Compassionate Release in Federal Prison

Federal compassionate release is a legal mechanism that allows inmates to request early release from prison for extraordinary and compelling reasons. In plain terms, it permits a federal inmate’s sentence to be reduced (often to time served) so they can go home early when continuing to imprison them no longer serves justice.

This comprehensive guide explains federal compassionate release, who qualifies, how to apply, and how the process works, with practical insights for inmates and families. We also provide examples and guidance on navigating the system and point you to further resources on eligibility, the First Step Act, medical criteria, application steps, motions, and more. We aim to empower you with knowledge about compassionate release and help you consider whether to pursue this relief for yourself or a loved one.

What Is Compassionate Release?

Compassionate release (also known as a compassionate sentence reduction) is a procedure in the federal criminal justice system that lets a prisoner be released early due to extraordinary circumstances such as severe illness, disability, advanced age, or family emergencies.

In practical terms, compassionate release from prison is a judicial sentence reduction – a federal judge shortens the term of imprisonment when “extraordinary and compelling reasons” exist (e.g., a terminal medical condition or a family tragedy). If granted, the inmate’s sentence is reduced to time served, and they are released from custody (usually to begin a term of supervised release under specified conditions).

This form of relief is designed to temper justice with mercy. It is not a general early release program for well-behaved prisoners or a loophole to escape punishment. Instead, it’s reserved for dire situations where keeping someone behind bars would be inhumane or pointless – for instance, when an inmate is dying of cancer or when the loss of a caregiver has shattered a family.

The federal sentencing court evaluates each case individually. Compassionate release from federal prison is intended to give deserving inmates a second chance when continued incarceration no longer meets the sentencing goals. Read our What Is Compassionate Release? page for a basic overview of compassionate release.

Compassionate release is distinct from other forms of early release, like parole (which the federal system eliminated for most offenses in 1987) or presidential clemency. Parole is not available in the federal system except for specific old sentences, and clemency (whether a commutation of sentence or pardon) is extraordinary and granted by the president.

Compassionate release is a judicial process governed by federal law, requiring court approval and specific qualifying reasons. It is essentially a sentence reduction for compassionate reasons. Federal compassionate release provides a safety valve in our justice system, allowing inmates to be released early when extraordinary circumstances make continued imprisonment unjustifiably harsh.

Ethical and Humanitarian Considerations in Compassionate Release

Compassionate release is built on more than just legal rules—it is grounded in core ethical and humanitarian principles. These values help explain why our justice system allows for early release in certain extraordinary circumstances.

The Importance of Human Dignity

At the center of compassionate release is the idea that everyone deserves to be treated with dignity, no matter their crime or sentence. When someone in prison is facing a terminal illness, severe disability, or overwhelming hardship, keeping them behind bars can become inhumane. The justice system recognizes that punishment should not turn into unnecessary suffering.

This focus on human dignity means that, at a certain point, mercy should guide our decisions. If continued incarceration serves no real purpose—such as protecting the public or encouraging rehabilitation—then it may be time to consider release on compassionate grounds.

Learn more about the ethical basis of compassionate release from the AMA Journal of Ethics.

Challenges with Medical Care in Prison

Prisons are not designed to provide advanced medical care, especially for people with complex or terminal illnesses. Limited resources, staffing, and security concerns make delivering end-of-life care that respects a person’s physical and emotional needs difficult.

When prisons cannot meet these needs, it is both humane and ethical to consider releasing the person so they can receive proper care elsewhere. This is a key reason for compassionate release.

The Role of Medical Professionals

Doctors and healthcare providers in prisons have a unique responsibility. They care for their patients and also advocate for their dignity and well-being. Medical ethics encourage professionals to speak up when a patient’s needs are not being met—this sometimes means supporting a compassionate release request or recommending policy changes.

The American Medical Association’s code of ethics urges physicians to promote changes that protect patient welfare and public health.

Justice, Mercy, and the Limits of Punishment

Compassionate release is a reminder that justice and mercy can—and should—work together. When the main reasons for incarceration are no longer served, and continued punishment only causes suffering, early release becomes the ethical choice.

Compassionate release prioritizes ethical and humanitarian considerations, ensuring our justice system remains fair, humane, and responsive to the most vulnerable.

Legal Background and the First Step Act

Compassionate release has a legal foundation in federal statute. The authority comes from 18 U.S.C. § 3582(c)(1)(A), often called the compassionate release statute. Under this law, a sentencing court may modify a prison term if extraordinary and compelling reasons warrant a reduction.

For many years after this law was enacted in the 1980s, only the Bureau of Prisons (BOP) could initiate a compassionate release motion – inmates could not petition the court directly. This meant the power to seek compassionate release lay solely in the hands of the BOP’s Director. In practice, the BOP was notoriously reluctant to bring such motions, resulting in very few inmates being released compassionately (in some years, only a few dozen nationwide).

The First Step Act of 2018 monumentally changed this. Section 603(b) of the First Step Act amended §3582(c)(1)(A) to empower federal inmates to file compassionate release motions on their own behalf (through the court) after first asking the BOP to approve a reduction.

Effective December 21, 2018, this reform means that if the BOP doesn’t act on an inmate’s request, the inmate can bring the request before their sentencing judge after allowing the Bureau 30 days to render a decision. In other words, the First Step Act gave inmates a direct path to the courts for compassionate release instead of relying on prison officials.

This change is critical because it opened the floodgates for worthy cases that the BOP might have otherwise ignored. The impact was dramatic. In 2018, the year before the First Step Act, only 24 federal prisoners were granted compassionate release. In 2019 (after the Act), that number jumped to 145, and in 2020, it surged to over 2,500 grants – primarily due to the COVID-19 pandemic creating urgent medical risks.

