court case death penalty

Madison v. Alabama: The Intersection of the Death Penalty and Mental Illness

Emily Steirman

Edited by: Noelle Curtis

The Eighth Amendment of the Constitution bans the infliction of “cruel and unusual punishments.”  An inherently subjective phrase, the understanding of what makes a punishment cruel and unusual is subject to interpretation.  Over the years, the types of punishments deemed cruel and unusual has expanded, including, under varying circumstances, the death penalty.  Various Supreme Court cases have dealt with the circumstances under which the death penalty may be imposed.

Madison v. Alabama, argued last October, asks whether states are prohibited from executing a prisoner who is mentally impaired and unable to remember committing the crime for which they were sentenced, under the Eighth Amendment’s ban on cruel and punishment and the Court’s subsequent jurisprudence, particularly in regards to Ford v. Wainwright and Panetti v. Quarterman.

Madison is the case of a prisoner who has been on death row for over three decades, and in that time has suffered several strokes.  Madison now experiences multiple symptoms of brain damage, including an inability to remember committing the crime he was sentenced to death for.  Madison is suing the state of Alabama, asking the Supreme Court to rule on whether the Eighth Amendment prohibits the execution of mentally disabled individuals, who cannot remember committing the crime they were sentenced for, or cannot sufficiently understand their punishment. 

In Ford (1986), the Court ruled that the execution of the insane is barred by the Eighth Amendment, in a 5-4 decision authored by Justice Marshall and joined by Justices Brennan, Blackmun, Powell, and Stevens.  The opinion relied on the idea that the Eighth Amendment forbids more than just the practices forbidden at the time it was written, as espoused in Gregg v. Georgia, and that the Court therefore takes current values into account in determining whether a punishment is in violation, as espoused in Coker v. Georgia.  In ruling against the execution of the insane, the Court in Ford relied on the prohibition against it in British common law, where much of U.S. law is rooted, and that the execution of the insane was not currently permitted in the United States, writing, “Today, no State in the Union permits the execution of the insane.  It is clear that the ancient and humane limitation upon the State’s ability to execute its sentences has as firm a hold upon the jurisprudence of today as it had centuries ago in England.”  

The Court in Ford further presents several specific arguments against the execution of the insane, particularly that there is a lack of “retributive value of executing a person who has no comprehension of why he has been … stripped of his fundamental right to life,” that there is a “natural abhorrence civilized societies feel at killing one who has no capacity to come to grips with his own conscience or deity,” and that “it provides no example to others and thus contributes nothing to whatever deterrence value is intended to be served by capital punishment.”  While clearly ruling the execution of the insane to be unconstitutional, the Court in Ford does not provide a high degree of specificity in regards to what qualifies an individual as insane in these circumstances, leaving that, whether intentionally or not, up to further interpretation and rulings.

In Panetti (2007), the Court revisited the issue of the execution of the insane, in this case, however, delivering an opinion that dealt primarily with the procedural issues of the case at hand rather than significantly furthering the Court’s jurisprudence on the subject matter.  Perhaps the most substantive section of Panetti is the Court’s interpretation of Ford, finding that a prisoner’s awareness of their sentence and the reasons for it does not necessarily constitute true understanding, and that a prisoner’s mere awareness may be insufficient to deem them competent of execution if their awareness is divorced from reality.  The Court in Panetti thus rejected the Court of Appeals’ application of Ford where it ruled that delusions suffered by a prisoner are irrelevant to determining competency, in that a prisoner’s delusions can impede their understanding.  However, while Panetti did go slightly beyond Ford, the Court explicitly declined to create a specific standard regarding determinations of insanity, writing, “Although we reject the standard followed by the Court of Appeals, we do not attempt to set down a rule governing all competency determinations.”

The generality in Ford, combined with the failure to provide significant specificity in Panetti, leave the current Court with a large amount of flexibility in determining what exact traits of competency are required for a prisoner to be considered sufficiently sane to be executed.  In the case of Madison, the prisoner is significantly mentally impaired, such that he cannot remember committing the crime for which he was sentenced, and it is debatable to what extent he understands his sentence.1

Given that Ford seems to take the view that mental impairment itself, (assuming it renders a prisoner insane,) is sufficient to prohibit execution, and that Panetti explicitly finds that an awareness of one’s punishment is not sufficient evidence of competency to be executed, precedent would seem to be in favor of Madison.  That he is mentally impaired is unquestioned, and while he may be aware of his punishment, such awareness is insufficient to render his execution legal.

While a decision in favor of Madison may be more in line with precedent, predicting what decision the Court will make is further complicated by the Court’s current ideological makeup, especially with the recent appointment of Brett Kavanaugh to replace Justice Kennedy.  As the decision in Ford was a narrow 5-4 ruling by the liberal wing of the Court, the current Court may believe that Ford itself went too far, and therefore be disinclined to expand on the protections laid out in Ford, even if such a decision would be more in line with the theory of jurisprudence underlying Ford and Panetti.  With a new swing vote on the Court and such a vaguely-defined standard as precedent, the Court could go either way in Madison.

Emily Steirman is a sophomore at the Johns Hopkins University, majoring in Political Science and International Studies and minoring in Spanish for the Professions.


1. Garrett Epps, “The Machinery of Death Is Back on the Docket,” The Atlantic, September 18, 2018,

Photo Credit: Getty Images/ Paul Buck

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