JUSTICE AND AID FOR THE MENTALLY ILL
Who's crazy - the people on the inside or the outside?
Russell Weston, the paranoid schizophrenic who killed two U.S. Capitol
Police officers in 1998, is not getting treatment for his
because if he were treated and recovered enough to stand
trial, he might
get the death penalty.
In other words, to stave off the threat of execution, he has
To cure him could kill him.
His lawyers, on the outside, apparently think this is
humane. By not treating a treatable disease and relieving
pain, they are
conceivably saving a life.
Who's crazy now?
The death penalty has introduced this medical paradox.
that states are not allowed to execute the insane. In 1992,
Supreme Court decided that the state could not mandate
treatment in order
to make a convict well enough to be executed. The
scheme would violate the prisoner's constitutional rights to
protection from cruel and unusual punishment.
So Michael Owen Perry, a paranoid schizophrenic who blasted
away with a shotgun nearly 20 years ago, remains on death row,
loudly to himself about God, the Mafia and Olivia Newton-John,
to news reports.
How do we feel about letting people slowly succumb to a
there is treatment available to help them?
This is what happened in the terrible Tuskegee experiment half
ago when black Americans were left without effective treatment
syphilis so researchers could study the natural course of the
The Clinton administration officially apologized for that
Withholding treatment when effective therapy is available and
could benefit from it is, on the face of it, immoral.
But the death penalty has turned medical ethics upside down.
To be sure, the purpose of medicine is to relieve suffering
patients overcome illness and injury.
Advances in psychiatric
better drugs, better therapeutic services - have brought new
the mental health field.
At the same time, physicians are also supposed to follow the
Medicating patients so that they can be executed would
constitute "doing harm." In this way, physicians can
themselves not treating a treatable problem. It is a choice
lesser of 2 harms.
"The eventual suffering of death is worse than suffering
treatment," says Michael Perlin, professor of law at New
York Law School.
"What is the most suffering? What is less
As Perlin points out, physicians inflict suffering on their
the time in order to prevent death. Look at invasive surgeries
powerful drug treatments: open heart surgery that cracks open
reroutes blood vessels and toxic chemotherapy that wipes out
system. These "harmful" treatments are prescribed in
the pursuit of a
cure - to prevent the greater harm of dying from the disease.
So, how harmful can it be to go without medication for
non-treatment can prevent the greater harm of dying by
Today about 3,700 people are on death row. Many have some form
illness. But very few are too insane to be executed.
being found mentally incompetent is hard to reach," says
executive director of the Death Penalty Information Center.
that anybody gets spared for this reason."
There's not a lot of sympathy for people who have been
horrendous crimes, no matter what their state of mind.
But the paradox, where to cure 'em is to kill 'em, does
grievous harm to
the medical profession.
Physicians and mental health workers
care of prisoners can't be "good" doctors - neither
good-moral. "It puts conscientious mental health
professionals in a very
difficult position," says Michael Radelet, chairman of
department at the University of Florida and author of
That violation of medical ethics has broader implications.
people think of the death penalty, the medical paradox on
defies common sense - and common decency.
(source: Washington Post)