Executing the Incompetent? Rethinking U.S. Supreme Court Standards on Mental Capacity

Executive Summary

This article examines whether the Supreme Court’s current standards for determining competence to be executed adequately protect individuals with severe cognitive impairments and mental illnesses. While landmark decisions , Ford v. Wainwright (1986), Panetti v. Quarterman (2007), and Madison v. Alabama (2019) , established that a person must possess a rational understanding of the connection between their crime and punishment, critics argue the framework remains unclear, inconsistently applied, and insufficiently protective.

The case of Ralph Menzies, a Utah death row inmate suffering from vascular dementia, illustrates these concerns. Despite serious cognitive decline and an inability to comprehend his punishment, Utah continues to pursue his execution. The Court’s standard leaves wide discretion to the states, creating procedural disparities, frequent “battles of the experts,” and significant hurdles for inmates, who bear the burden of proving their own incompetence.

This raises urgent legal and ethical questions: Does the existing framework adequately prevent unconstitutional executions, or must the burden shift to the states to ensure that no individual is put to death without a clear and rational understanding of why?


Introduction

Punishment in the United States is not supposed to be a random act. Its core function is to communicate society’s condemnation of a crime to the person being punished. While punishment can also serve other purposes , rehabilitation, deterrence, incapacitation,  if it fails to convey this condemnation, it falls short of satisfying the requirements of justice.

This principle carries particular weight when the punishment is death. Even strong proponents of capital punishment generally agree that the meaning of the ultimate penalty must register on the condemned. If an individual cannot comprehend why they are being executed, the constitutional promise of justice loses its force, and the act of execution risks becoming a hollow ritual rather than a legitimate exercise of state authority.


Rethinking U.S. Supreme Court Standards on Mental Capacity

I. The Legal Framework

The Supreme Court has addressed the question of competence to be executed in a trilogy of landmark cases:

  • Ford v. Wainwright, 477 U.S. 399 (1986): The Court held that the Eighth Amendment prohibits executing individuals who are “insane” at the time of execution and requires a competency hearing to assess this condition.

  • Panetti v. Quarterman, 551 U.S. 930 (2007): The Court refined the standard, holding that a person must possess a rational understanding of why they are being executed — not merely factual awareness.

  • Madison v. Alabama, 586 U.S. ___ (2019): The Court clarified that serious cognitive disorders such as dementia fall within the scope of protection; execution is unconstitutional if an individual cannot rationally comprehend the reason for their punishment, even if memory of the crime is absent.

Together, these rulings set the constitutional baseline: executing someone incapable of rationally understanding their punishment violates the Eighth Amendment.


II. Persistent Problems with the Court’s Standard

Despite these precedents, many legal scholars and mental health experts argue that the framework remains inadequate for today’s realities.

1. Undefined “Rational Understanding”

Although Panetti mandates a rational understanding, the Court has never precisely defined this term, leaving lower courts and experts to apply inconsistent interpretations.

2. Inconsistent State Procedures

The Court allows each state to develop its own competency evaluation procedures, generating significant disparities based on geography, expert witness availability, and judicial discretion.

3. Burden on the Inmate

Inmates are presumed competent and must prove themselves unfit for execution,  a high bar, especially for individuals with progressive illnesses like dementia or schizophrenia.

4. “Battle of the Experts”

Competency hearings often devolve into conflicting expert testimony. Courts must weigh whose mental health assessment is most credible, creating inconsistent and sometimes unreliable results.


III. The Menzies Case: A Modern Test of Justice

The case of Ralph Menzies starkly illustrates these challenges. Convicted in 1988 for abduction and murder, Menzies now suffers from vascular dementia, reportedly unable to recall his crime or the proceedings, dependent on oxygen and mobility aids. Still, Utah persists in pursuing his execution.

On August 29, 2025, the Utah Supreme Court temporarily halted his execution and ordered a reevaluation, citing “significant questions” regarding his competency. Yet Utah’s clemency board has never recommended mercy in a capital case, and procedural rules set a low threshold for denying incompetency claims.

The case highlights troubling questions about justice: whether individuals who cannot comprehend their punishment should ever face the death penalty,  and whether current Supreme Court standards offer meaningful protection.


IV. Philosophical and Constitutional Dimensions

Legal philosopher Herbert Morris argued that humans have a “right to be punished” because punishment affirms their autonomy and moral agency. However, that right assumes the individual has the cognitive capacity to understand the punishment. Executing individuals who lack such comprehension denies their status as moral agents and undermines justice itself.

Professors John Blum and Stephen Ceci note that the Supreme Court’s jurisprudence reflects this principle: executing someone without competency “offends humanity” and fails to achieve the legitimate purposes of criminal law. Yet, in practice, inconsistent standards and high evidentiary burdens often leave vulnerable individuals unprotected.

In his September 2025 article in VERDICT,  Amherst professor Austin Sarat “explores the importance of competency in death penalty cases, focusing on whether individuals like Ralph Menzies—who suffer from dementia and cannot comprehend their punishment should be eligible for execution. Professor Sarat argues that executing cognitively impaired individuals violates the core purpose of punishment as a form of moral accountability, and calls for shifting the legal burden onto the state to prove competency in such cases to prevent unjust and inhumane executions”.


Conclusion

The constitutional promise articulated in Ford, Panetti, and Madison is clear: executing someone who cannot rationally understand their punishment violates the Eighth Amendment. But as the case of Ralph Menzies demonstrates, the current framework often fails to uphold this principle.

To ensure justice, many believe courts should shift the burden of proof to the state, requiring prosecutors to demonstrate,  through independent and reliable evaluations,  that a condemned person possesses the capacity to understand the reason for their execution. Without this reform, constitutional protections risk becoming hollow promises, leaving individuals with severe cognitive impairments at risk of execution. In her comment in the Spring-Summer issue of Temple Law Review Danielle Devens argues that…” once the defendant has triggered that hearing process, the presumption of sanity vanishes and the burden should then shift to the government to prove the defendant’s competence”.

In a system meant to uphold justice, punishment without understanding is not justice at all.

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