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For AI members only

For AI members only AI index: AMR 51/020/2006 Distribution: PG/SC To: Health Professional Network, Death Penalty

AI index: AMR 51/020/2006

Distribution: PG/SC


Health Professional Network, Death Penalty Network


Health and Human Rights Team


31 January 2006

Execution of death row inmates with a mental illness USA


This action for the health professional and death penalty networks accompanies the report The execution of mentally ill offenders in the USA – summary report (AMR 51/002/2006, launched on 31 January 2006.

The full report (AMR 51/003/2006) will be available on the internet only. A separate action circular (AMR 51/006/2006) has been issued to USA CAP coordinators. In addition a press release (AMR 51/018/2006) is available.

Please liaise between those responsible for health and death penalty networks when undertaking activities.

AI concerns

[The below is taken from the summary report]

By end December 2005, more than 1,000 men and women had executed in the United States of America since executions resumed there in 1977. Dozens of these people had histories of serious mental impairment. Some had mental retardation 1 , others suffered from mental illness, and some were diagnosed with both.

In some cases, there were serious doubts about the defendant’s competence to stand trial – whether they genuinely understood the nature and seriousness of the proceedings against them or had the capacity to assist in their defence. Some had been restored to competency in psychiatric hospitals after their crimes, including with anti-psychotic

1 The report uses the term mental retardation, rather than learning disability, as it is the term used in the USA. Mental retardation / disability is a permanent developmental disability, whereas mental illness may develop and may be treated during one’s lifetime.

medication. Doubts existed also in some cases about the defendants’ competence to plead guilty or to waive trial counsel and to represent themselves

Inadequate legal representation left some juries unaware of the existence or extent of the mental impairment of the person they were being asked to sentence to death. In other cases, protecting their mentally ill clients from the death penalty proved an insurmountable challenge for under-resourced defence lawyers. Perhaps the defendant was medicated and to the jury, appeared remorseless – a highly aggravating factor in the life or death decisions of capital jurors. Or perhaps the defendants’ delusional illness rendered them unwilling to divulge information to a lawyer or doctor believed to be part of a conspiracy against them.

For some, the prosecutor appeared to denigrate evidence of mental disability or even to portray such impairment as a sign of a person’s dangerousness. In some cases, medical professionals joined in an unethical pact with the state to predict with absolute certainty the future threat posed by a defendant.

Amnesty International’s report discusses many cases and includes an illustrative list of 100 people who have been executed in the USA since it resumed judicial killing in 1977. Each of these individuals had suffered from some form of serious mental illness or mental impairment other than mental retardation. 2 As a minimum step, the USA should end the execution of people with serious mental illness. Amnesty International will join the campaign for such an exemption for those with a mental illness, even as the organization continues to seek to persuade the USA to end its use of the death penalty altogether.

Recommended action


Please write to NGOs in your countries who either work on mental health issues or on death penalty issues,

outlining AI’s concerns and enclosing a copy of the report;

requesting a meeting;

asking the NGO to highlight AI’s concerns in their newsletter to their membership; an article could simultaneously be used for membership recruitment if appropriate.

You could also contact your professional associations, for example, your nurses, medical and/or mental health associations,

explaining AI’s concerns and enclosing a copy of the report;

asking them for their position;

asking them to raise AI’s report at their annual general meeting.

proposing to publish an article in their professional journal.


In letter-writing this action will follow the USA CAP circular and will target Alberto Gonzales, US Attorney General, and clemency authorities in Texas, Indiana and Ohio. The reasons for focussing on these states are below.

2 For a list of 40 cases of people with claims of mental retardation who were executed in the USA between 1984 and 2001, see pp 100-101 of the report, USA: Indecent and internationally illegal – The death penalty against child offenders, September 2002,


Texas has carried out numerous executions of those with severe mental illness. The clemency Board has to make a favourable recommendation for clemency to the governor, which he can accept or reject. The Board actually recommended clemency for Kelsey Patterson, a severely mentally ill man, in the spring of 2004, which was virtually unprecedented. We think we can make an impact on the Board in future cases on these grounds.

