Ethics and the psychiatric determination of competency to be executed

Bull Am Acad Psychiatry Law. 1986;14(1):37-53.


For the last several centuries, most jurisdictions using capital punishment have had formal or informal rules that prohibit the execution of the mentally ill. In this article, the procedures for such exclusions in Florida are examined. The article begins by attempting to answer the question of why legislators and judges, at least nominally, have prohibited the execution of the mentally ill. Next, Florida's criteria for defining and procedures for excluding mentally ill prisoners are examined and found to be vague. We then turn attention to the ethical problems created by the statute and its implementation that face the participating psychiatrists and the profession. These problems are compounded because the physician's findings are not acted upon by politically neutral authorities and the inmate has no opportunity to challenge the findings with his own panel of experts. Finally, since any exclusion of the mentally ill from execution is temporary and the patient will be executed if he recovers, the dilemmas facing the treatment staff if the death sentence is not commuted to life imprisonment before treatment are discussed.

MeSH terms

  • Capital Punishment* / legislation & jurisprudence
  • Cognition
  • Ethics, Medical*
  • Florida
  • Forensic Psychiatry*
  • Humans
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy
  • Mentally Ill Persons*
  • United States