In short, the First Step Act made compassionate release far more accessible. It shifted the decision-making power to judges and allowed inmates and their attorneys to advocate directly for release.

Today, compassionate release remains governed by §3582(c)(1)(A) as amended. The statute lays out a few key requirements:

• A court can grant a sentence reduction for “extraordinary and compelling reasons” (a term not strictly defined in the statute but elaborated by guidelines and case law).
• Inmates (or BOP) must file a motion with the sentencing court to start the process.
• Before going to court, inmates must submit a request to their warden and wait 30 days.
• In deciding the motion, the court must consider the general sentencing factors in 18 U.S.C. §3553(a) (e.g., the seriousness of the offense, public safety, deterrence, and rehabilitation) and ensure that releasing the inmate early would not endanger the community.

The First Step Act’s changes mean the BOP and inmates can request compassionate release. If the BOP supports it, great – but if not, the inmate still has an opportunity to plead their case to a judge. This has shifted compassionate release from a rarely used tool to a more common recourse in extraordinary situations. (Read our First Step Act & Compassionate Release page for a detailed discussion of the First Step Act’s impact on compassionate release.)

Who Can Request Compassionate Release?

Under federal law, the Bureau of Prisons and inmates can petition the sentencing court for compassionate release. In practical terms, this means:

• BOP-Initiated: The BOP (typically via the warden’s recommendation to the Director of the Bureau of Prisons) can file a motion in court on an inmate’s behalf. This was the only method before 2018. Even today, the BOP retains this authority, though it’s used sparingly.

• Inmate-Initiated: Thanks to the First Step Act, inmates can seek compassionate release by filing a motion with the court, but only after first asking the BOP. The inmate must submit a request to the warden and wait 30 days before proceeding to court. Once this condition is met, inmates (usually through their attorney) can file a motion in the sentencing court.

In either case, a judge ultimately grants or denies compassionate release. Even if the BOP initiates or supports the request, the court must still review and approve it.

Family members cannot directly petition the court for a federal inmate’s release – only the inmate (or BOP) has standing to file the motion. However, family plays an important role: they can help an inmate prepare the request to the warden, provide supporting documents, or hire an attorney to file the motion.

BOP policy explicitly allows a defendant’s attorney or family members to assist an inmate who cannot prepare the request. For example, if an inmate is incapacitated in a hospital, the family or lawyer may draft and submit the request to the warden on the inmate’s behalf.

Virtually all compassionate release motions are now filed by inmates (or their lawyers), not by the BOP. The Bureau of Prisons rarely initiates these motions on its own. One analysis found that in 2020, out of thousands of cases, the BOP itself filed only 21 compassionate release motions – inmates or their attorneys filed the rest. This underscores the importance of inmates (and their advocates) taking the initiative.

If you think you or a loved one qualifies, you have the right to request compassionate release – you need not wait and hope the prison will do it for you. (See our Who Can Request Compassionate Release? page for common questions on this topic.)

Eligibility Criteria for Compassionate Release

Not every prisoner is eligible for compassionate release—it is intended for specific, extraordinary situations. The law does not list exact criteria, saying only extraordinary and compelling reasons justify release. However, guidance from the U.S. Sentencing Commission and BOP policy outlines common categories of qualifying circumstances.

Inmates must face a situation that is out of the ordinary and so severe that early release is warranted. Below, we outline the main eligibility criteria (extraordinary reasons) typically recognized in federal compassionate release cases:

Severe Medical Condition (Terminal or Debilitating Illness)

The most common basis for compassionate release is a serious medical condition. This includes inmates with a terminal illness – for example, end-stage cancer or advanced ALS – where life expectancy is 18 months or less. It also includes debilitating medical conditions or disabilities where the inmate is not terminal but is incapacitated.

For instance, inmates who have suffered a debilitating injury or illness (like a severe stroke) that leaves them unable to care for themselves (e.g., unable to walk or perform basic activities of daily living without assistance) may qualify. The Bureau of Prisons’ policy states that inmates can be considered if they are “completely disabled” or “capable of only limited self-care” due to an irrecoverable condition.

In short, inmates can pursue compassionate release if they are gravely ill or critically incapacitated and the correctional facility is not equipped to care for them. Medical cases are the heart of compassionate release – we will discuss them in more detail in the next section. Read our Compassionate Release for Medical Reasons page to dive deeper into medical criteria.

Advanced Age and Long-Term Incarceration

Elderly prisoners may be eligible if age has diminished their health or if they have served a significant portion of a lengthy sentence. There are several qualifying scenarios:

• “New Law” Elderly Inmates: Prisoners 70 years or older and have served at least 30 years in prison may be eligible by statute (18 U.S.C. § 3582(c)(1)(A)(ii)) – though this scenario is uncommon and applies primarily to long sentences.

• Elderly with Medical Conditions: BOP guidelines allow consideration for inmates 65 or older who have serious age-related health issues and have served at least 50% of their sentence. For example, a 68-year-old inmate with chronic heart failure and diabetes who has served decades behind bars might qualify due to age plus health deterioration.

• Other Elderly Inmates: Courts have released older inmates (e.g., in their 70s or 80s) who have served most of their sentence, even if not ill, on the grounds of dramatically lower risk of reoffending and diminishing justification for continued imprisonment. Age alone is usually insufficient, but age combined with other factors (e.g., declining health or an extraordinarily long sentence already served) can constitute compelling reasons.

Family Circumstances

Compassionate release can be granted for certain urgent family situations that only the inmate can resolve:

• Death or Incapacitation of a Caregiver for the Inmate’s Child: If an inmate has minor children and their caregiver (e.g., the other parent or a grandparent) dies or becomes incapacitated, leaving no one able to care for the child, the inmate can request release to step in as the caregiver. For example, suppose a single mother is in federal prison, and her only child’s guardian unexpectedly dies. In that case, that mother has a strong case for compassionate release to care for her child.

