The federal appeals court in St. Louis ruled yesterday that officials in Arkansas can force a prisoner on death row to take antipsychotic medication
to make him sane enough to execute. Without the drugs, the prisoner, Charles Laverne Singleton, could not be put to death under a United States
Supreme Court decision that prohibits the execution of the insane.
Yesterday's 6-to-5 decision is the first by a federal appeals court to allow such an execution.
"Singleton presents the court with a choice between involuntary medication followed by an execution and no medication followed by psychosis and
imprisonment," Judge Roger L. Wollman wrote for the majority in ruling by the United States Court of Appeals for the Eighth Circuit.
Judge Wollman said the first choice was the better one, at least when the drugs were generally beneficial to the prisoner. He said courts did not need
to consider the ultimate result of medicating the prisoner.
"Eligibility for execution is the only unwanted consequence of the medication," he wrote.
Judge Gerald W. Heaney, in dissent, said there was a third choice. He would have allowed Mr. Singleton to be medicated without fear of execution.
Based on extensive medical evaluations describing Mr. Singleton as psychotic, his lawyers have argued that he is mentally incompetent and thus cannot
be executed. Drugs alleviate his symptoms, however, and Judges Wollman and Heaney differed yesterday on whether they rendered Mr. Singleton sane or
merely masked his psychosis.
The Supreme Court has held that prisoners may be forced to take antipsychotic medications in some situations. Prisoners who are forced to take
medications to ensure that they are competent to stand trial are entitled to a hearing to consider the medical appropriateness of the treatment, the
risk the defendant poses to himself and others, and the drug's effect on the defendant's appearance, testimony and communications with his
The Supreme Court has not ruled on whether prisoners may be medicated in order to make them competent to be executed.
Over the years, Mr. Singleton has sometimes taken antipsychotic medication voluntarily and has sometimes been forced to take it. Arkansas officials
argued that Mr. Singleton must be medicated because he posed a danger to himself and to others.
Mr. Singleton's lawyers responded by saying, in Judge Wollman's characterization, that forcible medication "becomes illegal once an execution date
is set because it is no longer in his best medical interests."
The majority decision yesterday said Mr. Singleton's interest in being free of unwanted medication must be balanced against society's interest in
punishing criminal offenders. It overturned a ruling by a three-judge panel of the court, which had commuted Mr. Singleton's death sentence because
he could not understand his punishment without being medicated.
Judge Heaney, in dissent, noted that the majority's decision gave doctors hard choices.
"Needless to say," he wrote of the majority's holding, "this leaves those doctors who are treating psychotic, condemned prisoners in an untenable
position: 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."
Judge Heaney's opinion was joined by three other judges. Judge Diana Murphy dissented on a different ground. She said the record was not clear on
whether Singleton was psychotic and that it was premature to take up the case.
The American Medical Association's ethical guidelines prohibit giving medical treatment that would make people competent to be executed, said Dr.
Howard Zonana, who teaches psychiatry and law at Yale.
"You can't treat someone for the purpose of executing them," he said.
Jeffrey Marx Rosenzweig, Mr. Singleton's lawyer, said that he was considering asking the United States Supreme Court to hear the case, which he said
presented an important question of constitutional law.
"To what extent," he asked, "can a government take invasive, involuntary action using medical personnel who are sworn to heal, save and treat when
the result of their medical application and experience is not healing, treating and saving but instead has the result of causing execution?"
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