Early case law delineated the public's duty to care for its incarcerated in terms of the eighth amendment prohibition against cruel and unusual punishment. In Estelle v. Gamble, the U.S. Supreme Court set the controlling principle governing the State's duty with respect to the provision of medical care. In general, a responsive decency standard is usually applied by the judiciary in the assessment of deficiencies within the penal environment and in psychiatric services. Under this standard, deprivations of liberties and services must fulfill a legitimate penal goal and must not inflict wanton and unnecessary pain nor be so extreme that they cannot be countenanced by an orderly society. Tests determinative of the standard have included considerations of deliberate indifference, pattern of deprivation/series of incidents, the totality of circumstances, and the seriousness of the need for treatment. Additional standards by which courts can address the adequacy of psychiatric services are set forth in Capps v. Atiyeh. These standards impose an affirmative duty upon penal institutions to provide adequate psychiatric care for inmates. They show a humanistic and enlightened approach to prison reform which is the mark of an evolving society. Footnotes are included.