• Incapacitation of a Spouse or Partner: If an inmate’s spouse or registered partner becomes incapacitated (disabled) and requires the inmate’s assistance as the only available caregiver, that can qualify as an extraordinary circumstance. An example is a prisoner whose husband suffers a debilitating brain injury, leaving him unable to function independently. If no one else can provide care, the prisoner may seek release to care for her spouse. (The BOP requires medical documentation of the spouse’s incapacitation.)

These family-based cases require proof that the inmate is truly indispensable as a caregiver and that no other alternatives exist for caring for the dependent family member.

Other Extraordinary and Compelling Reasons

The law and guidelines recognize that “other” extraordinary situations may not fall into the above categories. This is a catch-all category. Historically, the Bureau of Prisons had to endorse any “other” reason, but now courts have greater latitude. Examples might include:

• Severe Pandemic Threat or Disaster: During the COVID-19 pandemic, many inmates won compassionate release due to unique risks to their health (e.g., immune-compromised inmates at high risk from COVID-19). Courts treated the combination of a global pandemic and specific health vulnerabilities as an extraordinary reason.

• Extreme Rehabilitation or Change in Law: Inmates have cited profound rehabilitation (far beyond normal) or gross disparities in sentencing (e.g., a change in law since sentencing that would have significantly reduced their sentence) as reasons. Courts have agreed these can be considered “extraordinary” on a case-by-case basis. For instance, if an inmate has served 20+ years and a later legal change means they would have received maybe 10 years today, some judges view that as a compelling reason to reexamine the sentence.

• Humanitarian situations: Other unique situations – for example, an inmate who saved lives during an emergency in prison or an inmate suffering irreversible cognitive decline like advanced dementia – could potentially qualify. These are not typical, but courts can consider any extraordinary scenario they find not foreseen at sentencing.

A Word of Caution

Meeting one criterion does not guarantee release. It simply means the basic eligibility threshold of “extraordinary and compelling reasons” is satisfied.

The court will still weigh other factors (discussed below) before deciding. However, if none of these extraordinary circumstances apply, a compassionate release motion will likely be denied. In other words, the inmate must fit into one of the above categories (or something comparably severe) to even get in the door.

Read our Compassionate Release Eligibility page for more information about who qualifies and specific eligibility examples. Likewise, our Medical Reasons for Compassionate Release page offers more information on health-related criteria.)

Data and Trends in Compassionate Release

The landscape of compassionate release in the federal system has evolved rapidly over the past several years, driven by legislative changes and unprecedented public health events. Understanding the data behind compassionate release motions and outcomes provides valuable context for anyone considering or advocating for this form of relief.

Growth in Compassionate Release Motions

Historically, compassionate release was rarely granted, with only a few motions approved each year. This changed dramatically after the First Step Act of 2018, which allowed incarcerated individuals to file motions directly with the courts rather than relying solely on the Bureau of Prisons (BOP) to initiate the process. In the year before the Act, fewer than 30 federal prisoners were granted compassionate release. Following the reform, the number of filings and approvals increased substantially.

Impact of the COVID-19 Pandemic

The onset of the COVID-19 pandemic in 2020 marked a significant turning point. Thousands of compassionate release motions were filed as concerns grew about the vulnerability of incarcerated individuals to the virus, especially those with underlying health conditions. During this period, the courts saw a surge in the volume of motions and the number of grants. For example, in the fiscal years encompassing the pandemic, the number of compassionate release grants exceeded 2,500 in a single year—an unprecedented increase compared to previous years.

Annual Trends and Recent Data

Recent United States Sentencing Commission (USSC) reports provide ongoing insight into compassionate release activity. Each fiscal year, the USSC analyzes the number of motions filed, the proportion granted or denied, and the characteristics of individuals seeking relief. Data snapshots reveal that while the initial pandemic surge has moderated, compassionate release remains far more common than it was prior to 2018.

Key trends include:

• A significant increase in inmate-initiated motions, with the vast majority now filed by individuals or their attorneys rather than by the BOP.
• Fluctuations in grant rates, often influenced by external factors such as public health emergencies or changes in judicial interpretation.
• Ongoing updates to eligibility criteria and policy statements continue to shape the types of cases courts consider compelling.

For the most current statistics, the USSC publishes quarterly and annual data reports, allowing observers to track compassionate release patterns over time.

Notable Developments

Analysis of recent years shows that:

• The First Step Act’s procedural reforms have made compassionate release more accessible.
• The courts have become a more active venue for these motions, with judges exercising discretion in evaluating “extraordinary and compelling reasons.”
• Grant rates vary by jurisdiction and are influenced by the underlying circumstances, the strength of supporting documentation, and evolving public health guidance.

Where to Find the Latest Data

Anyone interested in the most up-to-date figures can consult the United States Sentencing Commission’s dedicated data reports, which include breakdowns by year, reason for release, and outcomes. These resources provide a clear, evidence-based view of how compassionate release is applied in the federal system.

The data shows that compassionate release is no longer a rarely used option. Legislative changes and societal challenges have transformed it into a meaningful, regularly utilized path for sentence reduction, especially for those facing serious health risks or extraordinary personal circumstances. Staying informed about these trends is essential for anyone navigating or advocating within the federal compassionate release system.

Special Populations and Circumstances in Compassionate Release

Compassionate release is especially relevant for certain groups within the prison population who face extraordinary hardships due to age, severe medical conditions, or unique personal circumstances. Understanding how these special populations are affected is essential to appreciating why compassionate release exists and how it is applied.

