The defense of qualified immunity for claims seeking monetary damages for constitutionally inadequate medical care for people who are incarcerated is misguided. According to the U.S. Department of Justice, medical illness is the leading cause of death of people incarcerated in prisons and jails across the United States. Qualified immunity in these cases limits accountability for carceral actors, thereby limiting incentives for improvements in the delivery of constitutionally adequate medical care. The qualified immunity defense also compounds other existing barriers, such as higher subjective intent standards and the Prison Litigation Reform Act, to asserting legal accountability of prison and jail administrators. In addition, the defense is not appropriate because medical care decisions by carceral actors are fundamentally different than traditional qualified immunity cases. Traditional qualified immunity cases usually involve discretionary decisions that are one-off, emergency, binary choices made by a single actor or unit of actors. In contrast, medical decisions in carceral settings are often serial, ongoing, and usually involve multiple decision makers, sometimes acting beyond their area of expertise. These significant differences between medical decisions in carceral settings and traditional qualified immunity decisions illustrate the practical difficulties for incarcerated plaintiffs and their families in holding prisons accountable for violating the U.S. Constitution. Recent developments refining the doctrine may lessen the negative impact of the defense on these civil rights claims, but they also do not address the core disconnect between the rationales justifying qualified immunity and its application in cases of severe injury or death from inadequate carceral healthcare.

为在宪法上为被监禁的人提供不充分的医疗服务而寻求金钱赔偿的索赔的合格豁免权的辩护是错误的。据美国司法部称，医疗疾病是美国各地监狱和监狱中被监禁人员死亡的主要原因。在这些情况下，合格的豁免限制了对监狱参与者的责任，从而限制了改善提供符合宪法的适当医疗服务的激励措施。合格的豁免辩护还加剧了其他现有障碍，例如更高的主观意图标准和监狱诉讼改革法案，以主张监狱和监狱管理人员的法律责任。此外，辩护是不恰当的，因为监狱行为者的医疗决定与传统的合格豁免案件根本不同。传统的合格豁免案件通常涉及由单个行为者或行为者单位做出的一次性、紧急、二元选择的自由裁量决定。相比之下，监狱环境中的医疗决策通常是连续的、持续的，并且通常涉及多个决策者，有时会超出他们的专业领域。监狱环境中的医疗决定与传统的合格豁免决定之间的这些显着差异说明了被监禁的原告及其家人在追究违反美国宪法的监狱责任方面的实际困难。