Amnesty International Tuesday accused Iranian prison officials of “shocking violations of the right to life” by denying healthcare to ailing prisoners and refusing to investigate deaths in prison custody.

Their report describes the acts by prison officials as “arbitrary deprivations of life” which constitute “extrajudicial execution where there is intent to kill”. At least 96 of the deaths reported in custody occurred since 2017. An estimated 83% of the deceased were “younger and middle-aged,” with over 40 of the recorded 96 deaths being prisoners under 50 years old, suggesting that lives are being cut short by the denial of health care.

The deaths were largely caused by denial of medical care, which is not helped by Iran’s prison regulations. Iran’s Prison Regulations do not require doctors in prisons holding under 500 prisoners, and only require overnight doctors for prisons with over 3,000 prisoners. In addition, the prison regulations allow prison authorities with no medical expertise to “overrule or ignore the recommendations of healthcare professionals.”

Beyond the deaths in prison, the report alleges that Iranian officials have refused to investigate the ongoing crisis. Amnesty International stated that “lack of transparency around the number of deaths is a hallmark of the prevailing crisis of impunity for arbitrary deprivation of life in Iran.”

Iran’s Prison Organization is under the authority of Iran’s Judiciary. The head of Iran’s judiciary stated in a 2021 press event “[Iran’s] prisoners, compared to prisoners around the world, have better conditions in various ways” and even stated that “in terms of leniency shown to prisoners, our situation [in Iran] is unparalleled and nowhere else are leniencies afforded to prisoners to the extent seen in Iran.”

Amnesty International recommended an independent investigative and accountability mechanism to “break the chain of impunity”. However, the report notes that it “did not identify the exact official bodies involved in denying medical care to prisoners”. Rather, the report attacks Iran’s prison regulations, which have contributed to staffing issues and have “emboldened prison officials to continue to commit violations of the right to life by routinely denying prisoners vital medical care.”