The Aging Prison Population

The number of older adults in U.S. prisons has grown dramatically over recent decades. Longer sentences mean that many people are aging behind bars. This trend has significant implications:

• Rising Health Needs: Older prisoners are more likely to suffer from chronic illnesses, disabilities, and age-related cognitive decline. Many require specialized care, which prisons are often ill-equipped to provide.
• End-of-Life Challenges: Providing adequate end-of-life care in prison is difficult and costly. Facilities may lack hospice programs or the ability to offer palliative care that meets community standards.
• Lower Risk of Reoffending: Research consistently shows that elderly prisoners, especially those with serious health problems, have a low likelihood of committing new offenses if released.

These factors make elderly inmates prime candidates for compassionate release, particularly when their continued incarceration serves little public safety purpose and imposes undue suffering.

Prisoners with Severe or Terminal Medical Conditions

A core purpose of compassionate release is to address the needs of individuals suffering from life-limiting or debilitating illnesses:

• Terminal Illness: Inmates diagnosed with incurable diseases and limited life expectancy (such as advanced cancer or end-stage organ failure) may qualify for early release so they can receive appropriate care or spend their remaining time with loved ones.
• Severe Disability: Inmates who are completely disabled or incapable of self-care due to injury, neurological disease, or other conditions may also be eligible, especially when prisons cannot adequately meet their needs.

Providing proper medical care for such conditions in a correctional setting is often impractical or impossible. Compassionate release offers a humane alternative that recognizes the limits of incarceration and the importance of dignity at the end of life.

Cognitive Impairments and Mental Health

Some incarcerated individuals develop severe cognitive impairments, such as dementia or advanced Alzheimer’s disease, making it impossible for them to understand their punishment or participate in rehabilitation. These cases present special challenges:

• Loss of Capacity: When a person can no longer comprehend their situation or care for themselves, the purpose of continued incarceration is called into question.
• Need for Specialized Care: Prisons generally lack the resources to provide adequate care for those with serious mental or cognitive decline.

Judges may consider these factors extraordinary and compelling reasons for compassionate release, especially when no effective treatment or supervision is possible within the correctional system.

Family Circumstances and Caregiving

In certain situations, an inmate may be the only available caregiver for a dependent family member, such as a minor child or incapacitated spouse. If no one else can provide necessary care, courts may consider this a compelling reason for release. However, these cases are less common and subject to strict documentation requirements.

How to Apply for Compassionate Release (Administrative Process)

The process of obtaining compassionate release begins with an administrative request to the Federal Bureau of Prisons. Before a judge can consider releasing an inmate, the inmate must formally ask the prison to make such a request. This step is required by law – the BOP first must have a chance to act. Here’s an overview of how to apply for compassionate release within the federal prison system:

Submit a Written Request to the Warden

Inmates (or their representatives) must submit a compassionate release request to the warden of their facility. This is often fulfilled via a letter or a formal request form, sometimes called a “Reduction in Sentence (RIS) Request” or an “Inmate Request to Staff.”

The request should clearly state the extraordinary and compelling reasons for release and include any supporting documentation. For example, if the reason is medical, the inmate should include or reference medical records, doctor letters, or prognosis reports. If it’s for a family caregiver issue, include death certificates or letters from doctors attesting to the caregiver’s incapacity.

BOP rules also require the inmate to propose a release plan – where they will live and how they will be cared for if released (e.g., living with a relative, transferring to hospice, etc.). The more thorough and clear the request, the better. Inmates are typically encouraged to work with their Unit Team (case manager or counselor) when drafting the request.

Tip: If you have a compassionate release lawyer, they can write the request and send a letter to the warden on your behalf. Inmates physically or mentally unable to write the request can have a family member or attorney prepare and submit it for them, and the BOP must accept it.

Warden’s Review and BOP Decision

Once the warden receives the request, they will review it and typically consult with others (prison medical staff, case management, etc.) about the merits. The BOP’s compassionate release coordinator may get involved for specific categories.

The rules say the BOP should act on requests from terminally ill inmates within 14 days and other requests within 30 days, although in practice, it often takes longer. The warden can either approve forwarding the request up the chain or deny the request. If the warden (and BOP Central Office) approve, the Director of the BOP will direct the U.S. Attorney’s Office to submit a motion to the court on the inmate’s behalf – effectively, the BOP asks the judge to grant compassionate release.

If that occurs, the court process is straightforward (since BOP and the inmate agree). However, if the warden denies the request or makes no decision within 30 days, the inmate can move to the next step (court). It’s common for wardens to deny requests with a short memo or simply allow the 30-day period to expire without action.

Exhaustion or 30-Day Lapse

Under the First Step Act, the inmate must exhaust administrative remedies or wait 30 days after submitting the request to the warden, whichever comes first, before filing a motion in court.

Exhausting administrative remedies means the inmate has appealed the warden’s denial through the BOP’s Administrative Remedy Program (BP-9, BP-10, BP-11 appeals). This typically takes several months. However, the statute offers an alternative: if 30 days have passed since the warden received the request and there’s still no BOP decision, inmates can proceed to court without fully exhausting. Often, inmates proceed to court after 30 days rather than wait out the lengthy BOP appeal process, especially if the situation is urgent (and many courts accept that route).

Keep proof of when the request was submitted (such as a dated copy or receipt from the prison mail/tracking). This is crucial for showing the court that the 30-day waiting requirement is fulfilled. If a denial is received from the warden, that documentation is also essential to show that the administrative route was tried.

After either a denial or 30 days of no action, the administrative step is considered complete, and the inmate can move on to filing a motion in court. Read our How to Apply for Compassionate Release guide for a step-by-step breakdown and tips on navigating the BOP process.

