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Handbook of Forensic Psychiatric Practice in Capital Cases


Te legal test for ‘fitness for execution’ in common law jurisdictions relies upon a case from the USA, that of Ford v Wainwright.


Comprehension of execution


A mental health expert may be asked to comment on a person’s capacity to comprehend the nature of the death penalty and why it has been imposed upon him, as well as upon the significance of any mental disorder from which he suffers, for such ability.


Te test is based upon the notion that execution can only be applied to individuals who are aware of the nature of the punishment and why they are sentenced to such punishment, including having a moral comprehension of ‘culpability’ and ‘retribution’. And if, for example, the perpetrator is not able to make a moral connection between the crime and the punishment, then such punishment is considered to fail in its retributive function.


Te American Bar Association test might assist in understanding the possible purpose of mental health evidence:


A convict is incompetent to be executed if, as a result of mental illness or mental retardation, the convict cannot understand the nature of the pending proceedings, what he or she was tried for, the reasons for the punishment or the nature of the punishment. A convict is also incompetent if, as a result of mental illness or mental retardation, the convict lacks sufficient capacity to recognise or understand any fact which might exist which would make the punishment unjust or unlawful, or lacks the ability to convey such information to the court


Te clinical interview should consider, therefore, these different facets in relation to any diagnosed medical or psychiatric condition, specifically the convict’s:


• Understanding of the reasons for punishment • Understanding of the nature of the punishment itself, including its finality • Ability to reason and weigh up matters relevant to his current legal situation • Ability to provide instructions to legal representatives


Assessment and reporting on fitness for execution


Clinical assessment will be directed particularly at the questions raised immediately above, whilst any report should be directed to issues as they are raised by lawyers for the convict.


Recommendations concerning treatment ‘to make fit’ Where the cause of unfitness for execution is potentially reversible, such as where the condition is a severe psychosis, the ‘impossible question’ arises for any doctor responsible for the convict in the prison, or any doctor advising on fitness on the instructions of the convict’s lawyers, as to whether


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