XI. SUFFERING ON DEATH ROW Prisoners on death row languish in limbo for years and even decades. Conditions on death row echo the systemic failures of the criminal justice system: overcrowded cells result from an oversized death row population, many of whom are sentenced for “less serious crimes,” and prisoners are provided inadequate medical care, sometimes resulting in the deterioration of prisoners' mental and physical health. Similarly, confinement of juveniles and mentally ill persons on death row is proof of past and enduring transgressions of international law. These two groups are also more vulnerable to severe mental trauma that may result from confinement on death row, giving rise to further violations of international law. Finally, prisoners experience mental distress when Pakistan responds in ad hoc fashion to international condemnation of its execution practices, with many prisoners receiving a large number of black warrants before the stay of their executions. These experiences of prisoners on death row are a testament to the need for a comprehensive and urgent response from the international community. A. Conditions on death row amount to cruel, inhuman or degrading treatment and infringes on prisoners' human dignity. States parties to the ICCPR must observe certain minimum standards of detention, including the provision of medical care for prisoners.259 According to the Human Rights Committee, poor conditions of detention may amount to inhuman and degrading treatment in violation of Articles 7 and 10 of the ICCPR. Such transgressions have included overcrowding,260 inadequate sanitary facilities,261 inadequate nutrition,262 and lack of recreational facilities.263 In addition, the Committee has affirmed that “the obligation to treat individuals with respect for the inherent dignity of the human person encompasses the provision of, inter alia, adequate medical care during detention.”264 Despite its international obligations, Pakistan houses prisoners in poor, overcrowded conditions and routinely denies them adequate medical care.265 The cases examined in this report are replete with examples of inadequate or non-existent medical care for death row prisoners. AVERAGE NUMBER OF YEARS SPENT BY A PERSON ON PAKISTAN'S DEATH ROW 11.41 A “MOST SERIOUS CRIME”: PAKISTAN'S UNLAWFUL USE OF THE DEATH PENALTY 35