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State Can Make Inmate Sane Enough to Execute, Court Rules

A reader comments, on the following article:  In the words of Kafka, "There is hope, but not for us." "Eligibility for execution is the only unwanted consequence of the medication," he wrote.  Gee, no dry mouth, constipation, or drowsiness? A real wonder drug!

By ADAM LIPTAK

The federal appeals court in St. Louis ruled yesterday that officials in Arkansas can force a prisoner on death row to take antipsychotic medication to make him sane enough to execute. Without the drugs, the prisoner, Charles Laverne Singleton, could not be put to death under a United States Supreme Court decision that prohibits the execution of the insane.

Yesterday's 6-to-5 decision is the first by a federal appeals court to allow such an execution.

"Singleton presents the court with a choice between involuntary medication followed by an execution and no medication followed by psychosis and imprisonment," Judge Roger L. Wollman wrote for the majority in ruling by the United States Court of Appeals for the Eighth Circuit.

Judge Wollman said the first choice was the better one, at least when the drugs were generally beneficial to the prisoner. He said courts did not need to consider the ultimate result of medicating the prisoner.

"Eligibility for execution is the only unwanted consequence of the medication," he wrote.

Judge Gerald W. Heaney, in dissent, said there was a third choice. He would have allowed Mr. Singleton to be medicated without fear of execution.

"I believe," he wrote, "that to execute a man who is severely deranged without treatment, and arguably incompetent when treated, is the pinnacle of what Justice Marshall called `the barbarity of exacting mindless vengeance.' " Judge Heaney added that the majority's holding presented doctors with an impossible ethical choice.

Mr. Singleton killed a grocery store clerk in Arkansas in 1979 and was sentenced to death that year. His conviction was affirmed in 1981 by the Arkansas Supreme Court.

In 1986, the United States Supreme Court held in an opinion by Justice Thurgood Marshall, that the execution of the insane was barred by the Eighth Amendment, which prohibits cruel and unusual punishment.

Mr. Singleton's mental health began to deteriorate in 1987. He said he believed his prison cell was possessed by demons and that a prison doctor had implanted a device in his ear.

In December 2001, he wrote to the appeals court to inform it that he did not believe his victim was dead and that she was "somewhere on earth waiting for me — her groom."

Based on extensive medical evaluations describing Mr. Singleton as psychotic, his lawyers have argued that he is mentally incompetent and thus cannot be executed. Drugs alleviate his symptoms, however, and Judges Wollman and Heaney differed yesterday on whether they rendered Mr. Singleton sane or merely masked his psychosis.

The Supreme Court has held that prisoners may be forced to take antipsychotic medications in some situations. Prisoners who are forced to take medications to ensure that they are competent to stand trial are entitled to a hearing to consider the medical appropriateness of the treatment, the risk the defendant poses to himself and others, and the drug's effect on the defendant's appearance, testimony and communications with his lawyer.

The Supreme Court has not ruled on whether prisoners may be medicated in order to make them competent to be executed.

Over the years, Mr. Singleton has sometimes taken antipsychotic medication voluntarily and has sometimes been forced to take it. Arkansas officials argued that Mr. Singleton must be medicated because he posed a danger to himself and to others.

Mr. Singleton's lawyers responded by saying, in Judge Wollman's characterization, that forcible medication "becomes illegal once an execution date is set because it is no longer in his best medical interests."

The majority decision yesterday said Mr. Singleton's interest in being free of unwanted medication must be balanced against society's interest in punishing criminal offenders. It overturned a ruling by a three-judge panel of the court, which had commuted Mr. Singleton's death sentence because he could not understand his punishment without being medicated.

Judge Heaney, in dissent, noted that the majority's decision gave doctors hard choices.

"Needless to say," he wrote of the majority's holding, "this leaves those doctors who are treating psychotic, condemned prisoners in an untenable position: treating the prisoner may provide short-term relief but ultimately result in his execution, whereas leaving him untreated will condemn him to a world such as Singleton's, filled with disturbing delusions and hallucinations."

Judge Heaney's opinion was joined by three other judges. Judge Diana Murphy dissented on a different ground. She said the record was not clear on whether Singleton was psychotic and that it was premature to take up the case.

The American Medical Association's ethical guidelines prohibit giving medical treatment that would make people competent to be executed, said Dr. Howard Zonana, who teaches psychiatry and law at Yale.

"You can't treat someone for the purpose of executing them," he said.

Jeffrey Marx Rosenzweig, Mr. Singleton's lawyer, said that he was considering asking the United States Supreme Court to hear the case, which he said presented an important question of constitutional law.

"To what extent," he asked, "can a government take invasive, involuntary action using medical personnel who are sworn to heal, save and treat when the result of their medical application and experience is not healing, treating and saving but instead has the result of causing execution?"

Kelly Kristine Hill of the Arkansas attorney general's office, who represented the state, said the court's ruling was limited and correct.

"The ethical decisions involving doctors are difficult ones," she acknowledged, "but they are not ones for the courts."