When Treatment Leads to Execution

The case involves Claude Maturana who was sentenced to death 10 years ago for the brutal murder of a 16-year-old boy. While Maturana awaited execution, the court appointed Tucson attorney, Carla Ryan to handle his appeal, a job, she says that proved to be nearly impossible

You'll be talking to him and he'll start talking about the IRS and Interpol, and he'll go into numbers. He'll be talking to you, and then say 714, 8/19/42. And it goes by like that in the whole conversation.

Concerned about his sanity, Ryan asked the court to order a psychiatric evaluation of her client.

Two doctors were appointed, the state selected one of the doctors from the w I selected one. And they both came back very strongly saying my client was not competent.

So what did the court do?

They found him incompetent to be executed, and I sent my client to the state hospital.

There, Maturana was held in solitary confinement, in this specially built maximum security cell and put under the care of the hospital's chief psychiatrist Dr. Jerry Dennis, who diagnosed him as having paranoid schizophrenia. He would believe there were things that he was involved in, world investigations via an electronic device that has been implanted into his brain. Most of the time it involves what he calls world police, the INI, the [? Busu ?], the [INAUDIBLE].

Doctor Dennis agreed that Maturana was incompetent, which meant he could not be executed, unless that is he got better. And under Arizona law, the job of making him better fell to Dr. Dennis. If you gave him aggressive treatment, would he come up to a level that the state would accept as sufficient to put him to death?

That's a very good question. I believe that the probability is there that he would make substantial improvement.

As a Hippocratic Oath that you swear to when you became a doctor, says you shall do no harm, they're asking you to prepare some one to be put to death, which is the ultimate harm.

Yeah, so what do I do?

What he did was to refuse to comply with the law that said he was supposed to treat Maturana.

So I'm in a total no win situation. I'm in violation of law every day his quandary went beyond the law if he had medicated much around a heater violated the American Medical Association's Code of Medical Ethics, which specifically says physicians should not treat a prisoner to restore competence so he can be executed.

What would happen to you in the eyes of your profession, if you did treat Maturana?

I could lose my professional standing as a Board Certified Psychiatrist. You could be sanctioned. I could be sanctioned, lose my license.

Dr. Dennis put Maturana on a low dose of anti psychotic medication, enough to alleviate any suffering, but not enough to affect his paranoid schizophrenia. That infuriated the Arizona Attorney General's office, that felt Dr. Dennis's first duty was to obey the law, not the AMA. So the Attorney General kept pushing for another doctor to treat Maturana.

Jack Silver finally found someone, Doctor Nelson Bennett, a psychiatrist in Georgia who works for a For-Profit company, that provides mental health services to prisons around the country. Doctor Bennett said he was bound by the same Code of Ethics as the other doctors. But for $2,300, he agreed to see if Maturana was suffering in any way. Doctor Bennett wouldn't talk to us, so we asked the hospital CEO, Jack Silver, you found out he was suffering then what?

Well the Code of Ethics is clear, that's the one condition under which you can treat somebody who's in that situation, because it isn't physician's duty to relieve suffering.

Why didn't you rely on Dr. Dennis for that?

Well, Jerry was clear that he didn't believe he was suffering.

Well why have someone come and second guess your own doctor's opinion?

I guess it could be viewed as second guessing

Well what was it?

It was more of that same process of searching the country, searching the state to see if we could find a practitioner that would be willing to evaluate this individual and render a judgment about whether or not they felt they could treat him.

So what was Bennett's conclusion? Was he suffering?

Well, he didn't get that far. He determined that he was competent. He felt that the standard of the law--

Did you ask him to say whether he was competent?

That sort of surprised us that that was his conclusion. It hadn't occurred to us to ask to raise that question.

So you thought he was coming in to tell you whether he was suffering, which he never did.

Right

And he told you that he was competent, which you never asked him to determine.

Right

He spent a few minutes with my client on November 4, saw him again the next day, doing what I basically call a drive by psychological exam, and low and behold, my client's competent by this one doctor.

Carla Ryan was shocked. The opinion of the out of state doctor was nullifying the diagnoses of four other psychiatrists, and there was apparently no avenue of appeal. Dr. Dennis no longer has to choose between obeying the law and the ethics of his profession. The case is now out of his hands. While relieved, he worries that Maturana could now be put to death, even though in his opinion the man is simply not confident, with no idea of what it means to be executed.

HE really doesn't have an understanding of what that means. Believing he's already been killed before, he's been executed before, so he's already dead.

He says he's already dead?

Yes

He believes he's under special protection. He is scheduled to go now to the Vatican, so he can be in exile there, and get away from the situation.

And what outrages Carla Ryan, is that even the out of state psychiatrist who found Maturana competent, confirmed in his report that he believes he's dead. She read to us from that report.

--"Say I am immortal" They shut my heart up all the time in here. I walk around, sometimes for two days with my heart shut off. If I can survive that, maybe I can beat the lethal injection. I mean killing him, he thinks he's dead. He thinks he's already survived it. He thinks they've been executing him for years. This is the doctor who says my client is competent.

So once again, Ryan went back to court, this time to try and get Maturana's death sentence changed, to life in prison without the possibility of payroll. Again she was turned down.

To just proceed to kill somebody who has no concept of what's happening, who doesn't understand, who isn't being punished by it. I mean there's a line that's just morally wrong.

O Ryan vows to press the Maturana case all the way to the US Supreme Court.