Document Type


Publication Date

Fall 1992


The focus of this article is whether it is ethical for physicians to participate in the evaluation or treatment of condemned prisoners who are incompetent. According to Ward, this may be the "ultimate question, faced by psychiatrists who are asked to deal with execution competency. This article is not intended to offer an answer to this question. Rather, it seeks to (1) elucidate issues connected to the "ultimate question's" resolution, (2) articulate a set of premises within which psychiatrists should evaluate their relationship to institutions whose purposes include punishing criminals, and (3) suggest that, if the death penalty itself is just, then there are no coherent ethical objections to psychiatric participation. Part II of this article offers a brief review of the sociopolitical issues that provide the context for Ford and Perry, as well as brief summaries of those cases. Part III summarizes four types of arguments that advance the view that psychiatric participation is unethical and shows how these arguments are internally inconsistent and are contradicted by our intuitions about the "right" course of action in other situations. Part IV discusses the ethical justification of retributive punishment in a reasonably fair criminal justice system. Particular attention is given to those issues that might trouble psychiatrists contemplating evaluation or treatment of the potentially incompetent condemned. Part V suggests in a reasonably fair criminal justice system, psychiatrists can assume that a condemned criminal has given his hypothetical rational consent to evaluation and treatment, and that this consent provides a moral authorization for psychiatric participation in execution competency proceedings.