That’s an encouraging development, but as someone who’s spent more than his share of time in prisons right here in the U.S., I’m waiting for the other shoe to drop. More than 2 million people languish in prisons and jails here, frequently enduring conditions of confinement that rise to the level of torture.

TORTURE IN American prisons takes many forms, but one ever-present manifestation is the denial of adequate medical care. In Wisconsin prisons, death by refusal of medical treatment in the case of asthma attack has become a frighteningly common spectacle in the past several years.

In 2000, Michelle Greer, a 29-year-old inmate at Wisconsin’s Taycheedah Correctional Institution (TCI), suffered severe asthma attacks. As a result, she had a regular appointment at the prison’s Health Services Unit (HSU). Every morning at 8 a.m., Greer reported to the HSU to have prison nurses check her condition.

At 6:30 a.m. on February 2, the inmates in Greer’s housing unit were released from their cells for breakfast. During the meal, Greer approached a guard captain in the dining hall and reported that she was suffering an asthma attack. She said her inhaler was not functioning properly and she needed medical attention.

At 7 a.m., the captain called the HSU and spoke to nurse Todd Graff, who instructed the captain to tell Greer to return to her cell, relax, use her inhaler and report for her regular appointment at 8 a.m. The captain relayed these instructions to Greer--who by that time was screaming, demanding that she required immediate medical attention.

At 7:10 a.m., Greer left the dining hall and entered her housing unit. According to a guard sergeant on duty there, Greer was crying and screaming, saying she couldn’t breathe and that she needed medical attention. But the guard also told Greer to calm down and return to her cell, which she did.

At 7:25 a.m., the sergeant called the HSU and spoke to nurse Deborah Federer and told her that Greer said she was unable to breathe and appeared to be in bad shape. Federer told the sergeant that she would see Greer at 8 a.m.

At 7:50 a.m., a guard released Greer from her cell so that she could report to the HSU. The prison dining hall is 325 feet from the housing unit where Greer lived, and the HSU is an additional 575 feet away.

Greer entered the dining hall at 8 a.m., and inmate janitors were cleaning the area. Greer approached one of the janitors, stumbling and clutching at her chest. “Please help me,” she said and then collapsed. She died there on the floor of the dining hall.

On the outside, a person suffering an asthma attack can call an ambulance or go to an emergency room. In prison, however, an inmate suffering a medical emergency can only report their problem to a guard--and hope that prison employees react properly.

It is particularly disturbing that, in Greer’s case, it wasn’t prison guards who neglected her needs, but the medical professionals who lethally ignored their duties.

MORE COMMONLY, guards refuse to report inmates’ emergency medical concerns to medical staff.

David Urban was serving a 30-day sentence in the Winnebago County Jail in Oshkosh, Wis., in early 1995. At 1 p.m. on January 13, the 35-year-old Urban began complaining to guards that he felt ill and needed medical attention. The guards thought Urban was faking, and they refused to summon help. Urban died of a heart attack 20 hours later.

Urban was able to use a dayroom telephone, and he called his girlfriend, Vanessa Miller, several times during that afternoon and evening. At 11:00 p.m., Urban told Miller that he felt like his chest was caving in. In another call, Urban was screaming, saying, “I feel like I’m dying. All they’ve done is take my blood pressure and pulse.”

Patty Strassen, a clerk at the jail, testified at the inquest proceeding that on his last afternoon alive, Urban was vomiting, grabbing his stomach and chest, and talking to himself, saying, “My God, I’m sick. Someone help me.”

No one was prosecuted for Urban’s death, and there is nothing unusual in that. Wisconsin authorities routinely refuse to hold prison employees accountable in the deaths of inmates. In fact, Kristine Krenke, who was the TCI warden at the time of Michelle Greer’s death, was promoted six months after Greer died.

In 1990, guards at Wisconsin’s maximum-security Waupun Correctional Institution (WCI) completely immobilized inmate Donald Woods by using several restraining belts to strap Woods’ body to the steel-frame bed in his cell. In the process of this strap-down, a 250-pound guard knelt on Woods’ chest while cinching a restraining belt.

Restraining an inmate in that extreme fashion can lead to health problems, and Wisconsin law requires that a nurse check on immobilized inmates every 30 minutes. WCI nurse Beth Dittman was working the day guards strapped Donald Woods down, and she did check on Woods every half hour. Woods failed to respond every time she checked.

Dittman did not give Woods any medical attention, summon a doctor or instruct the guards to release Woods from the strap down. Instead, she faithfully wrote “nonresponsive” in the logbook every time she checked him. And that was all she did.

Donald Woods died of asphyxiation that day. The Wisconsin Medical Examiners Board suspended Dittman’s license for 30 days for “conduct below the standards of the profession.” But again, the Wisconsin Department of Corrections did not fire Dittman, but promoted her. After Woods’ death, Dittman became the director of the HSU at Wisconsin’s Dodge Correctional Institution.

Beth Dittman is no less a criminal than Lynndie England, the Army private who earlier this year pled guilty to abusing detainees at Abu Ghraib prison in Iraq. Yet because Dittman works in a prison inside the U.S. rather than in an American military prison in Iraq, her abuse of the human rights of inmates is treated in a manner strikingly different than the fate meted out to England.