Filing a Compassionate Release Motion in Court (Judicial Process)

If the BOP does not grant the request outright, the next phase is taking the case to federal court. This is where a judge will review the underlying circumstances and determine whether to grant compassionate release. Filing a motion in federal court is a critical step – it’s asking the sentencing judge to reduce the sentence based on the extraordinary circumstances. Here’s what the motion process involves:

Prepare the Motion

The inmate (through an attorney, if possible) files a motion for compassionate release in the same court and before the judge that imposed the original sentence (or a successor judge if the original judge is unavailable). The motion should include:

• A summary of the situation and why it is extraordinary and compelling (e.g., “Defendant has stage IV liver cancer, with a prognosis of 6 months to live…” or “The caregiver of Defendant’s young children has died, leaving the children with no caretaker…”).
• Evidence and documentation supporting the claims (e.g., medical records, doctor’s letters, Bureau of Prisons medical summaries, death certificates, letters from family, etc.). Often, exhibits are attached.
• A discussion of any relevant law or policy, such as U.S. Sentencing Guidelines §1B1.13 (the policy statement on compassionate release), and how the case fits those criteria.
• An argument addressing the 18 U.S.C. §3553(a) factors – essentially explaining why releasing the inmate early would still respect the purposes of sentencing. For example, the motion might argue that the inmate has served most of their sentence, is rehabilitated, and poses no danger to the public and that continuing to incarcerate them despite their condition is unduly harsh or otherwise not in the interest of justice.
• A proposed release plan. For example, where the inmate will live, who will support or care for them, how they will get medical treatment, etc. Judges want to see that the inmate won’t be released into an unsafe or untenable situation.

While there is an official form for pro se compassionate release motions (for inmates without lawyers), a detailed motion crafted by an attorney will typically be more effective. Given the complexity, having a federal criminal defense attorney handle the motion is highly recommended—they know how to frame the legal issues and persuasively present the facts.

Government’s Response

After the motion is filed, the U.S. Attorney’s Office (i.e., federal prosecutors) can respond. The government often opposes the motion, arguing the inmate doesn’t meet the criteria. Or, they may argue that release would be inconsistent with the §3553(a) factors (e.g., the inmate is still a danger or the crime was too serious to warrant early release). They may also submit evidence (or lack thereof) and legal arguments.

Sometimes, the government might agree or not oppose. This typically occurs when the BOP supports the motion or the circumstances are clear-cut (like a terminal illness with a short time to live). Joint motions have even been filed in a few cases, but that’s relatively rare unless the situation obviously warrants release.

Court Review and Decision

The judge will review the motion, the government’s response, and the evidence. Sometimes, the court may hold a hearing (allowing the lawyers to argue the case and occasionally taking testimony from medical experts or family). Other times, the judge decides based on the filings. The court essentially must answer two questions:

• Has the inmate shown “extraordinary and compelling reasons” for release? Do they fit one of the categories, like terminal illness, etc., or present an equally compelling scenario?
• If yes, do the sentencing factors favor release? Would releasing the inmate early be consistent with justice, considering aspects like the inmate’s rehabilitation, the severity of the original offense, the risk to the community, and whether early release would undermine the deterrent or punitive effect of the sentence?

Federal judges have broad discretion here. Even if an inmate meets the basic criteria (e.g., has a terminal illness), judges can deny the motion if, for example, the inmate’s crime was heinous and the judge believes early release would unduly diminish the punishment or endanger the public. Conversely, judges can (and often do) grant release when convinced the reasons are compelling and that the inmate’s release would not undermine the goals of the sentence. Essentially, it’s a balance of compassion and justice.

Factors supporting granting compassionate release include:

• The inmate has served most of their sentence.
• The inmate has a clean disciplinary record in prison.
• A detailed release plan and support network are in place.
• The nature of the extraordinary circumstance is compelling (e.g., imminent death).

Factors that weigh against granting relief include:

• The inmate poses a danger (perhaps a history of violence and no evidence of change).
• The criminal history is serious, and a shorter portion of the sentence has been served.
• The extraordinary reason is not compelling enough (e.g., a common illness the prison can manage).

Outcome – Granted or Denied

If the judge grants compassionate release, they will issue an order reducing the sentence. Usually, the sentence is reduced to time served, meaning the inmate is released immediately (after processing out of the facility, which can take a few days).

The court may impose or modify conditions of supervised release. For instance, the court may place the inmate on home confinement or impose other conditions as part of their supervised release term, especially if they still have a long time remaining on their original sentence.

Essentially, the inmate walks out of prison and enters federal supervised release. If the reason is medical, the release order often notes that the inmate should receive treatment or reside in a medical facility as part of their release plan.

If the motion is denied, the inmate remains in federal prison. The court’s denial will typically explain the reasons. Unfortunately, there is no automatic appeal as of right for a denial. While the inmate can appeal to the Court of Appeals, those appeals are rarely successful unless the judge makes a clear legal error since the standard is abuse of discretion.

If circumstances change – for example, the inmate’s condition worsens, or a new extraordinary reason arises – they can file a new motion later. But repeated motions on the same facts are discouraged. If denied, the inmate may need to wait and perhaps gather new evidence or wait for some time before trying again.

Compassionate Release Statistics

It’s worth mentioning that during the COVID-19 pandemic, courts were inundated with compassionate release motions. Statistics showed that roughly 17.5% of compassionate release motions were granted in 2020 and early 2021. This means the majority were denied, often because courts found the inmates didn’t meet the criteria or that release was inappropriate given their offense.

This underscores that while compassionate release is not broadly available, it’s far from guaranteed. Inmates must present a compelling, well-documented case to have a chance of success. Legal representation can be crucial here (we discuss this more below).

