Dr. Death makes another appearance in a landmark U.S. Supreme Court Case. In an earlier, I outlined the case of Barefoot v. Estelle, where Dr. James Grigson stated a defendant was so dangerous he would definitely kill again, despite never having met that defendant. Not exactly psychiatry's proudest moment--and keep in mind, this is a profession that used to scramble people's brains with an ice pick driven through their eye sockets.

In a different murder case from Texas, Dr. Grigson was hired to conduct a pretrial competency evaluation in 1973. The case involved Ernest Smith, who was arrested for participating in an armed robbery where an accomplice killed a grocery store clerk. Dr. Grigson reported that Mr. Smith was competent to stand trial and he labeled Mr. Smith a "severe sociopath." Interestingly, Mr. Smith's defense team had no idea that Dr. Grigson had evaluated him until they received the competency report filed with the court (this would never happen today. The process for obtaining a competency evaluation is clear and open).

Mr. Smith's case went to trial, and a jury convicted him. Prosecutors sought the death penalty, and one of the criteria the jury needed to weigh was the future dangerousness of the convicted defendant. Prosecutors called Dr. Grigson as a witness, who had only met with Mr. Smith for the pretrial, court-ordered competency evaluation. He testified that Mr. Smith remained highly dangerous and thus posed a continued risk to society. But really, did you expect Dr. Grigson to have any other opinion? His nickname was, literally, Dr. Death.

Based largely on Dr. Grigson's testimony, the jury decided the prosecution had made its case, and Mr. Smith was sentenced to death.

As is expected in every death sentence case, Mr. Smith appealed his conviction (in fact, an appeal was mandatory in Texas at the time). The case worked its way through the courts and ended up at the U.S. Supreme Court in October of 1980. Mr. Smith argued that by using the forced competency evaluation in his sentencing phase, his Fifth Amendment Rights against self incrimination were violated.

The Court agreed with Mr. Smith's argument. In their decision from 1981, the Court held, "(1) the admission of the psychiatrist's testimony violated the defendant's Fifth Amendment privilege against compelled self-incrimination, since the defendant was not advised before the pretrial examination that he had a right to remain silent and that any statement he made could be used against him at the sentencing proceeding, the defendant's statements to the psychiatrist when faced while in custody with a court-ordered psychiatric examination not being given freely and voluntarily without any compelling influence so that they could be used at the penalty phase only if the defendant had been apprised of his rights and had knowingly decided to waive them, and (2) the admission of the psychiatrist's testimony violated the defendant's Sixth Amendment right to the assistance of counsel, since defense counsel were not notified in advance that the psychiatric examination would encompass the issue of their client's future dangerousness and the defendant was denied the assistance of his attorney in making the significant decision of whether to submit to the examination and to what end the psychiatrist's findings could be employed, the Sixth Amendment right attaching when the doctor examined the defendant in jail and that interview proving to be a "critical stage" of the aggregate proceedings against the defendant."

In other words, the Court was insistent that Mr. Smith's Fifth Amendment Right had been violated because he was never informed during the court-ordered (in other words, forced) evaluation that he had the right to remain silent and that information he provided to the evaluator would be used against him at sentencing. And, the Court took their decision one step further: they held that Mr. Smith's Sixth Amendment Right to Counsel was violated because his defense team was never notified that the competency evaluation would be used to sentence him to death.

In subsequent cases now codified into state laws, data collected in court ordered competency evaluations cannot be used during the trial or sentencing phases of an individual's court case, unless the defendant raises the issue of his mental health as part of his defense and rebuttal testimony is needed.

Interestingly, in a Texas Court of Criminal Appeals opinion on this case, Judge Wendell Odom wrote, "Dr. Grigson's qualifications as a psychiatrist may be fine, but I find no testimony which qualifies him as an expert in predicting the future...It is my opinion that such future-telling testimony is admissible under no theory of law and prejudicial beyond belief...I am unable to find that much of the testimony offered was from this side of the twilight zone," (From Texas Monthly Magazine, 1978).