238 9 Corrections and Prison Practices—Adult Forensicsacknowledge the potential adverse effects that such treatment could have on the
clinician when he or she knows that rendering their services may result in the death
of another human being (Heilbrun et ai, 1992).
On the other hand, those who support treating incompetent death-row inmates
believe that everyone has the right to receive psychological treatment if they so
desire. However, this begs the question: Are incompetent individuals capable ot
providing informed consent? For example, suspected or documented mental retar-
dation is commonly used as a reason for examining a death-row inmate's compe-
tency for execution. In this country to date, 33 individuals with mental retardation
have been executed, including those with the cognitive functioning of a 7-year-old
child (Keyes, Edwards, & Perske, 1998). With this in mind it is questionable whether
such individuals are even capable of providing informed consent. Last, supporters
of treating the incompetent argue that refusing to provide such treatment is nothing
more than a protest against the death penalty and although the principle of doing
no harm applies in nonforensic settings, it is not as applicable to forensic treatment
settings (Heilbrun et al., 1992).
One final issue that is raised in the controversy over treating mentally incom-
petent death-row inmates pertains to medication. As in the case of Horace Kelly,
a psychotic disorder such as schizophrenia is a common mental illness for which
a eompetency-for-execution evaluation may be requested. Psychotic disorders are
most commonly treated by some form of psychotropic medication. Therefore,
death-row inmates who have been found incompetent for execution may be sent
to a state mental hospital to be restored to competency through the administration
of antipsychotic medication. A problem that arises in cases such as these is the fact
that individuals have the right to refuse treatment, including medication (Washington
v. Harper, 1990). However, the United States Supreme Court in Perry v. Louisiana
(1990) foiled to resolve whether a death-row inmate possesses the right to refuse
treatment (B.J. Wimck, 1992).Forensic Psychology and Policy ImplicationsThere are a number of policy implications for the fields of criminal justice and men-
tal health pertaining to the incarceration and execution of the mentally ill. There
was a time in this country when mentally ill individuals were primarily housed in
state mental hospitals. However, the deinstitutionalization of the mentally ill has
in reality reinstitutionalized such individuals in the local jails and state prisons. As
noted by Belcher (1988), mentally ill persons who are homeless or who have been
previously hospitalized are particularly vulnerable to subsequent incarceration. Per-
haps it is society's lack of appropriate means for caring for the mentally ill that leads
to the incarceration of such individuals. Policy reform would do well to introduce
alternative services to the mentally ill that would ensure that they received the
proper treatment needed in order for them to function appropriately in society.