LOUISVILLE — Tommy Dozier's body was taken over by cancer, and all he wanted to do was spend his final days with his family, which includes seven grandchildren, but the decision was not up to him. Mr. Dozier was an inmate at the Kentucky State Reformatory, and where he spent his final days was decided by a Parole Board.

        Kentucky state law allows the release of some terminally ill inmates, but the Parole Board rejected prison doctors' pleas that Mr. Dozier be sent home. The board told him to come back in 2007.

        Mr. Dozier had served 23 years of a life sentence for murder and a litany of other felonies. Six days after telling his story to a reporter in July, Mr. Dozier died.

        Kentucky is one of 33 states that sometimes grant “compassionate release” to dying or diseased prisoners under laws designed to show mercy. The laws were adopted during the epidemic of AIDS deaths in the 1980s.

        The laws also are designed to spare the costs of

        medical care for prison systems.

        Still, the Kentucky Corrections Department has spent $4,719,963 on doctor and hospital bills for 55 male and female inmates proposed for medical parole since January 1998.

        Such costs are expected to soar nationally as the prison population ages.

        A computer-assisted review by the Courier-Journal found that roughly three of every five inmates the Kentucky Corrections Department proposed for medical parole were rejected by the Parole Board or died before their cases were considered.

        Prisoner-rights advocates say more should be released.

        “Why on earth would we want to keep somebody in prison who is dying, and pay for all of their medical expenses, plus the costs of their upkeep — plus the cost of guarding them?” asked Louisville lawyer Oliver Barber Jr., the lead counsel in the historic consent decree that ultimately forced the state to spend $120 million to improve its men's prisons.

        But the crime victims, such as Tiffany Eddie, 29, differ.

        Ms. Eddie was 6 years old on Jan. 31, 1977, when she hid in the bathroom of a Louisville apartment and watched Mr. Dozier shoot her mother in the head.

        “Where was his compassion when he killed my mother?” she asked. “It may sound harsh, but I didn't think he should ever get out.”

        The Courier-Journal's review of cases since 1998 found one inmate was denied medical parole even though the Corrections Department's medical director certified that he was “in terminal stage of disease.” Another, who is paralyzed from the chest down, was rejected twice for release. A third, who had liver disease, died in prison even though the mother of his victim supported his release.

        Bids for medical release force the parole board to weigh the needs of dying or desperately ill inmates against society's desire for retribution, deterrence and protection.

        “Prison would be a horrible place to die, not being around your loved ones,” Parole Board Chairman John M. Coy said. “But you have to remember what brought them here.”

        Jo Ann Phillips, executive director of Kentuckians Voice for Crime Victims, noted that death and disease are an “unfortunate fact of life” and that “a lot of good people outside of prison suffer the same things.”

        Mr. Coy, who was named chairman in August, says that medical paroles present excruciating choices for the board, but that they have been handled fairly.

        Under Kentucky's law, prisoners with certain acute and chronic diseases — and those diagnosed with terminal illnesses who have less than a year to live — can be considered for medical parole. But they cannot be released based solely on their medical condition. The seriousness of their crime must be reviewed like any other parole applicant's.

        The newspaper's review found that the Parole Board generally grants medical paroles to inmates with convictions for non-violent crimes, but turns down almost all inmates who were convicted of violent crimes and sex offenses.

        Mr. Coy said the board's primary concern is public safety.

        Records show that no one granted a medical parole in Kentucky has been charged with another offense. Carol Czirr, the Corrections Department spokeswoman, said two people returned to prison for parole violations.

        Medical paroles also are intended to save states money. Inmates do not qualify for federally backed Medicaid, Medicare or Social Security, so the state pays all their medical costs.

        Mr. Coy said Kentucky's strictly worded statute explains why many inmates are rejected for medical parole. At the behest of the state Corrections Department, the law, which had covered only the terminally ill, was amended in 1998 to add acutely ill inmates with certain diseases and impairments.

        But the statute says those candidates must be “totally dependent on others for the activities of daily living.” Parole Board records show that it has rejected many inmates because they were able to feed, bathe and clothe themselves.

        However more inmates who have been released in Kentucky were released because of medical reasons. Forty-two percent of Kentucky's parolees were released for medical problems, while only 25 percent were for regular parole.

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