Medicate to Kill: Discussion of the Eighth Circuitís Opinion in Singleton v. Norris

James W. Evans, Jr., LL.M. Candidate

In February of this year, the United States Court of Appeals for the Eighth Circuit decided the issue of whether a state may execute a prisoner who had been involuntarily medicated under a Harper procedure. Singleton v. Norris, 319 F.3d 1018 (8th Cir. 2003).  A majority of the Court held that a mandatory medication regime, valid under the pendency of a stay of execution, does not become unconstitutional under Harper when an execution date is set.  Essentially, the Court found that the state may forcibly medicate an otherwise incompetent prisoner to render him competent for execution.
The underlying facts of this case are straightforward.  In 1979, the defendant entered a grocery store and stated his intentions to rob the store.  Soon thereafter, he stabbed a woman, repeatedly, in the neck.  The woman later died from the loss of blood from the stab wounds.  The defendant was found guilty of felony murder and sentenced to death.

During his incarceration, the defendant began exhibiting signs of depression and schizophrenic paranoia.  His condition gradually worsened and in 1997, the state placed him on an involuntary medication regime after a medication review panel unanimously agreed that he posed a danger to himself and others.  After the medication took effect, the defendantís psychotic symptoms abated.

In January 2000, the state scheduled the defendantís execution for March 1, 2000. Because the Eighth Amendment forbids the execution of an incompetent person, Ford v. Wainwright, 477 U.S. 399, 409-10 (1986), the state could only achieve its interest in carrying out the defendantís sentence if the defendant was competent, which he was through the use of medications.  The defendant filed a petition for habeas corpus arguing that the state could not constitutionally restore his Ford competency through use of forced medication and then execute him.

The defendant argued that the involuntary medication regime, legal under Harper during a stay of execution, becomes illegal once an execution date is set because it is no longer in his best medical interest, as defined in Harper.  The Supreme Court ruled in Washington v. Harper that forcibly medicating a dangerous prisoner with antipsychotic drugs was permissible if the drugs were in the prisoner's medical interest.  The majority then, engaged in a balancing test and found that the stateís interest in carrying out a criminal sentence was greater than when weighed against the defendantís interest in being free of unwanted antipsychotic medication, specifically noting that: (1) the defendant preferred to take the medication rather than be in an unmedicated and psychotic state; and (2) he suffered no substantial side effects.

The dissent found it significant that the drugs often masked the underlying psychosis.  Receiving treatment, they found, was not synonymous with being cured.  Drug-induced sanity is not the same as ďtrueĒ sanity; medication did not cure the defendant, it only ďmaskedĒ his insanity temporarily. Merely masking a defendantís incompetence does not make him competent for purposes of his execution in accordance with Ford and the Eighth Amendment.

Using psychiatric therapy and treatment to assist in the death of an individual, even one sentenced to die by the state, does not comport with notions of fairness and common decency. It certainly places ethical dilemmas in the hands of the defendantís treating physicians. The Supreme Court's precedents do not resolve the issue in the Singleton case, but do provide more direction than the majority chooses to accept.

The Ford Court found that incompetent persons cannot be executed. In the majority opinion in Ford, Justice Marshall outlined the historical prohibition on executing the insane. Although legislatures, courts, and commentators provided differing justifications for the prohibition, they all agreed on one thing: execution of the insane does not comport with the ideals of a civilized society. Id. at 408-10. Does a civilized society then, medicate an otherwise incompetent person so that he may be made competent for execution?