Assessing and restoring competency to be executed: Should psychiatrists participate?


  • Dr. Douglas Mossman M.D.

    Instructor in Psychiatry, Corresponding author
    1. Medical University of South Carolina
    • MUSC Medical Center, 171 Ashley Avenue, Charleston South Carolina 29425-0742
    Search for more papers by this author


Ford v. Wainwright (1986) is one among several recent U. S. Supreme Court decisions granting psychiatrists a distinct but awkward role in the capital punishment process. Ford affirms the right of the condemned to be spared execution while mentally incompetent, and validates state laws requiring psychiatric evaluation and treatment of capital inmates who plead that they have become insane while awaiting execution. The ruling raises troublesome questions for psychiatry, including whether it is ethical for psychiatrists to assess or treat prisoners, thereby enabling their execution. This article argues that evaluation and treatment of capital inmates is in accordance with medical practice standards that emphasize respect for patients' autonomy and rationality.