to worsening health problems, inflicts additional pain and suffering on sick prisoners, and ultimately results in preventable loss of life.

These violations of the right to life stem from an institutional culture in Iran’s prisons which has little regard for sanctity of human life and the inherent dignity of prisoners and are facilitated by unchecked powers granted to prison officials, amid a culture of impunity for torture and other ill-treatment and other violations against prisoners.

Consistent with entrenched patterns of systematic impunity, the Iranian authorities have refused to conduct any effective, prompt, thorough, transparent and independent investigations into deaths in custody following reports of deliberate and unlawful denial of medical care, let alone ensure that those responsible are prosecuted and punished.

Building on its long-term findings on deliberate denial of access to adequate healthcare in Iran’s prisons, Amnesty International has examined the circumstances surrounding the death in custody of 92 men and four women across Iran since January 2010, as documented by the organization or reported by independent human rights groups.

The 96 cases reviewed are illustrative, rather than exhaustive since the true number of deaths in custody is likely far higher. This is because human rights violations in Iran often go unreported due to well-founded fears of reprisals.

The list of cases excludes deaths in custody involving credible reports of physical torture or the lethal use of firearms, which Amnesty International addressed in a separate output in September 2021.

Ailing prisoners left to die

In Iran, prison clinics are not equipped with the facilities required for addressing complex health problems. Nor are they staffed by an adequate number of qualified general practitioners, let alone medical specialists. As a result, prisoners who experience medical emergencies and need specialized medical care must always be immediately transferred to outside medical facilities.

Sadly, Iranian prison officials have consistently refused to acknowledge this reality and respect the right to health and life of prisoners through timely transfers to outside medical facilities.

Sixty-four out of the 96 prisoners, whose cases Amnesty International reviewed, died in prison. Most died in their prison cells which means they were not given basic medical supervision in their final hours. Some died while held in poorly equipped and staffed prison clinics.

In at least six cases, critically ill prisoners were moved to solitary confinement, punishment wards, or quarantine sections; four of them died alone while two were eventually authorized for hospital transfers, but it proved too late.

At least 26 prisoners died during transfer or shortly after admission to hospital, following deliberate delays by prison officials, which proved fatal.

In many cases, both prison clinic medical staff and prison officials accused prisoners experiencing medical emergencies of “faking” or “exaggerating” their symptoms.

©Amnesty International

Of the 96 deaths in custody recorded, the vast majority (65) took place since January 2017. While this may be due to greater access to information in recent years, it serves as an alarming indication of how the prevailing climate of impunity continues to perpetuate serious violations of the right to life across Iran’s prisons.

©Amnesty International

In most cases, prisoners who died were young or middle aged – 23 were between the ages of 19 and 39, and 26 between the ages of 40 and 59, raising further concerns that lives are being cut short by denial of healthcare.

Sixty-four out of the 96 prisoners, whose cases Amnesty International reviewed, died in prison.

Many of them reported to the prison clinic before their death, complaining of various alarming health problems, including severe pain in their chest and breathing difficulties. Prison clinic staff frequently dismissed these emergencies and returned prisoners to their wards where they died shortly afterwards.

Some died while held in poorly equipped and staffed prison clinics. Others died in their wards amid the refusal of prison officials to even take them to the prison clinic.

At least 26 prisoners died during transfer or shortly after admission to hospital, following deliberate delays by prison officials, which proved fatal.

In at least six recorded cases, critically ill prisoners were moved to solitary confinement, punishment wards, or quarantine sections; four of them died alone while two were eventually authorized for hospital transfers, but it proved too late.

Crisis of impunity

The crisis of systemic impunity prevailing in Iran has emboldened prison officials to persist with deadly denial of medical care to prisoners.

The crisis is characterized not only by the authorities’ systematic refusal to investigate suspicious deaths in custody, but also by their promotion of narratives praising the quality of health services offered to prisoners as “exemplary” or “unparalleled” throughout the world, which indicates that they have no intent to change course.

Family members of people who die in custody in suspicious circumstances are also routinely subjected to various forms of harassment and intimidation by intelligence and security officers, particularly when seeking legal redress.