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 separateoutputin September 2021.

IN DEATH’S WAITING ROOM: DEATHS IN CUSTODY FOLLOWING DELIBERATE DENIAL OF MEDICAL CARE IN IRAN’S PRISONS

Deaths in custody resulting from the deliberate denial of healthcare amount to arbitrary deprivation of life, which is a serious human rights violation under international law.

Diana Eltahawy, Amnesty International

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.

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.

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.

64

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.

26

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

6

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.

Lives cut short across Iran

The 96 recorded deaths in custody cover 30 prisons in 18 provinces across the country. The four provinces of West Azerbaijan, Tehran, Sistan and Baluchestan and Alborz account for most of the recorded deaths.

Prisons with high populations of oppressed ethnic minorities feature particularly heavily – 22 of the 96 deaths recorded took place in the prison in Urumieh, West Azerbaijan province, where most prisoners are from Kurdish and Azerbaijani Turkic minorities. Thirteen deaths were recorded at the main prison in Zahedan, Sistan and Baluchestan province, where prisoners mostly belong to Iran’s oppressed Baluchi minority.

Amnesty International believes the extent of human rights violations being committed in many prisons across the country remains largely hidden from public view. Therefore, greater access to information about some prisons compared to others poses serious limitations to conducting effective comparative analysis.  


Mishandled medical emergencies leading to prisoners’ deaths


At least 11 prisoners died after being denied adequate healthcare for traumatic injuries resulting from specific incidents that occurred at the time of arrest or during imprisonment. These incidents involved beatings or gunshot wounds sustained at the time of arrest, accidents during arrest or in prison, drug overdose, hunger strikes, attempted suicides, and physical fighting among inmates.

Other prisoners died after being denied adequate medical care for serious medical emergencies involving, among other things, heart attacks and strokes, Covid-19 and other infectious diseases, gastrointestinal complications, neurological complications, respiratory complications and kidney problems, which either emerged suddenly or were related to pre-existing illnesses for which they had not received adequate specialization healthcare, including diagnostic tests, regular check-ups, and post-operative follow-up care, throughout their imprisonment.


Heart attacks & stroke

  • Habibollah Naderi
  • Hoda Saber
  • Ali Ashkan
  • Mansour Radpour
  • Afshin Osanlou
  • Anvar Lajevard
  • Shahrokh Zamani
  • Mousa Mir
  • Aziz Anvarian
  • Mohammad Esalati
  • Saeed Nouhi
  • Shiva Fekri
  • Akbar Kamali
  • Abdolnour Sharafnahal
  • Dariush Mansouri
  • Fardin Faramarzi
  • Nader Alizehi
  • Mohsen Moradi
  • Omar Badalipour
  • Omar Rasouli
  • Mehrdad Barideh
  • Nobakht (Nobat) Sahraei
  • Ali Paya
  • Dariush Kangarlou
  • Payam Khaledi
  • Hassan Javadi
  • Parviz Ghahremani
  • Farhad Rahimi
  • Shamsoddin Tatari

Traumatic brain injuries

  • Abdolvahed Gomshadzehi
  • Morteza Kargar

Diabetes

  • Khabat Moradi

Covid-19 & other infectious diseases

  • Fatemeh Alizadeh
  • Seyfoddin Bamoradi
  • Saeed Heidary
  • Zogh Ali Abbasi
  • Abdolvahid Rahmani
  • Akram Rahimi
  • Giti Hajrahimi
  • Baktash Abtin (legal name Mehdi Kazemi)
  • Alireza Karami Kheirabadi
  • Ayoub Raoufpour
  • Shafi Mohammad Tanoumand
  • Mehdi Narouiee
  • Abdolraouf Pahang
  • Gholamreza Goul
  • Eskandar Badrlou
  • Asghar Samani
  • Amir Najivash

Overdose toxicity

  • Hossein Afrasiabi
  • Sadegh Maleki
  • Rouhollah Maleki

Kidney problems

  • Arash Arkan

Cancer

  • Alborz Ghassemi-Shall
  • Mohsen Doghmehchi
  • Hassan Nahid
  • Abdolaziz Ma’reiee
  • Esmail Mostakhdem
  • Agha Shahbakhsh

Respiratory complications

  • Mohammad Mehdi Zaleh-Naghshbandian
  • Mohammad Javad Khoshnevisan
  • Ali Batrani

Drug withdrawal symptoms

  • Ramin Dokaleh

Gastrointestinal complications

  • Naser Khanizadeh
  • Mohammad Zinati
  • Reza Pour-Ramezan
  • Adel Naghizadeh
  • Moloud Vanousheh
  • Vahid Sayadi Nasiri
  • Shahab Daroonparvar

Neurological complications

  • Qolam Nabi Rigi
  • Behnam Mahjoubi
  • Sasan Niknafas

Bleeding resulting from injuries sustained in prison

  • Mohammad Talebi
  • Esmail Toutazehi
  • Hossein Pahandipour
  • Iman Rashidi Yeganeh

Medical condition unknown

  • Zaher Mostafaiee
  • Eshagh Hemati Janikanlou
  • Saman Amini
  • Jalalvand (first name unknown)
  • Gholam Rabani Barahouei
  • Saeed Mohammadi
  • Parviz Moradi
  • Ghorbanali Miresmaili
  • Abdolnabi Saresi
  • Sajad Jamalifard
  • Gholamreza Toupragh (also reported as Toubragh) Ghaleh
  • Reza Malekrezaiee
  • Abouzar Ghodsi
  • Hossein Atri
  • Ahmad Amoukhteh
  • Maraan Khamou
  • Mehdi Narimani
  • Ebrahim Johari
  • Shokrollah Jebeli

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. 

Critical action needed

To prevent further avoidable loss of life as a result of denial of vital medical care, Amnesty International is urging Iranian authorities to require, in law and practice, that, pending structural improvements in prison clinics, prisoners experiencing medical emergencies are immediately transferred to medical facilities outside prison. Prisoners diagnosed with serious pre-existing illness or displaying signs and symptoms of what may be serious health problems must similarly be promptly transferred to medical facilities outside prison for adequate medical care.

Amnesty International also calls on the Iranian authorities to reform deeply flawed provisions in Iran’s prison regulations, which grant prison directors and prosecution officials the power to ignore or overrule medical advice and make healthcare decisions concerning the transfer of prisoners for treatment.

Given systematic impunity in Iran, Amnesty International reiterates its call for the UN Human Rights Council to set up an investigative and accountability mechanism to collect, preserve and analyze evidence of the most serious crimes under international law and human rights violations committed in Iran to facilitate fair criminal proceedings.

Call on the Iranian authorities to stop violating prisoners’ right to life and health through denial of medical care

The Iranian authorities’ chilling disregard for human life has effectively turned Iran’s prisons into a waiting room of death for ill prisoners, where treatable conditions tragically become fatal. Deaths in custody resulting from the deliberate denial of healthcare amount to arbitrary deprivation of life, which is a serious human rights violation under international law.

Iranian prison officials are causing or contributing to unlawful deaths in custody by blocking or delaying prisoners’ access to timely hospitalization. Iran's authorities must stop violating prisoners’ right to life through denial of medical care! @khamenei_ir amn.st/5464