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Psychiatric Times. Vol. 25 No. 13
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PSYCHIATRY & THE LAW 

Dignity in the Gray Zone Indiana v Edwards

By James L. Knoll IV, MD
| November 1, 2008
Dr Knoll is director of forensic psychiatry and associate professor of psychiatry at SUNY Upstate Medical University in Syracuse.

"The dignity at issue is the supreme dignity of being master of one’s fate rather than a ward of the State—the dignity of individual choice."
US Supreme Court Justice Antonin Scalia,
Indiana v Edwards, USSC, 20081

"It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate: I am the captain of my soul."
William Ernest Henley, Invictus

The jaw-dropping indignity was easy to miss at a time when the O.J. Simpson murder trial was unfolding. A man named Colin Ferguson had been charged with killing 6 people and wounding another 19 after an apparently indiscriminant shooting spree aboard a Long Island railroad train. Ferguson’s trial somehow turned into a disgraceful demonstration of justice gone awry.

Insofar as justice refers to fairness, conformity to truth, and reason, the Ferguson trial appeared to be the antithesis. Ferguson was allowed to represent himself, despite a serious mental illness that any layperson would be able to recognize. As soon as Ferguson began to make his arguments, it was as if all dignity, fairness, and reason had fled the courtroom. Many times, the trial became both offensive and bizarre, as Ferguson demonstrated prominent irrational, delusional thinking, and “cross-examined” the victims he had shot.2 The debacle was broadcast live by both local media and court television.

Competence to stand trial

Competency to stand trial (CTST) is but one specific type of competency. In 1960, the US Supreme Court articulated the modern American standard for CTST in Dusky v United States.3 That standard is whether a criminal defendant “has sufficient ability to consult with his lawyer with a reasonable degree of rational understanding, and whether he has a rational as well as factual understanding of the proceedings against him.” At both the federal and state levels, the Dusky language has been adopted as the “test” for CTST.

In essence, the Dusky standard requires that the defendant:

• Understand the proceedings against him or her.
• Be able to assist counsel in his own defense.

Impairment in either of these elements may result in a finding of incompetency to stand trial (ICTST).

The defense attorney, the judge, or the prosecutor, at any point, may raise the issue of a defendant’s CTST during the criminal proceedings. In practice, it is the defense attorney who most often raises the issue. A defendant’s competency is often questioned when the defendant is obviously mentally ill, has a history of mental illness, or has demonstrated difficulty interacting with the court or defense counsel. In a review of 8416 patients referred for CTST examinations, evaluators found 19% of defendants to be incompetent to stand trial.4 Psychotic and “organic/intellectual” disorders were most strongly associated with findings of incompetence.

Table 1 lists some other common reasons why a defendant may be found incompetent to stand trial.Table 1

A defendant may exhibit symptoms of a major mental illness, yet still remain competent to stand trial as long as the symptoms do not impair the specific areas of functioning required for competence. The necessity of the defendant being competent to stand trial is guaranteed by the US Constitution, including the Sixth Amendment (right to confront witnesses, right to counsel) and the Fourteenth Amendment (right to substantive and procedural due process of law). Other reasons for requiring a defendant to be competent to stand trial include preserving the dignity of the defendant, as well as the dignity, fairness, and accuracy of the criminal justice system.

Indiana v Edwards

In its 2008 ruling in Indiana v Edwards, the US Supreme Court considered the case of a defendant with mental illness who was in the “gray area” of being able to satisfy the Dusky standard, yet who “may be unable to carry out the basic tasks needed to present his own defense without the help of counsel [page 10].”1 Ahmad Edwards had attempted to steal a pair of shoes and, in the process, he fired a gun at a security guard and wounded a bystander. He was charged with attempted murder, battery with a deadly weapon, criminal recklessness, and theft. Before Edwards ever went to trial on these charges, he had been found incompetent to stand trial twice and had made 2 requests to represent himself. Both requests were denied.

Edwards was ultimately convicted, at 2 different hearings, on all the previously mentioned charges. Edwards then appealed his convictions, arguing that he was deprived of his constitutional right (via the Sixth and Fourteenth Amendments) to represent himself at trial. The appellate court agreed, and the matter went to the Indiana Supreme Court who affirmed. The US Supreme Court agreed to consider Edwards’s case because the precise question presented had never been posed to them.

The American Psychiatric Association and the American Academy of Psychiatry and the Law (AAPL) submitted an amicus curiae (friend of the court brief) brief pointing out how disorganized thinking and other symptoms of serious mental illness can impair a defendant’s ability to “play the significantly expanded role required for self-representation even if he can play the lesser role of represented defendant.”5

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