For a detailed walkthrough of the court procedures and tips on motion drafting, see our Compassionate Release Motion Process page.

Compassionate Release for Medical Reasons

Medical and health-related situations are the most frequent grounds for compassionate release. The federal compassionate release program is often associated with releasing terminally ill or severely sick prisoners so they can die with dignity or receive specialized care outside prison. If you or your loved one is seeking compassionate release due to medical issues, it’s essential to understand what types of conditions and documentation are considered.

Terminal Illness

An inmate with a terminal illness is a prime candidate for compassionate release. Terminal generally means an incurable disease with a limited life expectancy (often around 18 months or less). Late-stage cancer, end-stage organ disease (like end-stage liver, heart, or lung disease), ALS, and advanced HIV/AIDS (with complications) are examples of diagnoses that could be considered terminal in this context.

The key is providing medical evidence: diagnosis and prognosis from physicians. The BOP and courts look for statements like “Patient has Stage IV pancreatic cancer with an estimated 6-month life expectancy.” If an inmate is in hospice or requires palliative care, that strongly supports a terminal status.

Terminally ill inmates have a strong case because keeping them in prison serves little purpose. They may not even make it to the end of their original sentence, and compassionate release allows them to receive end-of-life care in a more humane setting (often with family).

Federal law even mandates that the BOP notify a terminally ill inmate’s family about the compassionate release process and assist the inmate in applying, underscoring the importance of these cases.

Debilitating or Incurable Conditions

Not every gravely ill inmate is technically terminal. Some suffer from chronic conditions that won’t cause death within a short time but have left them severely debilitated.

For example, consider an inmate with a massive stroke or a severe brain injury. They may be paralyzed or in a wheelchair, require assistance with eating and bathing, and have no hope of recovering to a functional state. Or an inmate with advanced Parkinson’s or Alzheimer’s disease who can no longer remember family or perform basic self-care.

The BOP’s policy allows compassionate release for inmates who are “completely disabled” or “capable of only limited self-care” due to a chronic illness or injury from which they will not recover. If inmates are so ill or disabled they cannot carry out daily activities in prison without constant care, they may qualify.

Medical documentation is critical here. Doctors’ reports describing the inmate’s condition and capabilities and stating that the condition is incurable or progressive are essential. The prison’s medical staff evaluations are also influential; if prison doctors indicate the inmate’s functioning is extremely limited, that bolsters the case.

Untreatable or Severe Pain Conditions

An inmate might have a condition causing extreme pain or suffering that prison medical staff simply cannot alleviate. While rare, courts have considered cases where an inmate’s quality of life is so poor (constant pain, for example) that compassionate release is merciful. However, typically, the focus is on functional impairment and life expectancy.

Health and COVID-19

The COVID-19 pandemic led to a unique wave of medical-based compassionate release motions. In 2020, courts received thousands of motions citing COVID-19 risks, especially from inmates with underlying conditions (like asthma, diabetes, or obesity) that placed them at higher risk of severe illness. Many courts granted release due to health vulnerabilities and prison outbreaks.

While the acute phase of the pandemic has subsided, the legacy is that courts recognize infectious disease risk combined with other health issues as a potential extraordinary reason. For instance, an immunocompromised inmate might still argue that even outside of COVID, their immune system disorder in a prison environment is extraordinarily dangerous. But, more recently, courts have been less inclined to grant release solely for COVID-19 risk unless the inmate’s health is extremely fragile.

Documentation and Support

Inmates should gather comprehensive medical records for any medical compassionate release request. Include recent progress notes, hospital reports, prognosis letters, and anything showing the trajectory of the illness.

Expert letters and reports help, for example, a letter from an oncologist detailing that the inmate’s cancer is metastatic and terminal. If the inmate is a veteran treated by the VA or has outside specialists, their input is invaluable.

In addition, prepare a release plan for medical care: If released, will the inmate go to a hospital, a nursing facility, or live with family? Who will provide care? Is insurance or Medicaid in place?

Courts want reassurance that the inmate’s medical needs will be met outside prison. Often, family members coordinate with hospice or care facilities in advance to have a plan ready.

BOP Medical Opinions

Bureau of Prisons doctors occasionally support an inmate’s compassionate release by writing a referral. But often, they oppose it (perhaps believing they can manage the care in prison). Courts will consider the BOP’s stance but are not bound by it. Under the First Step Act, courts may even consider reasons the BOP didn’t consider, but strong medical evidence can overcome a lack of BOP support.

Various Paths to a Successful Medical Compassionate Release

Medical compassionate release is grounded in showing that an inmate’s health condition is so severe that keeping them in prison is unjust. The prototypical case is a dying inmate who poses no threat and wishes to spend his final days with loved ones. But even short of terminal, conditions causing severe permanent disability can qualify.

If you think you or your loved one fits these criteria, focus on documenting the condition and its effects thoroughly. Our Compassionate Release for Medical Reasons article details the medical criteria and preparing these requests.

Examples of Compassionate Release Cases

The First Step Act of 2018 empowered federal courts to grant compassionate release for incarcerated individuals facing extraordinary and compelling circumstances. The following case studies illustrate the human side of compassionate release—how individuals and their families are affected, the obstacles they encounter, and the outcomes that follow.

Example 1: Terminal Illness – Inmate with End-Stage Cancer

In United States v. Wong Chi Fai (E.D.N.Y. 2019), the petitioner was an aging inmate who had served 26 years of a long drug-trafficking sentence. Diagnosed with metastatic thyroid cancer and given only months to live, he faced his final days in a correctional facility.

The court recognized that his terminal condition was an extraordinary and compelling reason for release. Supported by Bureau of Prisons medical reports, the judge granted compassionate release, allowing him to receive end-of-life care outside prison and spend his remaining time with loved ones.

