On Friday, the Pennsylvania Board of Pardons will meet for the last time this year and will consider the commutation petitions of 18 people who are serving life without parole sentences. The list includes Pedro Reynoso, a 59-year-old Hispanic man from Philadelphia who is a colon three cancer survivor, who has been incarcerated for 23 years, even though 10 alibi witnesses claim he was in the Dominican Republic at the time of the murder. Another person up for commutation is Henrietta Harris, a 62-year-old black woman from Philadelphia, who has been incarcerated for four decades for a murder she participated in at the age of 21.

For people like Reynoso and Harris, a recommendation for commutation from the Board of Pardons and a commutation from the governor is the only way they can avoid dying in prison.

After two decades in which commutations have been extremely rare, Lt. Gov. John Fetterman has made them a top priority for the administration. This year alone, the Board of Pardons heard the petitions of 31 lifers and recommended 15 commutations.

There are compelling arguments for commutations. It’s a way to reverse-engineer the decades of criminal justice policies that led to mass incarceration. And the state is now staggering under one of the unintended consequences of so many behind bars: a sick and aging population. Expanding compassionate release and implementing medical parole is worth considering.

The elderly population — those over 50 — accounts for about 20% of the overall 47,600 population of Pennsylvania state prisons. This population costs the Department of Corrections $2.9 million every month in medication alone.

Because of the aging population, the DOC operates a 150-bed specialized care unit in Laurel Hill with ventilator capacity. Across the state, there are about 40 people with dementia in prison infirmaries. On average, about 150 people die of age-related illnesses in Pennsylvania’s prisons every year. The DOC also provides hospice care, with caregivers often drawn from the prison population.

The commonwealth pays the cost of health care during incarceration, without assistance from the federal government (one exception is hospitalization in the community). In addition, every medical expense is higher because of the added security component. The elderly population accounts for 64% of emergency room trips, each one requiring extra security.

Pennsylvania has a compassionate release law on the books, but it is strict and rarely used. It requires the person to be terminally ill with a prognosis of less than a year to live. In March, State Sen. Lisa Baker, a Republican from Northeast Pennsylvania, circulated a cosponsorship memo to establish a medical parole program that would create a path for elderly or ill incarcerated people to be transferred to a nursing home in the community. To complement the efforts of the lieutenant governor to ease the burden on the DOC and to save money, the state Senate should advance medical and compassionate parole legislation.

Prisons should not house people with dementia or operate hospices — it is expensive and, in cases like dementia, unjust. Both the General Assembly and the Board of Pardons should continue to work to reduce the size of the aging prison population.