Connecticut authorities can forcibly administer anti-psychotic medicine on a mentally ill doctor charged in the murder of a Yale University physician so he can be competent to stand trial, the state Supreme Court ruled Tuesday. 
 
 Justices released a 7-0 decision that rejected the appeal of Lishan Wang, whose lawyer argued that medicating Wang against his will would violate his constitutional rights to a fair trial and to mental and physical bodily integrity, as well as conflict with a 2003 U.S. Supreme Court ruling restricting involuntary medication of defendants. 
 
 Wang, a Chinese citizen from Beijing, is charged with murder in the 2010 fatal shooting of Dr. Vajinder Toor outside Toor's home in Branford. He is also charged with attempted murder on allegations he shot at Toor's pregnant wife, who wasn't injured. Wang has pleaded not guilty, and he has insisted he is competent and doesn't need medication. 
 
 Authorities say the shooting appeared to stem from a 2008 workplace dispute Wang had with Toor and other doctors when they worked together at Kingsbrook Jewish Medical Center in New York City. Wang was fired from the medical center that year after a series of confrontations with Toor and other colleagues. 
 
 Wang represented himself in the case until a judge ruled him incompetent last year and assigned a public defender. In November, New Haven Superior Court Judge Thomas O'Keefe Jr. ruled that state officials could forcibly medicate Wang to make him competent to stand trial and that doing so would not violate Wang's constitutional rights or the 2003 U.S. Supreme Court ruling. O'Keefe's decision was put on hold pending the Supreme Court appeal. 
 
 A main issue in the appeal was whether prosecutors showed that it was "substantially likely" that forcing medication on Wang would restore him to competency. The "substantially likely" standard was set — but not specifically defined — in 2003 by the U.S. Supreme Court, which said the government can force medication on mentally ill criminal defendants only in the rarest of circumstances and only if certain conditions are met. 
 
 The Connecticut Supreme Court said state prosecutors met those conditions and concluded that it was substantially likely that Wang would be restored to competency with medication. State justices relied on the testimony of a state psychiatrist, who said the chances of success in restoring Wang to competency with recommended medications was in a percentage range from the mid-50s to 70. 
 
 Wang's public defender on the appeal, Mark Rademacher, argued that a projected success rate of mid-50s to 70 percent did not make it "substantially likely" that Wang would be restored to competency. The Supreme Court disagreed and defined "substantially likely" as "more likely than not, or a greater than 50 percent probability." 
 
 "They just set the bar too low before they can violently restrain a patient, knock him out with a sedative and inject him with medication," Rademacher said Tuesday. "It's an extremely serious thing to do and shouldn't be taken lightly." 
 
 Rademacher said he will be deciding whether to appeal the state Supreme Court ruling to a federal court, possibly the U.S. Supreme Court. 
 
 Prosecutor Nancy Walker has said the ruling by O'Keefe in November did not violate Wang's rights or the U.S. Supreme Court restrictions. She said his case is based on the sound medical advice of experts and is one of the rare instances where forced medication is allowed. ||||| (CBS Connecticut) — The Connecticut Supreme Court today found that the state can forcibly medicate a man accused of killing a Yale doctor. 
 
 Mentally ill Doctor Lishan Wang does not want to take medication that could make him competent to stand trial. 
 
 But in its decision, the state Supreme Court confirmed that it is substantially likely that Wang would be made competent by the medication, and that it is unlikely he will suffer from side effects. 
 
 The court also found no less-intrusive option exists, and that the drugs are in Wang’s medical best interest. 
 
 Wang is charged with shooting and killing Yale Doctor Vajindor Toor outside Toor’s home in Branford. 
 
 The defendant was also accused of shooting at Toor’s pregant wife, but missing. ||||| On Wednesday, Scott Panetti will become the latest American prisoner to be put to death in apparent disregard of the constitutional ban on executing the insane 
 
 Nearly two decades after the US supreme court outlawed the execution of severely mentally ill people, Andre Thomas was placed on Texas death row for killing his estranged wife, his four-year-old son and his one-year-old stepdaughter while carrying out what he believed was an order from God to exorcise their demons. 
 
 He cut out his children’s hearts and part of his wife’s lung then tried to stab himself to death. When that failed he put the organs in his pocket and walked home. Reading the Bible in prison a few days later, he came across a passage from Matthew: “If thy right eye offend thee, pluck it out.” He gouged out his right eye. 
 
 Diagnosed with paranoid schizophrenia, he was subsequently treated and deemed fit to stand trial two months later. In court, prosecutors argued that his violent behaviour was explained by drink and drugs while clawing out his eye was simply a moment of madness. In 2005, a jury gave him the death penalty. 
 
 In 2008, he pulled out his left eye and ate it. The following year, in rejecting an appeal, a judge with the Texas court of criminal appeals wrote: “This is a sad case. [Thomas] is clearly ‘crazy’ but he is also ‘sane’ under Texas law.” 
 
 This is a sad case. [He] is clearly ‘crazy’ but he is also ‘sane’ under Texas law. 
 
