The U.S. Supreme Court in February issued two opinions on when people with mental disabilities are eligible for the death penalty.

In Madison v. Alabama, decided February 27, the Court held that the Eighth Amendment does not prohibit executing a person who has no memory of the crime they committed so long as the person understands the reasons for their death sentence. The Court further held that, in applying this standard, the person’s particular mental disability or illness is not important. What is important is whether the person, due to any mental disability or illness, cannot understand the reasons for their death sentence.

And in Moore v. Texas, decided February 19, the Court, in a very fact-specific opinion, again ruled that Texas courts improperly applied the Court’s rulings on intellectual disability in finding that Bobby Moore was not intellectually disabled.


Vernon Madison was sentenced to death in 1985.

In 2015 and 2016, he suffered major strokes, and now has dementia and memory loss such that he can no longer remember the crime he was convicted of.

Alabama courts had previously denied relief on grounds that even though Madison did not remember his crime, he was competent to be executed because the he did not have paranoia, delusions or psychosis. And the U.S. Supreme Court had previously denied habeas relief under the highly deferential Antiterrorism and Effective Death Penalty Act (AEDPA) standard, because Madison could not show that the Alabama courts had unreasonably applied clearly established federal law.

When Alabama set an execution date in 2018, Madison again returned to state court to argue that his mental condition precluded execution, and that since the courts’ last decisions, he had suffered further mental decline.

The Alabama courts again denied relief. Madison appealed to the Supreme Court.

As an initial matter, the Court held that “because the case now comes to us on direct review of the state court’s decision (rather than in a habeas proceeding), AEDPA’s deferential standard no longer governs.”

Turning to the merits, the Court held that Madison’s case presents a straightforward application of Panetti v. Quarterman, 551 U.S. 930 (2007), which held that the Eighth Amendment prohibits the execution of a person whose mental illness prevents them from rationally understanding why the State seeks to impose the death penalty.

“The first question presented is whether Panetti prohibits executing Madison merely because he cannot remember his crime,” the Court said.

That answer is no, the Court held, because “a person lacking memory of his crime may yet rationally understand why the State seeks to execute him.”

As an analogy, the Court said that a person may not remember their first day of school, “[b]ut if your mother told you years later that you were sent home for hitting a classmate, you would have no trouble grasping the story.”

“[S]imilarly, if you somehow blacked out a crime you committed, but later learned what you had done, you could well appreciate the State’s desire to impose a penalty.”

Such memory loss still factors into the “rational understanding” analysis that Panetti requires, the Court said. “If that loss combines and interacts with other mental shortfalls to deprive a person of the capacity to comprehend why the State is exacting death as a punishment, then the Panetti standard will be satisfied.”

“The second question raised is whether Panetti permits executing Madison merely because he suffers from dementia, rather than psychotic delusions,” the Court said. Alabama argued that mere dementia was not sufficient to bar execution, because it was not a mental illness like psychosis.

But “[w]hat matters is whether the person has the ‘rational understanding’ Panetti requires – not whether he has any particular memory or any particular mental illness,” the Court held.

“In evaluating competency to be executed, a judge must … look beyond any given diagnosis to a downstream consequence,” the Court said. Panetti is “utterly indifferent to a prisoner’s specific mental illness.”

The Court remanded the case for further consideration in light of these standards.

Justice Alito, joined by Justices Thomas and Gorsuch, dissented. Justice Kavanaugh did not participate.


In 2015, Texas courts held that Bobby Moore did not have intellectual disability, and thus, was eligible for the death penalty.

The Supreme Court reversed that holding Moore v. Texas in 2017. The Court held that Texas courts had overemphasized Moore’s adaptive strengths and behavior in prison, and used other factors that had no grounding in prevailing medical practice.

On remand, Texas courts again found that Moore was not intellectually disabled. In a per curiam opinion, the Supreme Court again reversed.

The Court chastised Texas courts for essentially readopting their prior rulings, despite the Court’s decision in Moore I. “We have found in [the Texas court’s] opinion too many instances in which, with small variations, it repeats the analysis we previously found wanting, and these same parts are critical to its ultimate conclusion,” the Court said.

The Texas court had again overemphasized adaptive strengths, rather than adaptive deficits; relied heavily on Moore’s behavior in prison; and relied on Moore’s ability to read and write based on pro se papers Moore had filed in court, without any determination whether Moore himself had actually written the papers.

The Texas court also ruled that Moore failed to show that his deficient social behavior was not caused by “emotional problems.” But the Supreme Court had said in Moore I that a personality disorder or mental-health issue is not evidence that a person does not also have intellectual disability.

The Court found that “Moore has shown he is a person with intellectual disability,” and remanded the case.

Justices Alito, Thomas and Gorsuch dissented.