The death penalty is cruel. But so is life without parole.

The sentence itself generally gives rise to what is sometimes referred to as the “death row phenomenon” or “death row syndrome,” resulting in psychological illness and physical deterioration: depression, hallucination, delusion, weight loss, and susceptibility to physical illness. Prisoners on death row face unique existential stress from “living under an ever present sentence of death, with much of this time spent not knowing when the actual execution will take place.”1 This stress is exacerbated under the present circumstances, where executions might not be on schedule, and stays or drug shortages can result in quick cancellations (as Stern and Crair demonstrate). Numerous courts, including the Supreme Court of California and the Inter-American Court of Human Rights, have found that the wait for execution “terrorizes” prisoners and thus constitutes cruel, inhuman, and degrading treatment. Many inmates prefer death and volunteer for their own execution. Others don’t wait: The suicide rate on death row is at least six times higher than in the general prison population.

Given that death row is associated with the harshest conditions of confinement, this is hardly surprising. Pettigrew’s review of confinement for capital convicts, conducted over three years, found striking similarities across prison experiences. “Inmates on death rows across the United States are routinely incarcerated for 23 hours a day, or more,” he writes. “Shackled whenever they leave their cell, arbitrarily denied even the most basic services: showering, exercise, unspoiled food, psychological and medical care…access to education, self improvement, and work opportunities.”