Is It Ethical for Psychiatrists to Participate in Competency-To-Be-Executed Evaluations?

January 1, 1998

In its 1986 decision in Ford v. Wainwright, the U.S. Supreme Court found that death row prisoners had a constitutional right not to be executed if they were incompetent (477 U.S. 399 [1986]). Competence for execution-an odd concept, but one whose roots go back to biblical times-usually requires that a prisoner understand the nature of the punishment about to be imposed and why it is being imposed.

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Point

In its 1986 decision in

Ford v. Wainwright,

the U.S. Supreme Court found that death row prisoners had a constitutional right not to be executed if they were incompetent (477 U.S. 399 [1986]). Competence for execution-an odd concept, but one whose roots go back to biblical times-usually requires that a prisoner understand the nature of the punishment about to be imposed and why it is being imposed.

Dr. Lawrence Hartmann and I differ on whether it is ethical for a psychiatrist to evaluate a prisoner whose competence has been questioned. In my view, such an evaluation-which may result in saving the prisoner's life-is an ethical act. Indeed, failure to conduct the evaluation, which may be tantamount to condemning the prisoner to execution, may be unethical. Full Story

Counterpointby Lawrence Hartmann, M.D.

What counts as participation in capital punishment? Is it possible for a medical activity to be ethical in one context, but a similar one not ethical in another? Is death different? Are there neat and universal ethical rules that will always guide us wisely, or are there inevitable clashes among various legitimate and important values? Is it ethically possible that a forensic psychiatrist is not a psychiatrist, as Dr. Paul Appelbaum has argued? How strongly should physicians protect their duty to always help and not harm all individual patients in the face of many pressures to do otherwise?

All these questions bear on the current debate as to whether it is ethical for a psychiatrist to perform a competency-to-be-executed evaluation. My position (a widespread and traditional position [Freedman and Halpern, 1996]), is that it is not ethical. Full Story

Is It Ethical for Psychiatrists to Participatein Competency-To-Be-Executed Evaluations?

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