 Another man wedged in this logic-defying legal conundrum is set to receive a lethal injection on Wednesday at 6pm local time in the Texas death chamber in Huntsville, near Houston. Barring the success of last-minute appeals, Scott Panetti will become the latest American prisoner to be put to death in apparent disregard of the constitutional ban on executing people with mental illness. 
 
 Panetti’s attorneys have issued a flurry of appeals to various courts and a determined campaign for clemency is backed by evangelical religious leaders and influential conservative figures such as the libertarian Ron Paul. 
 
 But on Monday, the Texas board of pardons and paroles voted unanimously not to delay Panetti’s sentence or recommend it be commuted to life. Earlier in the day the Wisconsin native’s lawyers asked the supreme court for a stay. They also appealed to the outgoing Texas governor, Rick Perry, to grant a 30-day reprieve. 
 
 The plea to Perry is probably a long shot. In 2004 he rejected a rare recommendation of clemency from the pardons board for Kelsey Patterson, a schizophrenic man who heard voices and believed the military had planted a mind-control device inside his head. Three years earlier, Perry vetoed a bill that would have banned executing the mentally disabled. 
 
 In the past, Perry vetoed a bill that would have banned executing the mentally disabled. Photograph: Laura Skelding/AP 
 
 ‘I am the Prince of God and I will rise again’ 
 
 Judicially killing mentally ill inmates is not a phenomenon unique to Texas – last year, Florida put to death John Ferguson, a man with paranoid schizophrenia whose last words were “I am the Prince of God and I will rise again.” But even since the supreme court’s 1986 ruling, Texas prosecutors have shown a tenacious desire to secure death penalty convictions regardless of medical evidence, and juries have frequently been persuaded to mete out the ultimate punishment. The state’s appeals courts and the highly conservative federal fifth circuit appellate court have shown scant inclination to overturn original trial verdicts – no matter how problematic. 
 
 Among contentious cases in recent years: Texas death row inmate Steven Staley is a delusional paranoid schizophrenic man with an IQ of 70, right on the intellectual disability threshold. For years, prosecutors sought the right to medicate him forcibly so they could make him competent enough for execution, but in 2013 the Texas court of criminal appeals stopped the involuntary medication on the basis that a district court had overstepped its authority. 
 
 In 2002, Texas executed Monty Delk, who on death row covered himself in feces and claimed to be a submarine captain and an agent with the FBI and CIA. His last words were: “I’ve got one thing to say, get your warden off this gurney and shut up. I am from the island of Barbados. I am the warden of this unit. People are seeing you do this.” 
 
 Before Panetti shot dead his parents-in-law in the Texas hill country in 1992, he had been hospitalised more than a dozen times for illnesses including schizophrenia, delusions and manic depression 
 
 Then – off his medication – he insisted on representing himself at his 1995 trial. Frequently incoherent, wildly unfocused and rambling, and referring to an alter ego called “Sarge”, he dressed in a purple cowboy suit and called veterinarians to the witness stand rather than mental health experts. His actions seemed to intimidate jurors, who at the time did not have the option to sentence him to life without parole. Soon after he was convicted, he was found incompetent to represent himself for the appeals process. 
 
 ‘Rational understanding’ in an irrational system 
 
 Mentally ill criminals do not have the same level of protection from capital punishment as other categories of vulnerable people, notably juveniles and people who are intellectually disabled. 
 
 In 2005, in a 5-4 ruling, the US supreme court banned the execution of anyone under 18, citing “national consensus” and evidence that minors are too immature to be held fully accountable for their crimes. 
 
 In a 2002 case known as Atkins v Virginia, the court prohibited the execution of people they termed “mentally retarded” because it would violate the eighth amendment’s prohibition of “cruel and unusual punishment” – though, problematically, the court left it up to individual states to determine the mental disability threshold. Texas issued criteria partly based on the character of Lennie from the John Steinbeck novel Of Mice and Men. 
 
 But Panetti has not so far profited from a notable supreme court case bearing his name. In a key ruling from 1986, Ford v Wainwright, the supreme court held that it is unconstitutional to execute the mentally incompetent. Then, in a 2007 judgment known as Panetti v Quarterman, the court added detail by declaring that death row inmates must have a rational understanding of the reason for their executions. 
 
 ‘Mentally ill people can be perfectly normal for weeks or years then suddenly have a psychotic break,’ said Stephen Bright. Photograph: Steve Atkins/Alamy 
 
 However, the justices left the definitions of key criteria such as rational understanding and competency up to lower courts. This absence of a clear standard has allowed a series of courts to find that even though there is no question that Panetti is seriously mentally ill, he is still eligible for the death penalty. As one federal court put it: “The test for competency to be executed requires the petitioner know no more than the fact of his impending execution and the factual predicate for the execution.” 
 
 In a decision worthy of Catch-22, the fifth circuit ruled last year that since Panetti was rational enough to argue at trial that he is insane, he is sane enough to be executed. 
 
