By Marissa Ditkowsky
On February 28, 2019, the Supreme Court decided Madison v. Alabama. The Court expanded the previously established tests under Panetti and Ford, holding that executing an individual experiencing dementia who does not comprehend why he is facing execution may violate the Eighth Amendment. On its face, this decision appears to be a win for disabled persons and advocates, since it signals the expansion of exceptions under which capital punishment might be constitutionally prohibited. However, in reality, this standard remains impossible to prove or implement. The fact-specific nature of an inquiry that essentially requires mind reading will still leave many with psychiatric disabilities on death row.
In 1985, Vernon Madison killed a police officer and was subsequently sentenced to death. Madison spent more than thirty years in solitary confinement. Since he began his tenure on death row, he has experienced several strokes and developed vascular dementia, which involves “disorientation and confusion, cognitive impairment, and memory loss.” In reviewing these facts, the Court held that dementia can prevent an individual from rationally understanding why he is on death row, in which case the Eighth Amendment’s prohibition against cruel and unusual punishment would also prohibit the application of the death penalty. The Supreme Court remanded the case for further proceedings to determine Vernon’s capacity.
Although this assertion should come as no surprise, it is important to note that prisons are not only detrimental to mental health, but they also serve as “dumping grounds” for people with psychiatric disabilities. Organizations such as Mental Health America have even called for a moratorium on the death penalty, citing the fact that those with psychiatric disabilities are more likely to be coerced into false confessions and feared or stigmatized by jury members. Mental Health America also highlights other practices that deny people with disabilities of due process and increase the likelihood of error in pursuing the death penalty. The intersections of disability and race also play a pivotal role in this risk of error and lack of due process.
The problem with the Supreme Court’s line of decisions regarding mental health and the death penalty is that it attempts to essentially fit a square into a circle—the Court attempts to assert humanitarian requirements into a practice that is anything but humane. The decision highlights the problematic nature of the death penalty itself, the risk of error, and the sheer lack of protection available for prisoners with disabilities. The Court does not offer a solution that will effectually protect the individuals it aims to protect; instead, it offers a standard that exists but is impossible to apply in individual cases.
The Panetti standard, as expanded under Madison, is unworkable and meaningless. It seems just about as helpful as the standard the Supreme Court established to determine when counsel is required in civil cases. The test the Court established for such cases relies so heavily on specific facts and differs so much in individual cases that courts rarely implement it correctly.  If a right exists, but it cannot be accessed, what is the purpose of such a right? And in this case, the right is not simply the right to raise a child—it is, quite literally, the right to live.
How do we ensure that people with disabilities, or individuals who do not understand why the state seeks to end their lives, are not erroneously killed? The sole answer that is completely fool proof is to obliterate capital punishment altogether. These holdings and tests that the Court establishes attempting to protect marginalized populations are the equivalent of wet Band-aids: they exist to heal the wound, but they are, essentially, unusable and utterly ineffective. Until the Supreme Court finally breaks from its inexplicable precedent that capital punishment is not an inherent violation of the Eighth Amendment, people with disabilities, and people of color, will continue to die disproportionately and, potentially, erroneously.
 Madison v. Alabama, No. 17-7505, slip op. at 1 (U.S. Feb. 27, 2019)
 Id. at 12-14 (U.S. Feb. 27, 2019) (holding the Panetti standard has no interest in establishing any precise cause); see also Panetti v. Quarterman, 551 U. S. 930, 959 (2007) (holding the Eighth Amendment prohibits execution of individuals whose psychiatric disability prevents them from “rational[ly] understanding” why they are receiving the punishment sought); see also Ford v. Wainwright, 477 U. S. 399 (1986) (holding the Eighth Amendment prohibits execution of an individual who develops psychiatric disabilities involving delusions following sentencing).
 Madison v. Alabama, No. 17-7505, slip op. at 3 (U.S. Feb. 27, 2019).
 Id.; Matthew S. Schwartz, Executing Someone with Dementia Might Violate Constitution, Justices Say, NPR (Feb. 28, 2019, 7:21 AM), https://www.npr.org/2019/02/28/698831666/executing-someone-with-dementia-might-violate-the-constitution-court-says
 Madison, slip op. at 3.
 Id. at 12-14.
 Madison v. Alabama, No. 17-7505, slip op. at 17-18 (U.S. Feb. 27, 2019).
 Information Sheet: Mental Health and Prisons, World Health Org., available at https://www.who.int/mental_health/policy/mh_in_prison.pdf.
 Position Statement 54: Death Penalty and People with Mental Illness, Mental Health America, https://www.mentalhealthamerica.net/positions/death-penalty (last visited Feb. 28, 2019).
 See, e.g., The Case Against the Death Penalty, Am. Civil Liberties Union, https://www.aclu.org/other/case-against-death-penalty (last visited Mar. 5, 2019) (arguing the death penalty inherently violates the Constitution).
 See Panetti v. Quarterman, 551 U. S. 930, 959 (2007); see also Madison v. Alabama, No. 17-7505, slip op. at 12-14 (U.S. Feb. 27, 2019).
 See Turner v. Rogers, 564 U.S. 431, 444-45 (2011) (applying the Mathews test to determine whether counsel was required by due process in a specific civil contempt case); Lassiter v. Dep’t of Soc. Servs. of Durham Cnty., 452 U.S. 18 (1981) (refusing to require representation for an indigent client in a case regarding the termination of parental rights).
 See generally Brief for American Bar Association as Amici Curiae Supporting Appellant, Olson v. Olson, No. S-15802 (Alaska 2015), available at https://www.americanbar.org/content/dam/aba/administrative/amicus/olson.pdf.
 See Gregg v. Georgia, 428 U.S. 153, 182-83 (1976) (refusing to hold that the death penalty is per se unconstitutional).