Moreover, in Perry v. Louisiana, 498 U.S. 38 (1990), the Court used that decision to bolster Louisiana's attempts to forcibly medicate a prisoner in order to make him death-eligible. If one agrees that the death penalty is a just penalty for one who has committed a capital crime, and that the reason that mentally ill defendants should not be executed is because they lack competence, then it does not seem unethical to allow them to be forcibly medicated in order to be competent. After all, in that scenario, avoiding medication could be likened to any other attempt to avoid punishment. Moreover, an organic physical disorder that arose after conviction, but that would have prevented a defendant from committing a crime, would not be sufficient reason not to execute a person on death row.
However, forced medication, especially for court appearances, may violate a defendant's Fifth Amendment right to present a defense. After all, if a defendant's defense is based on insanity, or he intends to rely upon a mental illness as one of his mitigating factors, then forcing him to present himself in a medicated state before the factfinder deprives him of a meaningful element of his defense.
In addition, the above arguments rest upon the assumption that these mental illnesses have all arisen in post-conviction settings, because our justice system theoretically embraces the notion that people who were insane at the time of the commission of the crime should not face criminal convictions, but, instead, be diverted into civil commitments or other proceedings, designed to get them assistance and make them "healthy." In addition, our criminal justice system purports to ensure that defendants are competent to stand trial, which would ensure that they are able to participate in their own defenses and not fall prey to the very problems that make the execution of the mentally ill morally questionable, even for advocates of the death penalty. The problem is that those assumptions are simply not warranted.
In fact, for the first time, the Supreme Court's decision in Panetti v. Quarterman, 127 S. Ct. 2842 (2007) seemed to recognize that the criminal justice system simply was not giving adequate consideration to capital defendants' mental statuses. According to Richard Bonnie, the Panetti litigation:
exposes the utter failure of the criminal justice system to take adequate account of the effects of severe mental illness in capital cases, specifically by failing to assure a fair defense for defendants with mental disabilities, by failing to give morally appropriate mitigating effect to claims of diminished responsibility at the time of the crime, and by failing to correct these deficiencies in post-conviction proceedings. Indifference to claims of incompetence on the eve of execution is only the last link in a long chain of indifference and neglect. (Bonnie, 2007).
The history of Panetti dramatically illustrates how mental illness can impact a defendant in all stages of the criminal process. Panetti had a lengthy and well-documented history of mental illness, including more...
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