The U.S. Supreme Court is considering whether the Eighth Amendment's prohibition against cruel and unusual punishment bars the execution of an inmate suffering severe dementia. Put bluntly, can a state execute a prisoner who no longer remembers his own name, much less committing the capital crime of conviction? In October, the Supreme Court heard oral argument in Madison v. Alabama, a case that will determine whether the Eighth Amendment prohibits the execution of a prisoner whose medical condition deprives him of any memory of his offense.

In 1985, Vernon Madison killed a police officer in Mobile, Alabama. Madison was convicted of capital murder and sentenced to death. While awaiting execution on Alabama's death row, Madison suffered several strokes and was diagnosed with acute vascular dementia; his cognitive functioning is massively impaired and he has a very limited ability to remember events. In particular, Madison cannot recall any details of his crime or trial.

In January 2018, Madison requested a stay of execution. In his petition, Madison claimed that he lacked the competency to be executed. The state court denied Madison's petition, but the Supreme Court granted the stay—and ultimately a full writ of certiorari—in order to consider Madison's Eighth Amendment claim.

Madison argued that his execution would violate the Eighth Amendment's ban on cruel and unusual punishment and would contravene U.S. Supreme Court precedent barring the execution of mentally disabled or insane prisoners, see Panetti v. Quarterman (2007) (mentally disabled); Ford v. Wainwright (1986) (insane). Additionally, Madison stated that his execution would not serve the underlying rationales of the death penalty; because Madison does not understand why he is being executed, his execution would not deter future crimes and would not punish Madison for his crime.

By contrast, Alabama maintained that whether Madison remembers his crime is not dispositive in determining whether he may be executed for that crime. Rather, Alabama contended that Madison understands the reasons for his execution and therefore may be executed in accordance with the Eighth Amendment. In support of this argument, Alabama relied on the findings of the court-appointed psychologist, who concluded that “Madison has a rational understanding that he is to be executed for killing a police officer in 1985.”

At oral argument, Chief Justice John Roberts took a lead role in trying to clarify the issues presented in Madison's case. For Roberts, the first issue was whether “someone who doesn't remember the details of their crime” is properly analogized to the examples of insane or disabled prisoners whose execution has been held unconstitutional by the Supreme Court. In response to this first issue, Madison's lawyer quickly acknowledged that Madison's inability to remember the details of his crime does not, without more, make his execution unconstitutional.

Second, Roberts stated that the court needed to examine whether dementia meets the Ford standard for incompetence—and therefore renders unconstitutional the execution of a prisoner suffering dementia. On this second point, Thomas Govan, Alabama's deputy attorney general conceded that, “if someone has vascular dementia or any other mental illness, if it precludes them from having a rational understanding of their punishment, and that they will die when they're executed, they would meet the Ford and Panetti standard.” With this concession, Roberts articulated the narrow issue in this case as “whether Madison himself meets the Ford and Panetti standard?”

Alabama did not appear to persuade a majority of the justices that Madison fell short of that standard. Govan explained that “there is no confusion from Madison's perspective” regarding his incarceration or execution. Further, Govan argued that a state court had already decided that, even now, Madison possessed a rational understanding of his crime and execution. Justice Sonia Sotomayor curtly rejected this interpretation, stating that Madison is “just not rational in the way you and I understand it.” Madison's attorney further emphasized that Madison cannot have this understanding because dementia robs its victims of the ability to sustain understanding over a period of time. More fundamentally, Justices Ruth Bader Ginsburg and Elena Kagan appeared to discount Govan's argument that the state court's inquiry into Madison's rationality was sufficiently thorough.

The court could issue its decision anytime between now and June 2019. When announced, the Madison case will provide important insights about the Eighth Amendment's restriction on capital punishment of the mentally disabled.

Stephen A. Miller practices in the commercial litigation group at Cozen O'Connor's Philadelphia office. Prior to joining the firm, he clerked for Justice Antonin Scalia on the U.S. Supreme Court and served as a federal prosecutor for nine years in the Southern District of New York and the Eastern District of Pennsylvania.

Rachel Collins Clarke also practices in the firm's commercial litigation group. Prior to joining the firm, she served as an Assistant District Attorney in Philadelphia and graduated from Georgetown University Law Center.