The capital punishment debate in America took a ghoulish new twist when a federal appeals court decided that a mentally ill inmate on Death Row could be treated with anti-psychotic drugs to make him sane enough to be executed.
In a 6-5 vote, the Eighth Circuit court in St Louis found "involuntary medication followed by execution" was "a better choice" than the withholding of drugs followed by psychosis and imprisonment.
The ruling is likely to go to appeal at the Supreme Court, which, in 1986, barred the execution of insane prisoners.
The case that has created new anger among opponents of the death penalty involves Charles Singleton, who was convicted of killing an Arkansas grocery store worker in 1979. He has been on Death Row ever since.
In 1987, his mental health began to worsen. He came to believe his prison cell was inhabited by demons and a prison doctor had implanted a device in his ear. Singleton has subsequently been administered anti-psychosis drugs, sometimes voluntarily, sometimes by force.
The hearings in St Louis involved Arkansas prison officials arguing that Singleton had to be medicated to prevent him being a danger to himself and to others. But, his defence insisted, that forcible medication became illegal once his execution date was set, because it was no longer in his ultimate medical interest.
The defence also argued that without drugs the prisoner could not understand his punishment. And, one dissenting judge wrote in a minority opinion, "receiving treatment is not the same as being cured. Drug-induced sanity is not the same as real sanity." That judge acknowledged doctors treating a mentally ill convict faced an "untenable" choice between making the convict fit for execution, or withholding treatment and condemning him to Singleton's life of hallucination and delusions. For foes of the death penalty, the answer is simple: abolish it for all prisoners in this predicament.
The American Medical Association agrees, holding it unethical for a doctor to give treatment that makes someone competent to be put to death.
In October 2001, a panel of the Eighth Circuit ruled that Singleton should be sentenced to life without the possibility of parole. The state appealed, and the court has now reversed that decision.
The Death Penalty Information Centre, an anti-capital punishment group, says 44 mentally ill people were executed between 1976 and 2002.
In one instance, Governor Bill Clinton of Arkansas left the 1992 presidential campaign to fly home for the execution of Rickey Ray Rector, a murderer who blew away part of his brain in a suicide attempt after he shot and killed a police officer. Rector was so brain-damaged, his lawyers said, that he asked that his dessert of pecan pie be put aside for him to eat as a snack after his execution. Clinton rejected Rector's final appeal for clemency.