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Should an incompetent inmate be forcibly medicated to restore competency for execution? Why or why not?

Should an incompetent inmate be forcibly medicated to restore competency for execution? Why or why not?


Should an incompetent inmate be forcibly medicated to restore competency for execution? Why or why not?



Should an incompetent inmate be forcibly medicated to restore competency for execution? Why or why not?

  1. Introduction

In the United States, criminal defendants may not be tried or punished for a crime while they are incompetent to do so. Godinez v. Moran, 509 U.S. 389, 391 (1993). This principle is well established and has been the law in the United States since the nation was founded. Incompetent criminal defendants may be confined to a mental health facility for treatment designed to restore their competency. During the past ten years, there has been a significant increase in the number of incompetent defendants whose cases are pending in the criminal justice system due to the shift in many states from custodial care in state hospitals to community-based treatment. It is estimated that there are presently over 15,000 defendants incarcerated in jails who are deemed incompetent to stand trial and are awaiting transfer to state mental health facilities (Slobogin, 1993). The increase in the number of incompetent defendants in the criminal justice system and the trend toward community-based restoration treatment has brought the issue before the courts and created a need for clear legal standards to govern the involuntary administration of antipsychotic medication to restore competency.

1.1 Definition of incompetence

Diminished Capacity Was formerly considered as a full defense. It is not incompetence in the sense that the defendant did not understand the charges or the legal process, but rather it is a non-capital murder charge with the premise that the defendant’s capacity was so diminished that he was unable to entertain the legal and moral intent requisite to the commission of the crime. Now regarded as a partial defense, this will still have bearing on execution-related issues as the defendant may have a later tenuous understanding of the reason for the sentence and still be more likely to plead incompetence to avoid execution. This would entitle him to a competency evaluation at the time of the proceeding.

Incompetency Incompetency is a legal rather than a psychiatric term. It refers to a defendant’s current state of mind rather than his factual knowledge in regard to the legal process and its implications. The criteria for deciding whether a defendant is competent varies from state to state, but the standard is generally a determination of the defendant’s rational and factual understanding of the proceeding and an ability to consult with his attorney. While the term is not ambiguous in itself, its interpretation and requisite level of functioning have yet to be universally agreed upon (Pinals & Mossman, 1986). When the Supreme Court first addressed the issue of competency in Dusky v United States (1960), they stated that a defendant is competent to stand trial if he has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding. Now, with the surge in research regarding competency restoration, more specific psycho-legal standards are being developed which better define various components of incompetence.

1.2 Importance of competency for execution

Proponents of restoration cite the therapeutic benefit of restoration efforts, the underlying goal of the criminal justice system to serve justice by punishing those responsible for wrongdoing, and general moral and ethical considerations relevant to equal and fair treatment of mentally disordered capital defendants. In contrast, critics of restoration believe that it is unfair and discriminatory to prolong the incarceration of mentally disordered persons solely because they are facing a capital charge. They argue that a mentally disordered defendant who is not facing a capital charge would not receive the same level of treatment simply to render him or her fit to stand trial, and that it is discriminatory to force treatment solely because execution is at stake (Grisso et al., 2005). This is complicated by the absence of a clear answer in the question of how long it is ethically and morally justifiable to try to restore competency for a consequence that becomes increasingly elusive and in effect serves as life without parole.

A finding of incompetence to be executed in the United States now results in indefinite detention (Sell v. United States, 2003). Because execution is the legally prescribed consequence for a capital crime, there is a public assumption that capital defendants are fit to be executed. Even though there is no medical evidence to suggest that persons with mental illness are at increased risk of danger to self or others compared with mentally competent persons (Appelbaum, 2001), there remains a societal appetite for removal of mentally disordered individuals from the community. People found incompetent to be executed are now often detained in high-security hospital facilities that resemble prisons more than therapeutic settings. In such locales they may be confined alongside persons committed through the criminal justice system, possibly resulting in long periods of incarceration with no hope of release (Slobogin, 1999; Bonnie et al., 2002). This is a far cry from the outcome in Jackson’s era, when a finding of incompetence led to quick release back to the community for those thought unlikely to regain their fitness (Perlin and Dorfman, 2009).

1.3 Ethical considerations

This leads us to ask the question of what is to be achieved by forcibly medicating an inmate. If it is said that it is done so the state can be “freed of the administrative burdens that court proceedings place on the state” and it “clears the docket of criminal cases,” then it would be argued that it is not in the interest of the inmate, but the state. This is shown by the fact that it creates an opportunity for the trial to continue should the inmate be restored to competency and lead to the charges not being dismissed. The death penalty is said to be a punishment for the seriousness of the crime committed and will be carried out in furtherance of justice.

Another important aspect to consider is whether forcibly medication violates the inmate’s Eighth Amendment rights. This is the right not to be subjected to cruel and unusual punishment. According to the Eighth Amendment, it would be unconstitutional to execute a person who is insane. Since medication is used in an effort to have the inmate carry on with the execution, it would be likely that the real intention would be to try and execute the inmate who otherwise would not be fit to do so. This is certainly unnerving and the use of the death penalty on an incompetent person may be considered cruel (2004). Say it is determined that a mentally ill inmate who was on death row would be treated and restored to competency. The trial court will lose jurisdiction of the inmate and he will be returned to the penal system because charges were not dismissed (1994). There is a real chance that the inmate who is only restored to competency to stand trial will have to face the front of court again and his charge and penalty will not be dismissed. This is another real possibility that medication will result in an incompetent person being sentenced to death.

  1. Arguments in favor of forcibly medicating incompetent inmates

2.1 Ensuring justice is served

2.2 Upholding the rule of law

2.3 Providing closure to victims’ families

  1. Arguments against forcibly medicating incompetent inmates

3.1 Violation of human rights

3.2 Ethical implications of involuntary medication

3.3 Potential for misdiagnosis or errors

  1. Alternatives to forcible medication

4.1 Rehabilitation and treatment programs

4.2 Postponing the execution until competency is restored

4.3 Reviewing the validity of the death penalty

  1. Legal considerations

5.1 Constitutional rights of inmates

5.2 Precedents and court rulings

5.3 Balancing the rights of the inmate and the state

  1. Psychological evaluations and assessments

6.1 Diagnostic criteria for incompetence

6.2 Role of mental health professionals

6.3 Assessing the potential for restoration of competency

  1. Implications for the criminal justice system

7.1 Impact on public perception and trust

7.2 Challenges in implementing forcible medication

7.3 Ensuring transparency and accountability

  1. International perspectives on forcible medication

8.1 Comparison of policies in different countries

8.2 Human rights implications on a global scale

8.3 International standards and recommendations

  1. Case studies and examples

9.1 Notable cases involving forcible medication

9.2 Outcomes and controversies surrounding these cases

9.3 Lessons learned and potential improvements

  1. Conclusion

10.1 Summary of arguments for and against forcible medication

10.2 Considerations for future policy and legal reforms

10.3 Final thoughts on the ethical dilemmas involved

Should an incompetent inmate be forcibly medicated to restore competency for execution? Why or why not?

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