Sane Enough to Kill?

Court decision shields juries from evidence of psychosis.

It is wrong to punish, much less execute, insane people who commit crimes.

This has been the law since the 19th century. Although standards for applying the insanity defense in criminal matters vary among states, in general, a defendant will be found "innocent by reason of insanity" if "at the time of committing the act, he was laboring under such a defect of reason from disease of the mind as not to know the nature and quality of the act he was doing, or if he did know it, that he did not know what he was doing was wrong."

This is the so-called "M'Naghten rule" established in the 1843 case of Daniel M'Naghten. M'Naghten, suffering from delusions, believed that the pope and the British Prime Minister were conspiring against him. He killed a man as he tried to assassinate British Prime Minister Robert Peel.

Today, about half of the states have modified the insanity defense to a slightly broader standard devised by the American Law Institute. The ALI test holds that a person would "not [be] responsible for criminal conduct if at the time of such conduct as a result of mental disease or defect he lacks substantial capacity either to appreciate the criminality (wrongfulness) of his conduct or to conform his conduct to the requirements of law."

Although television crime dramas may give the public the impression that defendants regularly resort to the insanity defense, this is not the case. A 1991 National Institute of Mental Health study found that the insanity defense was used in fewer than 1 percent of criminal cases and that it is was successful in only 26 percent of those cases. Furthermore, those who successfully argue that they are not guilty by reason of insanity do not just get off. Most are committed to mental health facilities where they are often confined longer than they would have been had they been convicted of the crime they committed.

Which brings us to the case of Charles Laverne Singleton reported on the front page of the New York Times today. In a 6-to-5 decision, the United States Court of Appeals for the 8th Circuit ruled that Singleton could be forced to take anti-psychotic medications to make him sane enough to be executed. Singleton must be forced to take the drugs because the United States Supreme Court has prohibited the execution of insane people.

Singleton murdered a grocery store clerk in Arkansas 24 years ago. Apparently when he was convicted in 1979 he was considered sane, that is, the jury believed that he knew what he did was wrong. However, in capital cases, the appeals process averages longer than 10 years. As Singleton's case was wending its way through that process, he evidently began to experience psychotic delusions. By 1987, Singleton believed that his cell was inhabited by demons and that his doctor had implanted electrodes in him.

It is troubling that courts often require defendants to take psychiatric medications so that they will be "competent" to stand trial. The idea here is that defendants need to be able to participate intelligently in their own defense. However, let's assume that medication actually works, and that a defendant using it is aware of right and wrong and able to conform his or her conduct to the dictates of the law. That still tells us nothing about his or her state of mind when he or she committed the crime in question. In fact, such defendants may well be horrified by what they did while out of their minds. If defendants can be restored by medication to complete sanity, we still don't punish them if they were insane at the time they committed their crimes.

It is true that the defense can offer evidence and testimony about the defendant's state of mind during the commission of the crime, but that evidence will rarely be as effective as actually experiencing someone who is in a psychotic state. A defendant who is sitting medicated in the courtroom would give the jury a very different impression than one who is showing signs of full-blown psychosis. Apparently the U.S. Supreme Court will soon be taking up the issue of whether or not a non-violent defendant can be forced to take anti-psychotic medication in order to be made "competent" for trial.

Setting aside general arguments for and against the death penalty, did the 8th Circuit decide Singleton's case rightly? First, it would clearly be wrong to execute Singleton while he is still delusional. It would be, in the words of Justice Thurgood Marshall, "the barbarity of exacting mindless vengeance." We punish people both to provide an example to others and to exact vengeance. In Singleton's case, executing him while he is delusional will not send a message to other insane people not to murder. Nor would his execution satisfy vengeance in which the wrongdoer knows that his fellow citizens regard his act as so heinous that he must be cut completely out of the life of the community.

But what if Singleton is forced to take anti-psychotic medication and his delusions abate, restoring him to sufficient sanity so that he knows that murdering that grocery store clerk while he was sane in 1979 was wrong? Then perhaps the requirements of being both a warning example and vengeance would be satisfied. Then again, some might say that suffering psychotic delusions for the rest of one's life would be punishment enough.