Case study: woman with ALS granted compassionate release

What the law says now (October 2026). A federal judge can reduce a sentence for “extraordinary and compelling” reasons (reasons that are especially unusual and convincing). You must first ask the warden in writing. You can file in court 30 days after the warden gets the request, or sooner if you finish the Bureau of Prisons’ appeals (18 U.S.C. § 3582(c)(1)(A)). The judge also weighs the sentencing factors in 18 U.S.C. § 3553(a). See who may seek compassionate release.

The Sentencing Commission’s policy statement. Since November 1, 2023, U.S.S.G. § 1B1.13 applies to motions filed by prisoners as well as by the Bureau of Prisons, and a reduction must be consistent with it (18 U.S.C. § 3582(c)(1)(A)). Posts from 2020–2023 that say courts were “not bound” by it describe the law before that date. Rutherford (2026) held the policy statement invalid to the extent it lets a non-retroactive change in law count as a reason.
Bureau of Prisons rules. The Bureau’s current policy is Program Statement 5050.51 (September 3, 2026). It has no 18-month life-expectancy rule, it dropped the child-caregiver, spouse-caregiver, and “other elderly” categories, and it lets people in halfway houses or on home confinement apply.

Outcomes vary. A past result does not predict or guarantee the outcome of any other case.

In 2016, a woman we call Sarah, who was dying of ALS, was granted compassionate release and went home to her family. Her case shows how a well-prepared petition moves through the Bureau of Prisons and the court.

Getting compassionate release is not easy, and Criminal Center has experience helping clients through it. Sarah’s case is one we are aware of, and it shows that with careful representation, release is possible.

Sarah’s background

Starting in 2013, Sarah had a medical condition no one could diagnose while she was serving a federal prison sentence for bank robbery.* It began as tingling in her left foot, and then the foot started to drop. Over time she needed a brace to hold her foot in place to walk, then a cane, and finally a wheelchair.

For three years, Bureau of Prisons medical staff did not diagnose or treat her condition. Her health kept getting worse. The only clear thing was that she had some kind of neurological (nerve and brain) condition.

After three years of asking for help, Bureau medical staff finally diagnosed her with ALS, a terminal illness. Sarah was clearly a good candidate for compassionate release.

Researching and drafting the petition

Once Sarah hired a lawyer to help with compassionate release, he got to work right away.

First, he had Sarah sign a release so he could talk with the Bureau of Prisons directly. Then he got a copy of her medical records. Next, he interviewed Sarah on a legal call and spoke with her family to understand her situation.

This matters because the petition must also include the person’s release plan, including where they will live, how their medical care and money will be handled, and any work plans. With that information, the lawyer drafted her petition.

The petition itself is a fairly simple document. The key is to explain exactly how the person’s situation fits the BOP’s criteria for a compassionate release. That took detailed knowledge of the Bureau’s policy at the time, Program Statement 5050.49. (The Bureau’s current policy is Program Statement 5050.51, September 3, 2026.)

Following the Bureau’s compassionate release policy, along with the Code of Federal Regulations, the United States Code and the U.S. Sentencing Guidelines Manual, the lawyer determined that Sarah qualified under the Terminal Medical Condition criteria, PS 5050.49(3)(a).

How the petition moved through the system

Before filing, the lawyer asked Sarah and her family to review the draft to make sure it described her situation the way they wanted. Once they approved it, he filed the petition with her warden to start the compassionate release process.

The warden assigned the petition to the Case Manager Coordinator (CMC), the staff member who handles these requests inside the prison. Because the petition was based on a terminal illness, the prison’s Clinical Director was asked to review it. He wrote a report for the Warden’s review that described Sarah’s ALS diagnosis and recommended that release be granted.

After reading that report, the warden recommended approval. He sent the petition and his written recommendation to the BOP’s Office of General Counsel. General Counsel agreed and sent it to the Bureau’s Medical Director, because the request was based on a terminal illness. The Medical Director also agreed, and the petition went to the BOP Director.

The Director granted the petition and sent it to the U.S. Attorney for the District of Massachusetts. The U.S. Attorney then filed a motion under 18 U.S.C. § 3582(c)(1)(A) asking the court to reduce her sentence. The judge granted it in March 2016.

Going home

A social worker at Sarah’s prison was the first to tell her she would be released. She left within three days of the judge’s order.

Her family was contacted and connected with a local ALS support group that helped with the move home. That meant bringing special medical equipment into the house and setting up daily nurse visits.

When her flight landed, the ALS group met her with a wheelchair-accessible van and drove her home. Her whole family was waiting in “Sarah Strong” t-shirts. It was a bittersweet moment, but Sarah was able to stay at home with her family until she passed.

We were sad when Sarah passed away, but very proud that she got home to be with her family in her last few weeks. Her family was grateful she could come home.

*The inmate’s name has been changed to protect her privacy.

Outcomes vary. A past result does not predict or guarantee the outcome of any other case.

If you want help with a compassionate release request, book a consultation.