 Other courts have since affirmed that the 56-year-old is eligible to be put to death because he has a “rational understanding” of his situation. But the argument that Panetti truly comprehends the cause and effect of his punishment would appear undermined by his delusion that he is being executed as part of a satanic plot that involves Texas prison officials conspiring to silence him because they want to stop him preaching the gospel. 
 
 “I think that intersection of law and psychiatry has always been very murky and subjective and in fairness mental illness is very hard to understand in comparison with [intellectual disability],” said Ron Honberg at the National Alliance on Mental Illness. 
 
 “In some cases, the mental illness surfaced while the person was incarcerated but in Scott Panetti’s case there has been a steady, consistent, unremitting pattern of delusional thinking,” he said. 
 
 I think that intersection of law and psychiatry has always been very murky and subjective 
 
 “One lesson here is the supreme court needed to be more specific in explaining what it meant. Procedures and criteria need to be developed by lower courts in assessing the competency of such individuals.” An estimated 5-10% of death row prisoners have a serious mental illness, according to the advocacy group Mental Health America. 
 
 ‘Well, he’s not that bad’ 
 
 Stephen Bright, president and senior counsel of the Southern Center for Human Rights, believes that people with mental disorders suffer in a legal system that is generally indifferent to those on the margins of society and inexact in the way it defines and understands mental illness. 
 
 “Mentally ill people can be perfectly normal for weeks or years then suddenly have a psychotic break. It’s not as easily put in a compartment [as other disabilities] so the courts just don’t deal with it,” he said. “It’s such an uncertain area, there’s always somebody who’s going to say, ‘Well, he’s not that bad.’” 
 
 Despite Panetti’s illness history stretching back long before he committed murder, state medical experts have indicated in court documents that they believe his symptoms are to some extent faked. 
 
 US senator and potential 2016 Republican presidential candidate Ted Cruz, then Texas solicitor general, argued before the supreme court in 2007 that Panetti was a malingerer and that possessing “rational understanding” was too high a bar, which opened the door to con artists and risked throwing a wrench into the works of the state’s well-oiled machinery of death. Instead, Cruz proposed, only those inmates who are so deficient that they lack the capacity to comprehend their punishments should be put to death. 
 
 The death chamber at Huntsville prison, Texas. Photograph: Joe Raedle/Getty Images 
 
 Panetti’s legal representatives argue that they should be afforded time and court-designated funds to further litigate their claim that he is incompetent. He last had a competency hearing in 2007, according to his lawyers, who say that his mental health has deteriorated further in recent months and that he believes prison officials implanted a listening device in one of his teeth and tracked him through bugs placed in Halloween pumpkins. 
 
 In 2006, he told an interviewer he had scars on his body from burns that were healed by John F Kennedy using coconut milk in the Pacific during the second world war, the New York Times reported. 
 
 Last week the Texas court of criminal appeals twice refused to issue a stay, saying that it did not have jurisdiction. But fissures among the court’s nine judges have become evident. 
 
 Tom Price, a Republican whose term expires next month after 18 years as a Texas appeals judge, issued a dramatic dissent in which he said that Panetti’s execution would be unconstitutional, arbitrary and have no benefit. Moreover, he no longer supports the death penalty at all. 
 
 He wrote: “Based on my specialized knowledge of this process, I now conclude that the death penalty as a form of punishment should be abolished because the execution of individuals does not appear to measurably advance the retribution and deterrence purposes served by the death penalty; the life without parole option adequately protects society at large in the same way as the death penalty punishment option; and the risk of executing an innocent person for a capital murder is unreasonably high.” 
 
 Another conservative, Elsa Alcala wrote in her dissent: “This court, at best, deprives appellant of a fair opportunity to litigate his claims, thereby violating the constitutionally required procedural protections recognized in Ford. At worst, this Court’s decision will result in the irreversible and constitutionally impermissible execution of a mentally incompetent person.”
– Lishan Wang, a Chinese doctor charged with murder in Connecticut, can be forced to take anti-psychotic medication in order to be competent enough to stand trial, the AP reports. The state Supreme Court ruled Tuesday it wouldn't be a violation of the mentally ill Wang's rights to forcibly medicate him. As laid out in a 2003 US Supreme Court ruling, prosecutors had to show it was "substantially likely" the medication would make Wang competent to stand trial. A state psychiatrist testified there was a 50% to 70% chance of that happening. While Wang's public defender, Mark Rademacher, argues that doesn't meet the threshold, the state Supreme Court ruled 7-0 that anything greater than 50% constitutes "substantially likely." The court also ruled there wasn't a "less-intrusive option" to forcibly medicating Wang and that he was unlikely to have side effects from the medication, CBS Connecticut reports. Rademacher may appeal the decision to the US Supreme Court. "They just set the bar too low before they can violently restrain a patient, knock him out with a sedative, and inject him with medication," he tells the AP. Wang is charged with fatally shooting Dr. Vajinder Toor and shooting at Toor's pregnant wife in 2010 outside their Connecticut home. Wang was fired from his job in 2008 after multiple confrontations with Toor and other doctors. Wang maintains that he's not guilty and doesn't need medication.