Supreme Court Extends Eighth Amendment Protections to Prisoners with Dementia


The United States Supreme Court today ruled in favor of EJI client Vernon Madison, a 68-year-old man suffering from severe vascular dementia following multiple life-threatening strokes. The Court held that Mr. Madison, who is legally blind, incontinent, cannot walk without a walker, speaks with slurred speech, and has no memory of the crime or the circumstances that brought him to death row, is entitled to an assessment that recognizes that dementia and other mental conditions are covered by the Eighth Amendment’s ban against cruel and unusual punishment.

“We are thrilled that today the Court recognized that people with dementia like Vernon Madison, who cannot consistently orient to time and place, are protected from execution and cruel and unusual punishment under the Eighth Amendment,” said EJI Executive Director Bryan Stevenson, who argued Mr. Madison’s case. “Prisoners who become incompetent due to dementia and severe mental illness are vulnerable and should be shielded from abusive and cruel treatment. The Court’s opinion affirming the basic principle of a humane system of justice is a significant victory.”

In a 5-3 decision written by Justice Elena Kagan, the Court explained that the Eighth Amendment bars executing a person whose mental disorder makes him unable to reach a rational understanding of the reason for his execution.

The critical question is whether a “prisoner’s mental state is so distorted by a mental illness” that he lacks a “rational understanding” of “the State’s rationale for [his] execution.”  Or similarly put, the issue is whether a “prisoner’s concept of reality” is “so impair[ed]” that he cannot grasp the execution’s “meaning and purpose” or the “link between [his] crime and its punishment.”

Contrary to the State of Alabama’s argument in state court that this precedent does not apply to Mr. Madison because he is suffering from dementia rather than psychotic delusions, the Court held that “a person suffering from dementia may be unable to rationally understand the reasons for his sentence; if so, the Eighth Amendment does not allow his execution.”

The Court reasoned that the standard “focuses on whether a mental disorder has had a particular effect: an inability to rationally understand why the State is seeking execution.” The standard does not require “establishing any precise cause: Psychosis or dementia, delusions or overall cognitive decline are all the same under Panetti, so long as they produce the requisite lack of comprehension.”

The Court returned the case to the state court for renewed consideration of whether Mr. Madison is competent under the Eighth Amendment. It barred the state court from relying on arguments or evidence tainted by legal error, including portions of the experts’ reports and testimony that “expressly reflect[] an incorrect view of the relevance of delusions or memory” as well as other evidence that “might have implicitly rested on those same misjudgments.”