Keywords: medical standard, intellectual disability, capital punishment
Moore, a death row inmate, challenged his sentence, arguing that he had an intellectual disability. A Texas state court found him to have an intellectual disability, using modern medical standards. However, the Texas Criminal Appeals Court overturned that decision based on older, lay standards. Here the Supreme Court vacated the Texas Criminal Appeals Court’s decision, and held that modern medical standards must be used when determining the intellectual functioning status of a prisoner facing the death penalty.
In 1980, Bobby James Moore (“Moore”), a 20-year-old African American man, was convicted of capital murder following a robbery, wherein he shot and killed a store clerk. Although a federal habeas corpus court later vacated that sentence, Moore was resentenced to death in 2001, which was affirmed by the Texas Criminal Court of Appeals (“CCA”). Moore again sought review of this sentence, and in 2014 a Texas state court conducted a hearing to determine whether Moore was intellectually disabled.
The state court concluded that Moore had significant difficulty with both mental and social functioning since an early age. The record showed that Moore was separated from his class in school and was unable to keep up with lessons, dropped out of high school after failing every subject in the ninth grade, and lacked basic understandings of time, days of the week, and months of the year. In determining that Moore was intellectually disabled, the state court consulted current medical diagnostic standards from the 11th edition of the American Association on Intellectual and Developmental Disabilities (“AAIDD”), which defines three core elements for diagnosing intellectual disability: (1) significant limitations in intellectual functioning, indicated by an IQ score of roughly 70, adjusted for standard error of measurements, (2) significant limitations in adaptive behavior, which includes conceptual, social, and practical skills, and (3) “the onset of these deficits while still a minor.”
The state court found that Moore met this standard. The average of his six IQ tests came out to a score of 70.66. The testimony of several mental-health experts showed significant deficits in adaptive behavior. And the evidence showed the onset of these difficulties from at least age 13. Ultimately, the state court recommended that the CCA reduce the sentence from death to life imprisonment, or grant a new trial with consideration of the state court’s findings.
The CCA rejected the recommendations of the state court, denied Moore relief, and instead reaffirmed their 2004 decision in Ex Parte Briseno, stating that Briseno set the standard for consideration of intellectual disability in Texas death penalty cases. Ex parte Briseno, 135 S.W.3d 1 (Tex. Crim. App. Feb. 11, 2004). Briseno used a definition and standard for assessing intellectual disability from the 1992 edition of the American Association on Mental Retardation’s (“AAMR”) manual. This test requires that adaptive deficits be related to intellectual functioning deficits, and includes seven factors to determine whether adaptive and intellectual deficits are sufficiently related, without citation to any authority, medical or otherwise. Briseno also set a specific benchmark IQ of 70, above which there cannot be a finding of “sub-average general intellectual functioning.”
The CCA held that by failing to use the Briseno standard, the state court’s decision was in error. The CCA argued that the Supreme Court left standards of enforcement for determining intellectual disabilities up to the States, and that the Briseno standards remain adequately informed despite medical advancements.
More specifically, the CCA rejected as unreliable five of Moore’s IQ tests, and held that Moore scored an average of 76 points. The CCA further held that Moore did not sufficiently prove a relationship between intellectual and adaptive deficits, as required by the Briseno standard and factors. The CCA also credited several of Moore’s “adaptive strengths”, such as living on the streets, mowing lawns for money, and committing the crime in a sophisticated way, without attributing any weight to his adaptive weaknesses. The U.S. Supreme Court granted certiorari to review the case.
The basis of the Court’s Eighth Amendment analysis is the text, specifically the prohibition against cruel and unusual punishment and the need to honor the dignity of all persons. This language informs all Supreme Court precedent in this area of law as well. Atkins v. Virginia and Hall v. Florida are the two leading cases on this topic cited by the Court.
