One option is to "medicate and execute," assuming that sanity is restored under the treatment (the U.S. Supreme Court has held it unlawful to execute a capitally sentenced inmate who has become "insane"). Another option is "don't medicate, don't execute." Under this option an inmate who refuses medication should be allowed to remain "insane" while postponing indefinitely the imposition of the death sentence. The third option is to "medicate, don't execute." Under this option, the state would remit the death sentence and, with the inmate's consent, provide treatment. The author believes that the most ethically acceptable option is to medicate the inmate, forcibly if necessary, and then set the date for and implement the execution. This obviously assumes the moral acceptance of the death penalty itself. The author attaches conditions for the ethical acceptability of this option. First, the inmate must be seriously mentally ill and violent, posing a threat to himself/herself and/or others. Second, the medication administered must be effective, and its benefits must outweigh the negative side effects. Third, the inmate must become sufficiently sane to qualify for execution; i.e., the inmate must be aware of the nature of the punishment and know why it has been imposed. Finally, the death penalty must be justified in the inmate's case. 45 notes