That's the title of a front page article in today's Wall Street Journal. It carries the subtitle, "Can States Execute Inmates Made Sane Only by Drugs? Medical, Legal Quandary." The article examines the issue through the case of Tennessee death row inmate Gregory Thompson. It also mentions Texas death row inmate Steven Staley. Earlier this year, a state district judge ordered that Staley, severely mentally ill, be medicated with the possibility that he could become competent to be executed.
The Journal article is here.
Today, however, Mr. Thompson's case is at the center of a complex debate about the death penalty in the U.S. Recently, the Supreme Court ruled that mentally retarded defendants and juveniles cannot be sentenced to death. Mr. Thompson is asking the courts to decide whether mentally ill prisoners can be executed if rendered competent only by medication. His twice-delayed execution and similar cases are working through the judicial system; one will likely end up in front of the high court.
There are more than 3,300 people awaiting execution in the U.S., according to the Death Penalty Information Center, a nonprofit group critical of how the death penalty is administered. Various organizations conservatively estimate that at least 10% of them suffer from serious mental illness. In all, about 17% of the nation's prisoners have a diagnosis of serious mental illness.
The Supreme Court ruled 20 years ago that federal and state authorities could not execute defendants too insane to understand that they were about to be killed. But states have wide latitude to determine how sane a defendant must be in order to be executed. They can also choose to medicate defendants to reach that point, a practice that's been outlawed in at least three states with the death penalty. Some medical and legal groups argue that it puts doctors in an ethical bind: having to treat people in order for them to be killed.
And:
Opponents of medicating death-row inmates to make them competent argue that the practice violates the Eighth Amendment's prohibition of "cruel and unusual punishments." Many groups argue that the mentally ill shouldn't face capital charges under any circumstances. Such defendants, they argue, have reduced ability to control their conduct and therefore less moral culpability.
The Supreme Court has never addressed the medication question in a capital-case ruling. It ducked the issue in the 1990s in the case of Michael Perry, a Louisiana death-row inmate, by sending the case back to the Louisiana Supreme Court. The state's high court decided it wouldn't force Mr. Perry to take medication, due in part to the ethical dilemma such a move would present to doctors. He remains on death row.
In 2003, in the case of convicted murderer Charles L. Singleton, the Supreme Court let stand an appeals-court ruling that there is no constitutional barrier to executing someone who is medicated. Mr. Singleton, who suffered from schizophrenia, was being treated against his will because he was considered a danger to himself and others. He was executed in January 2004.
The American Medical Association has tried to weave a path through this thorny problem. It says physicians shouldn't treat an inmate to restore competence except if medical intervention is needed to mitigate suffering, which could also hasten an execution. The AMA acknowledges "it will not always be easy" to decide whether or not to medicate and leaves the ultimate decision to the treating physicians.
More on the Staley case is here and here. Our mental illness category is here and includes news articles and OpEds. More on Ford v. Wainwright, the Supreme Court's 1986 decision, is here.
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