The holding from Atkins is that the Constitution restricts the powers of the States to impose the death penalty on any person with an intellectual disability. They concluded that executing people with intellectual disabilities serves no penological purpose, is against national consensus, and is likely not justified in the face of factors that call for a less serious punishment.
The Supreme Court held in Hall that, even if a defendant’s IQ score is above 70, States must entertain other evidence of intellectual disability. States, therefore, do not have unfettered discretion, and must be informed by “the medical community’s diagnostic framework” in order to comply with the requirements of the Eighth Amendment. Although States do not need to meet strict adherence to everything the medical community says or recommends, under Hall, they are also forbidden from entirely disregarding it.
In the current case, the Supreme Court held that the CCA’s conclusion that Moore was not intellectually disabled, based only on an IQ score above 70, was error. Hall first and foremost requires a court to consider the standard error of measurement when the score is close to 70; doing so, the Court points out, “yields a range of 69 to 79,” based on the score of 74. And because the lower range is below 70, the State was required to hear further evidence of Moore’s adaptive functioning.
Further, the Supreme Court held that, what consideration the CCA did give to Moore’s adaptive functioning still fell short of modern, and even older, clinical standards for evaluating that type of evidence.
The CCA further erred by characterizing Moore’s adaptive weaknesses as either a product of his childhood abuse, or as evidence of a personality disorder. The medical community considers childhood abuse to be a “risk factor” for people with intellectual disabilities, meaning that if childhood abuse occurs, it is likely to exacerbate the symptoms of the intellectual disability later in life. Further, personality disorders are considered “comorbidities” with intellectual disabilities, meaning they often occur together. The presence of a personality disorder does not preclude an intellectual disorder, and if both are present they will likely cause the symptoms of the other to be more severe.
The Supreme Court then discussed the Briseno factors. They held that these factors, which used lay perceptions of intellectual disabilities, created a high risk that people with intellectual disabilities would be executed. The Court pointed out that these factors rely primarily on stereotypes, asking, for example, whether the defendant shows leadership in their conduct, whether the defendant’s conduct in response to external stimuli is rational and appropriate, or whether the defendant can hide facts or lie effectively in their own or others interests.
Further, the Court noted that the Brisano factors were outliers when compared to the standards used by other States’ handling of intellectual disability death penalty cases. They also are outliers when compared to Texas’s treatment of intellectual disabilities in other contexts, such as juvenile cases, where they apply the latest standards from the medical community. The Court noted that Texas could not satisfactorily explain the discrepancy.
Ultimately, the Court held that States must be informed by modern medical standards during determinations of intellectual disability for defendants facing the death penalty. Because the court previously, in Atkins, held that states were constrained in their ability to execute people with intellectual disabilities, they add the further constraint, modern medical standards, to protect the holding in Atkins.The Supreme Court also held that the analysis from the state court was correct, because they applied current medical standards when they determined that Moore had an intellectual disability. By rejecting that opinion and relying on outdated standards and stereotypical factors, the CCA did not meet the above standard of being informed by modern medical standards. Therefore, the Supreme Court vacated the decision of the CCA and remanded the case
This case is different from many other cases brought by prisoners with disabilities, in that it is not related to Moore’s treatment while in prison. Those cases often rely on the Eighth Amendment in conjunction with the ADA and the Rehabilitation Act. The ADA and Rehabilitation act, however, do not apply in this instance. Those laws are aimed at ensuring that qualified prisoners with disabilities have the same access to programs and benefits afforded to other prisoners. Moore was therefore forced to rely purely on the Eighth Amendment and its prohibition of cruel and unusual punishment. Although this case is at times complex and scientific, it really involves only one point of law, the standard by which States must determine intellectual disabilities in cases involving the death penalty.The Supreme Court in Moore stresses the importance of considering scientific and medical consensus in the area of intellectual disabilities. Instead of relying on outdated stereotyping, this decision ensures that the national restriction against the imposition of Capital Punishment on a person with an intellectual disability will be upheld, by requiring States to use modern medical standards.