Supreme Court Decides that Executing a Person With Dementia Could Be Unconstitutional

The United States Supreme Court has reversed a deci­sion of the Alabama state courts that would have per­mit­ted the exe­cu­tion of Vernon Madison (pic­tured), a death-row pris­on­er whose severe demen­tia has left him with no mem­o­ry of the crime for which he was sen­tenced to death and com­pro­mised his under­stand­ing of why he was to be exe­cut­ed.

The Alabama courts had nar­row­ly con­strued the Supreme Court’s past rulings that pro­hib­it­ed the exe­cu­tion of pris­on­ers who had become men­tal­ly incom­pe­tent, lim­it­ing those rul­ings to cas­es in which a men­tal­ly ill prisoner’s lack of under­stand­ing of why he was being exe­cut­ed had been caused by psy­chosis or delu­sions. In a 5 – 3 deci­sion on February 27, the Supreme Court ruled that the Eighth Amendment for­bids the exe­cu­tion of a pris­on­er who does not have ​“a ratio­nal under­stand­ing of the rea­son for [his] exe­cu­tion,” irre­spec­tive of its cause. 

Writing for the Court, Justice Elana Kagan said: ​“What mat­ters is whether a per­son has the ​‘ratio­nal under­stand­ing’ [the con­sti­tu­tion] requires — not whether he has any par­tic­u­lar mem­o­ry or any par­tic­u­lar men­tal ill­ness.”

In 2015 and 2016, Madison suf­fered mul­ti­ple severe strokes that caused him brain dam­age, vas­cu­lar demen­tia, and ret­ro­grade amne­sia. The strokes also left him with slurred speech, legal­ly blind, incon­ti­nent, and unable to walk inde­pen­dent­ly. In addi­tion to hav­ing no mem­o­ry of the offense, he can no longer recite the alpha­bet past the let­ter G, soils him­self because he does not know there is a toi­let in his cell, asks that his moth­er—who is dead—be informed of his strokes, and plans to move to Florida when he is out of jail. Madison’s lawyers argued that he had become incom­pe­tent to be exe­cut­ed. At a hear­ing in state court, he pre­sent­ed evi­dence that he had no mem­o­ry of the crime for which he was sen­tenced to death. 

The state’s expert agreed that Madison exhib­it­ed cog­ni­tive decline but said there was no evi­dence that his impair­ments were a prod­uct of psy­chosis or delu­sions. State pros­e­cu­tors also argued to the state courts that the Supreme Court’s caselaw lim­it­ed incom­pe­ten­cy to be exe­cut­ed to cas­es involv­ing psy­chot­ic men­tal ill­ness. Emphasizing the absence of evi­dence of delu­sions or psy­chosis, the Alabama courts denied Madison’s com­pe­ten­cy claim.

The five-justice major­i­ty declared that com­pe­ten­cy deter­mi­na­tions are gov­erned by what a pris­on­er under­stands, not by what phys­i­cal or men­tal health con­di­tion impairs his under­stand­ing. Lack of mem­o­ry of a crime, Justice Kagan wrote, is not in itself proof of incom­pe­tence, although it may be evi­dence of it. ​“If Alabama is to exe­cute Madison,” the major­i­ty said, ​“the Eighth Amendment requires, and the state must find, that he’ll under­stand why.” Expressing no opin­ion on the ulti­mate ques­tion of Madison’s com­pe­ten­cy, the Court returned the case to the state courts for a new com­pe­ten­cy deter­mi­na­tion using the cor­rect legal stan­dard. In a fiery dis­sent the major­i­ty dis­missed as ​“high dud­geon,” Justice Alito, joined by Justices Thomas and Gorsuch, accused the Court of ​“mak[ing] a mock­ery of our rules” and reward­ing a defense ​“trick” by decid­ing the case based on an argu­ment he claimed was not raised in Madison’s peti­tion for cer­tio­rari. Kagan respond­ed that Madison’s peti­tion had ​“pre­sent­ed two ques­tions — the same two we address here.” Justice Kavanaugh did not par­tic­i­pate in the case.

Madison’s lawyer, Bryan Stevenson of the Equal Justice Initiative, said he was ​“thrilled that today the Court rec­og­nized that peo­ple with demen­tia like Vernon Madison, who can­not con­sis­tent­ly ori­ent to time and place, are pro­tect­ed from exe­cu­tion and cru­el and unusu­al pun­ish­ment under the Eighth Amendment.” Stevenson said that “[p]rison­ers with demen­tia or severe men­tal ill­ness are extreme­ly vul­ner­a­ble,” and called the Court’s deci­sion ​“enor­mous­ly impor­tant if our sys­tem is going to func­tion in a humane and just man­ner.” Alabama Attorney General Steve Marshall derid­ed Madison’s com­pe­ten­cy claim as an attempt to ​“evade” jus­tice and pre­dict­ed that Alabama’s state courts would again rule that Madison is com­pe­tent to be exe­cut­ed.

(Jordan S. Rubin, Roberts Casts Swing Vote for Death Row Inmate With Dementia, Bloomberg Law, February 27, 2019; Supreme Court says inmate can­not be exe­cut­ed if demen­tia means he can­not under­stand pun­ish­ment, Washington Post, February 27, 2019; Adam Liptak, Supreme Court Rules for Death Row Inmate With Dementia, New York Times, February 27, 2019; Andrew Chung, U.S. top court backs killer who for­got crime in death penalty case, Reuters, February 27, 2019.) See U.S. Supreme Court and Mental Illness.