As noted in the lower court's dissent: "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." Simply put: The Court found it in the state of Arkansas' best interest for Singleton to be forcibly treated and executed rather than left untreated but alive." The U.S. Supreme Court has been consistently clear since the decision in Gregg v. Georgia that the Constitution does not prohibit execution as long as procedural safeguards are established, but the Court's jurisprudence concerning the mentally ill as opposed to the mentally retarded has been less clear. In 2002, the Court ruled that it is unconstitutional to execute the mentally retarded (see Atkins v. Virginia). The Court, however, has upheld executing the mentally ill with a series of inconsistent, or perhaps ambiguous, opinions. "

In another case, Ford vs. Wainwright, the U.S. Supreme Court ruled that executing an insane inmate is not constitutional, because it does not teach the sane any lessons, nor does it serve to rehabilitate other insane inmates.

In Riggins v. Nevada, the U.S. Supreme Court ruled that the state could not forcibly medicate a capitally charged defendant prior to trial, and in Sell v. United States, the Court held that the state could not forcibly medicate a defendant to make him competent to stand trial unless there was an issue of danger to self or others."

The difference between Riggins and Sell on the one hand and Ford and Singleton on the other appears to be that the former still were considered defendants, whereas the latter were "offenders." Defendants lose certain constitutional protections (such as the right to refuse antipsychotic medication) in their passage to the status of offender/prisoner. Basically, mentally ill defendants -- innocent until proven guilty -- are not subject to government-imposed treatment regimens until convicted. But a death row inmate cannot be executed if, as a result of mental illness, the prisoner is unaware of his or her pending execution and the reasons for it. A mentally ill death row inmate can only be executed if he or she is restored to competency (sanity) and understands the above. Restoration may be accomplished through a variety of means that normally would include medication in addition to therapy. A death row inmate who takes antipsychotic medication voluntarily presents no constitutional issues. The problem is with those inmates who refuse to take antipsychotic medication and the role that the medical profession should play."

Stone, Alan. Condemned Prisoner Treated and Executed.

Psychiatric Times; 3/1/2004)

Those who assist in the medication of the mentally ill on death row facilitate the harm done by the execution. This is a point that has been argued in the courts for many years and is still hotly debated today.

Severe mental illness -- a separate issue -- afflicts at least 370 condemned inmates, according to the National Mental Health Association. This category includes schizophrenia, bipolar disorder, psychosis, major depression and suicidal thoughts. Some people with mental illnesses, like Keel, suffer from both brain damage and a serious personality disorder. "One problem is that the definition of mental retardation is different from state to state. North Carolina has an absolute cut-off of 70 IQ, and Keel's actual score was...

Mike Easley, the only person with the authority to halt the execution, said he met Keel's attorneys
Tuesday. A clemency decision is expected Thursday or Friday.

Easley will also decide the fate of John Dennis Daniels, scheduled for lethal injection Nov. 14, who psychiatrists testified has "the emotional and social development of an 11- or 12-year-old child."

The Supreme Court set an incredibly low standard for execution of the mentally ill," said one expert, "Basically, you just have to understand that you're being executed." "You can be so far gone you can't help your attorneys, you can't remember your alibi, where you were, or what you were doing - but you're still eligible for the death penalty." No state explicitly permits the execution of a mentally ill prisoner, but in practice, competency standards are so low as to permit severely ill people to be held fully accountable for their behaviour, legal scholars say.

The execution of the mentally ill after forcing them to take medication has been upheld in several U.S. courts. The logic behind such decisions is flawed for several reasons. The mentally ill who are so disordered that they cannot function are not forced to stand trial, nor are they required to answer for their crimes. They are allowed an insanity defense that allows them to seek treatment and eventually apply to be released back to society. It does not make sense, that a mentally ill person can be force fed medications so that they become sane enough to be executed, if defendants cannot be force fed medications for the purpose of understanding their crime and standing trial. The health care industry is built on not harming others. It makes no sense to ask its members to provide medical treatment that will ultimately result in the death of that patient.

Executing the mentally ill or the mentally retarded is unconstitutional especially in light of the fact that those same people would not be required to stand trial if their illness had shown itself at the time. It is time to become more stringent in this debate and raise the standards so that severely mentally ill people cannot be forced to take medications that will make them well enough to be executed.

Works Cited

RIGHTS-U.S.: DEATH PENALTY for MENTALLY ILL CALLED a RIGHTS ABUSE

Inter-Press Service English News Wire; 11/7/2003; Katherine Stapp

Inter-Press Service English News Wire

Killer's case stirs debate about death penalty for the mentally ill.

Knight Ridder/Tribune News Service; 8/16/1999; Moritz, John

Forcible medication of mentally ill criminal defendants: the case of Russell Eugene Weston, Jr. (Notes).

Stanford Law Review; 4/1/2002; Feinberg, Aimee

Doctors, lawyers clash over death-row case; Issue in Arizona: Should inmate's mental competency be restored so he.(USA)

The Christian Science Monitor; 8/19/1999; Schwartz, David H.

Condemned Prisoner Treated and Executed.

Psychiatric Times; 3/1/2004; Stone, Alan a.

Byline: Alan a. Stone, M.D.

Do no harm: should we medicate to execute?

Commonweal; 6/20/2003; Hensl, Kursten

Do no harm: should we medicate to execute?

Commonwealth; 6/20/2003; Hensl, Kursten)

Forcibly medicating death row inmates with mental illness -- an ethical dilemma.(Guest Editorial)

Behavioral Health Management; 1/1/2004; Eisenberg, James R.)

RIGHTS-U.S.: DEATH PENALTY for MENTALLY ILL CALLED a RIGHTS ABUSE Inter-Press Service English News Wire; 11/7/2003; Katherine Stapp)

Stanford Law Review; 4/1/2002; Feinberg, Aimee)