In this chapter we address what has become a challenging area of law-the standards that govern the treatment of "special needs" of vulnerable criminal offenders. The challenging nature of the topic stems largely from the fact that applicable legal doctrines are often contradictory and operate at cross-purposes with one another. These core contradictions are simple to articulate but difficult to resolve. On the one hand, the special needs of offenders ostensibly entitle them to enhanced services and treatment while incarcerated. These same needs also make the prisoners uniquely vulnerable to the potential pains of incarceration that, in turn, theoretically afford them greater claim to special protections. On the other hand, in a political climate in which correctional agencies focus more on delivering punishment than providing services, these claims can take on problematic significance. Special needs and heightened vulnerability may mean that offenders are less able to conform their conduct to the requirements of the institution, resulting in their exclusion from already limited programs and subjecting them to increased punishment. Rather than more treatment, they may get less than other offenders and little of what they need.Another contradiction affecting offenders with special needs is that contemporary criminal justice thinking still emphasizes punishment over rehabilitation, and there 51