During his 24 years on death row, Singleton had been treated often for his psychiatric disorder. At times, he voluntarily took his medication (Appellant's Brief to the Eighth Circuit 2000 WL 33983423: 2000). For instance, in a 1995 hearing, Singleton stated that he was then voluntarily taking antipsychotic medication. Two years later, in 1997, he ceased taking the medication voluntarily. At that time his psychiatrist diagnosed him as psychotic, delusional and suffering from paranoid schizophrenia. He referred Singleton to the Medication Review Panel, which ordered involuntary treatment under the guidelines established by the Supreme Court in Washington v Harper, 494 US 210 (1990). Harper provided for involuntary treatment when a prisoner is dangerous to self or others, and "the treatment is in the inmate's medical interest." Harper does not deal with the issue of restoration to competency to be executed. It was clear that Singleton had become competent to be executed under the regimen of depot injections ordered under Harper, so his lawyer appealed.
According to the Arkansas Supreme Court, (99 SW2d 768,769):
The primary legal issue presented in this case was whether the State may mandatorily administer antipsychotic medication to a condemned prisoner [under Harper guidelines] when a collateral effect of that medication is to render him competent to understand the nature and reason for his execution.
The Arkansas Supreme Court ruled that it "must look to the intent of the state in its decision to involuntarily medicate appellant" and concluded that "the intent of the state was not to make him competent to be executed" but to treat him under Harper.
How the state Supreme Court could identify the intention of the state of Arkansas baffled many who commented on the decision. As one reviewing judge noted respectfully, the state had been trying to execute Singleton for 20 years, which might indicate they had other intentions.
Singleton's lawyer Jeff Rosenzweig, who spoke to me by phone, has argued that treatment under Harper for a death row inmate might be constitutionally permissible during a stay of execution. However, once an execution date has been set, continuing involuntary treatment is not in the inmate's medical interest and other constitutional limitations on the state's power apply. He made those arguments to the Eighth Circuit Federal Court of Appeals. Wollman, in the previously mentioned 6-5 decision, rejected Rosenzweig's argument; however, he did not rely on the Arkansas Supreme Court's intent of the state rationale. The judge reviewed the major constitutional cases dealing with the state's power to impose involuntary treatment. Wollman ignored the fact that none of those decisions dealt with capital punishment and that the Sell decision in his own court (about restoring competency to stand trial) had said that forced treatment for the death penalty raised different questions, 282 F3d 560 (2002). He reviewed the involuntary treatment decisions only for the standards they established for the medical appropriateness of forced treatment. Wollman observed that antipsychotic medication controlled Singleton's symptoms, that there were no untoward side effects, that there was no less intrusive treatment, that Singleton does not dispute that medication "is in his medical interest during the pendency of a stay of execution" and that it has restored his competency. These observations led Wollman to conclude that Singleton's treatment was medically appropriate and "the best medical interests of the prisoner must be determined without regard to whether there is a pending date of execution." Wollman then reformulated Powell's ominous footnote:
A state does not violate the Eighth Amendment as interpreted by Ford when it executes a prisoner who becomes incompetent ... but who subsequently regained competency through appropriate medical care.
Like the Arkansas Supreme Court, Wollman's opinion ignored the basic moral-legal question: Is it wrong--cruel and unusual, or excessive punishment--to restore a condemned madman to sanity so he can be executed by the state? Wollman also ignored the ethical questions raised by organized medicine and psychiatry that his dissenting colleagues addressed.