This case highlights not just the medical criteria but also the emotional impact on the inmate and his family, who were able to reunite in his final days.

Example 2: Family Caregiver for Incapacitated Parent

In United States v. Bucci (D. Mass. 2019), the defendant was about ten years into a 151-month sentence for non-violent offenses (drug trafficking, money laundering, and tax evasion). His mother, who was terminally ill, had no other available caregiver.

Bucci petitioned for compassionate release, arguing he was the only one who could provide the care she desperately needed. Even though family circumstances in the Sentencing Guidelines traditionally covered only a spouse or minor child, the judge extended it to a terminally ill parent. The court agreed, finding this family circumstance extraordinary and compelling. He was released to care for his mother at home.

This example demonstrates the profound effect compassionate release can have on families in crisis and the difficult choices faced when loved ones are separated by incarceration. The case set an early example post-FSA that sole caregiver responsibilities can warrant release, emphasizing the Act’s intent to inject flexibility and humanity into the process.

Example 3: Elderly Prisoner with Severe Health Deterioration

In United States v. McGraw (S.D. Ind. 2019), a 72-year-old inmate serving a life sentence for a drug conspiracy was released after 17 years due to his deteriorating health.

McGraw’s medical condition had progressively worsened: he was wheelchair-bound, dependent on a portable oxygen machine, and suffered from a litany of chronic illnesses, including:

• Type II Diabetes (with neuropathy)
• Emphysema
• Stage III Kidney Disease
• History of Hepatitis C

The court determined that aging-related decline had left McGraw unable to care for himself in prison, meeting the criteria of a “serious deterioration in physical health” for compassionate release.

The judge found that further incarceration was unnecessary and unduly harsh. His release allowed him to spend his remaining years with family, underscoring the importance of dignity and support at the end of life.

This outcome underscores that elderly inmates with significant health problems can merit early release when continued imprisonment would be excessively harsh and of little benefit to society.

Example 4: Profound Rehabilitation and Sentencing Disparity

In United States v. Hope (S.D. Fla. 2020), the defendant was serving a mandatory life sentence for a non-violent drug offense under outdated laws. After nearly 30 years in prison, the law had changed, and his sentence would be far shorter today.

During those decades behind bars, Mr. Hope demonstrated remarkable rehabilitation and personal growth: a clean disciplinary record, completion of many programs, and evidence of personal transformation. In granting relief, Judge Kathleen Williams cited the “drastic sentencing disparity” (between Mr. Hope’s original punishment and what current law would impose) combined with his “profound rehabilitation” as an extraordinary and compelling reason to reduce his sentence.

The court rejected the Government’s argument that a lack of medical issues barred relief, emphasizing that compassionate release isn’t limited to the sick or elderly. He was freed to begin rebuilding his life outside prison.

This case highlights how the First Step Act opened the door for judges to remedy unjustly long sentences, particularly where an inmate has shown they have reformed, under the catch-all provision of “other” extraordinary and compelling circumstances.

Why These Real-World Outcomes Matter

These cases illustrate the legal standards for compassionate release and the real-life impact on individuals and their families.

For many, compassionate release is a lifeline—an opportunity to reunite with loved ones, provide care in times of crisis, or spend final days with dignity and support. The process can be challenging and uncertain, but these stories show the profound difference compassionate release can make when justice and compassion intersect.

See our Compassionate Release Case Examples resource page for a deeper dive into additional rulings and emerging trends.

Advocacy and Reform Efforts: Expanding Access to Compassionate Release

While the legal framework for compassionate release is essential, much of the progress in expanding access and improving these programs has come from the tireless work of advocacy organizations and reform campaigns. These groups have significantly highlighted deficiencies, pushed for policy changes, and provided practical tools to support federal and state reform.

Leading Advocacy Organizations and Campaigns

Organizations such as Families Against Mandatory Minimums (FAMM) and the American Bar Association (ABA) have led efforts to improve compassionate release. FAMM, for example, has published detailed studies and report cards evaluating how each state handles compassionate release, identifying gaps and best practices. They also provide toolkits and resources designed to help lawmakers and advocates address shortcomings and strengthen early-release programs for medically vulnerable and aging prisoners.

The ABA has submitted recommendations and supported changes to federal sentencing guidelines to remove procedural barriers and promote fairer, more accessible compassionate release policies. Their work has contributed to recent reforms, such as expanding eligibility and granting incarcerated individuals more direct avenues to seek relief.

State Policy Grading and Reform Resources

 A key part of advocacy work has been the development of state-by-state evaluations and practical guides. These resources give policymakers and advocates a clear understanding of where compassionate release programs are succeeding or falling short and suggest concrete steps for improvement. For example:

• FAMM’s state compassionate release report cards and policy summaries offer an overview and comparison of each state’s approach.
• Their toolkit for fixing underperforming programs provides actionable strategies for advocates and lawmakers.
• A summary chart of state programs helps identify where reforms are most urgently needed.

 These materials empower stakeholders to advocate for policies that ensure the most vulnerable incarcerated people, such as those who are elderly, terminally ill, or severely disabled, are not overlooked.

The Impact of Advocacy on Federal Policy

Advocacy has also been crucial in shaping federal reforms. For instance, coordinated campaigns, public pressure, and data gathered during the COVID-19 pandemic influenced the First Step Act and recent sentencing guideline amendments. These efforts have expanded eligibility, reduced procedural hurdles, and emphasized fairness and public safety.

The ABA’s ongoing involvement, including promoting principles to end mass incarceration, has helped bring about meaningful changes at the federal level. See the ABA’s update on compassionate release for more on their recent advocacy and the resulting policy shifts.