Indiana : Numerous cases of inmates with severe mental illness have come before the Indiana clemency Board in the last year or so. The case of Arthur Baird resulted in commutation of his sentence, on the grounds of mental illness.

The Indiana Parole Board maintains one set of mandatory and a second set of permissive substantive criteria upon which it may base its clemency decisions. The second set includes "the offender's psychological and psychiatric condition and history." The Board can recommend clemency, but the governor's decision does not depend on it.

Ohio has become one of the top executing states in the country and mental illness has been a big concern in some of these cases. In the general prison system, however, Ohio has invested in mental health treatment for inmates and appears to be a model for reform in this area. We have an opportunity to place extra pressure on the board and encourage conformity with the way those with mental illness are treated by the rest of Ohio's corrections system (beyond death row).

In all letters, please use relevant examples from the list of illustrative cases in the appendix to the summary report, or use the most recent DP/USA Urgent Action where mental illness was an issue. When you are writing to state clemency authorities, select those cases that are relevant to the state you are writing to.

Please follow the guidelines below in your letters to both the Attorney General and the Parole Boards:

Introducing yourself as member of AI’s health professional or death penalty network, saying that you are writing in the context of AI’s report: USA : The execution of mentally ill offenders;

express your concern about the continuing use of the death penalty against people with serious mental illness in the USA;

inviting a response.

In addition, please include the following in letters to the Attorney General:

urging him to do all he can to ensure that Federal prosecutors do not pursue a death sentence against any defendant with a serious mental illness, and that no-one with a claim of serious mental illness is executed.

Please add the following to the clemency authorities:

urging them to ensure that no-one with a claim of serious mental illness is executed in their state.



Federal authorities

Alberto Gonzales Attorney General The Honorable Alberto Gonzales Attorney General, Office of the Attorney General U.S. Department of Justice 950 Pennsylvania Avenue NW Washington, DC 20530-0001 Tel: + 1 202 353 1555 Fax: + 1 202 307 6777 Email:

State clemency authorities


Ms. Rissie Owens, Presiding Officer, Board of Pardons and Paroles

1300 11th Street, Suite 520

PO Box 599 Huntsville, TX 77342-0599 Fax : +1 936 291 8367

The following are all the other members of the Board:

Jose Aliseda, Jr. Charles Aycock Jackie DeNoyelles Linda Garcia Juanita M. Gonzalez

Texas Board of Pardons and Paroles P. O. Box 13401 Austin, Texas 78711-3401 Fax : +1 512 463 8120

Local addresses for Board Members can be obtained through:


Ohio Department of Rehabilitation and Correction Ohio Parole Board

1050 Freeway Drive North

Columbus, Ohio 43229 Fax : +1 614 752 0600

Ms. Cynthia B. Mausser, Acting Chair Mr. Jim Bedra, Member Dr. Sandra Crockett Mack, Member Ms. Betty J. Mitchell, Member Ms. Cheryl Martinez, Member Mr. Peter Davis, Member


Mr. Robert Maszczynski, Member Mrs. Kathleen Kovach, Member Ms. Ellen Venters, Member

The Board can recommend clemency, but the governor's decision does not depend on it.


Indiana Parole Board Indiana Government Center South 302 West Washington, Room E-321 Indianapolis, IN 46204 Fax : +1 317 232 5738

Raymond W. Rizzo, Chairman Valerie J. Parker, Vice Chair Thor R. Miller, Member Randall P. Gentry, Member

Please also write to diplomatic representatives of the USA accredited to your country.

If you receive no reply within six weeks of sending your letter, please send a follow-up letter seeking a response. Please send copies of any letters you receive to the International Secretariat, attention of the health and human rights team or email: