religions Article Dying in the Margins: A Literature Review on End of Life in English Prisons Renske Claasje Visser   Citation: Visser, Renske Claasje. 2021. Dying in the Margins: A Literature Review on End of Life in English Prisons. Religions 12: 413. https://doi.org/10.3390/rel12060413 Academic Editor: Paul Morris Received: 7 May 2021 Accepted: 28 May 2021 Published: 4 June 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). School of Health Sciences, University of Surrey, Guildford GU2 7YH, UK; r.visser@surrey.ac.uk Abstract: This paper explores dying in English prisons. Whilst often conflated, death and dying are conceptually different. While there is increased attention given to the investigation of deaths in custody, and the impact of prison deaths on healthcare staff and custodial staff, little attention has been paid to the experience of dying people themselves. Post-death investigations tell us little about dying experiences of the dying. This paper reviewed the literature on dying in English prisons and highlights this clear gap in knowledge. Four types of dying will be discussed in this paper: (1) suicide, (2) dying in older age, (3) deaths post-release, and (4) COVID-19 deaths. The importance of providing good end-of-life care and palliative care in prison is acknowledged in the literature, but this only shows awareness of the needs of a particular part of the prison population. To understand the complexities and nuances of dying in prison, all voices need to be included in research, otherwise what is left post-death of a person who died in prison is a Fatal Incidence Report. More empirical research is needed to illuminate the diversity of prison deaths and the lived reality of those dying behind locked doors. Keywords: dying; death; prison; marginal deaths; place of death; older people; suicide 1. Introduction In England, people are dying in prison on an almost daily basis. Between September 2018–2019 there were 308 deaths in prison custody in England and Wales. Ninety deaths were self-inflicted, which means a person takes their own life in prison every four days (INQUEST 2020). The current COVID-19 pandemic has been a catalyst for more suicides, and in May this year five people took their own lives within six days in prisons across England and Wales (The Guardian 2020). Most of these deaths are not witnessed by the general public and remain unexamined or are misunderstood. Yet, these deaths have wider implications on the lives of fellow prisoners (Turner and Peacock 2017), custodial staff (Barry 2019; Turner and Peacock 2017), prison healthcare staff (Humblet 2020), and the family and friends of people in prison. Liebling (2017, p. 20) argues that: “The ending of life in custody should be controversial. Deaths in prison raise issues of accountability, legitimacy, and quality of life as well as questions about the quality of death (not only for those who die of natural causes in prison as a result of their age or sentence).” Liebling (2017) outlines three versions of “ending life” in prison, namely, suicide, murder, and “whole life sentences”. She argues that a whole life sentence is a form of “dying without death” (Liebling 2017, p. 20), as these prisoners have to live their entire life in prison with no chance of release. “Forcing prisoners to live without hope, creating a climate in which death is preferable to life, and organising prisons with an expectation of death take us far away from the principles of legitimate imprisonment” (Liebling 2017, p. 28). These types of ending life in prison or, in other words, dying in prison, challenge the purpose of prison and thus need to be scrutinised and understood carefully. Religions 2021, 12, 413. https://doi.org/10.3390/rel12060413 https://www.mdpi.com/journal/religions