How to Support Reform Initiatives

Individuals interested in supporting or learning more about compassionate release reform can get involved through advocacy organizations. Many groups offer opportunities to participate in campaigns, contact legislators, or access educational materials. For example:

• FAMM provides a tool to contact your state legislators and encourages public engagement in efforts to expand compassionate release.
• Their second chances portal offers updates on ongoing campaigns and ways to help.

By staying informed and taking action, you can contribute to ongoing efforts to make compassionate release a more effective and humane option for prisoners facing extraordinary circumstances.

The Importance of Legal Representation – Federal Compassionate Release Lawyers

Navigating the compassionate release process can be complex and challenging. While it’s possible for inmates to file requests and motions pro se (on their own), having an experienced federal compassionate release lawyer on your side can significantly improve the chances of success. Here’s why legal representation is valuable for compassionate release:

Experienced Guidance on Eligibility

A knowledgeable attorney can quickly assess whether a client’s situation will likely meet the eligibility criteria. They can provide an honest evaluation – for example, if the circumstances aren’t strong enough, they might suggest waiting until conditions change or gathering more evidence. This prevents wasting time on long-shot petitions and focuses efforts on cases with merit.

Crafting a Persuasive Petition

Compassionate release requires blending compelling human stories with legal arguments. Attorneys focusing on federal post-conviction matters know how to do this effectively. They gather medical records, letters, and documents and present them in a coherent narrative, highlighting the extraordinary nature of the case. Small details matter – an attorney will ensure the motion checks all the boxes (from citing the right statutes and guideline policy to including a solid release plan).

Navigating BOP Procedures

The bureaucratic maze of the Bureau of Prisons can be frustrating. Experienced attorneys understand BOP regulations and can facilitate communication with the institution. For instance, they might correspond with the warden or staff to follow up on a pending request or ensure that a request isn’t lost in the shuffle. If a warden denies a request, a lawyer knows how to use that denial (or the lapse of time) to move to the next step promptly.

Advocacy in Court

Perhaps the most significant role of a federal compassionate release lawyer is to advocate in court on the inmate’s behalf. They write the legal brief (motion) persuasively, drawing on precedent from other cases where release was granted in similar situations.

If there’s a court hearing, the attorney presents oral arguments, answers the judge’s questions, and rebuts the prosecutor’s points. A seasoned attorney can anticipate the government’s likely arguments (for example, “the inmate is still dangerous” or “everyone has hardships; this isn’t unique”) and preemptively address them.

Knowledge of Latest Developments

The landscape of compassionate release is evolving. Courts’ interpretations of “extraordinary and compelling reasons” have shifted (especially after the Sentencing Commission’s recent guideline amendments in 2023).

Lawyers steeped in this area stay updated on the latest legal developments, such as new guideline definitions, appellate court decisions, or Department of Justice policy changes. They can leverage this knowledge. For example, if the Sentencing Commission expands criteria to include a particular situation, a lawyer will highlight that new language.

Maximizing the Odds

While no attorney can guarantee compassionate release, having experienced counsel improves the odds. The process involves procedure (deadlines, filings, exhaustion) and persuasion. Missing a procedural step (like not waiting 30 days or not including a required detail in the request) can sink a motion – lawyers ensure that doesn’t happen.

And when it comes to persuasion, attorneys are trained to argue cases compellingly. Compassionate release often involves tugging at the court’s sense of justice and empathy while grounding arguments in law; that’s a delicate balance an attorney can strike.

Handling Denials or Appeals

If a compassionate release motion is denied, an attorney can advise on the next steps. Sometimes, a denial can be appealed, or a renewed motion can be filed later if circumstances change. Lawyers know the appropriate course (for instance, if an appellate court in your circuit has set standards that the district judge might have misapplied, an appeal could be worthwhile; otherwise, it might be better to wait and reapply with new evidence).

Your Federal Compassionate Release Lawyers

Compassionate release gives deserving individuals a chance to return home, but achieving that outcome requires overcoming legal and bureaucratic hurdles. Experienced federal lawyers who handle compassionate release understand these hurdles intimately. They can strategize the best approach, whether pushing the BOP to act or making a case directly to a judge.

Given what’s at stake – the remainder of a person’s life and freedom – it’s wise to seek legal counsel when pursuing compassionate release. Our attorneys are well-versed in compassionate release matters if you need assistance. See our Federal Compassionate Release Lawyers page for more information on how we can help.

Conclusion: A Second Chance Through Compassion

Federal compassionate release is a vital relief valve in the justice system, allowing courts to show mercy when unforgiving circumstances arise. It is grounded in the recognition that people and situations can change: health deteriorates, families break apart, or sometimes the purpose of punishment is fulfilled early. This guide has provided an overview of compassionate release – what it is, who can request it, the eligibility criteria, and how the process works from start to finish.

If you or your loved one might qualify, it represents hope: hope that a dying inmate can spend his final days at home, that a rehabilitated prisoner can rejoin society, or that a parent can return to care for children in crisis. The process is not easy – it requires patience, paperwork, and persuasion – but it is navigable, especially with the proper knowledge and support. We encourage you to use the information and resources in this guide to assess your situation.

Finally, remember that you need not pursue this alone. Consulting with an experienced attorney can help you present the strongest case possible. Compassionate release is about justice and mercy working hand in hand. With a compelling reason and a sound legal strategy, that second chance – the day when an inmate walks out of prison earlier than expected, into the arms of family – can become a reality.

Consider scheduling an initial consultation for more information or to discuss a specific case. Our team is here to help evaluate and, if appropriate, vigorously pursue compassionate release on your behalf.

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Published Mar 7, 2022 by Christopher Zoukis, JD, MBA | Last Updated by Christopher Zoukis, JD, MBA on May 16, 2025 at 7:03 pm