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92 UMKC L. Rev. 153 (2023-2024)
Condemning Those with Multiple Disabilities to Die: Dual Diagnosis of Substance Abuse and Intellectual Disability in Capital Sentencing Proceedings

handle is hein.journals/umkc92 and id is 163 raw text is: CONDEMNING THOSE WITH MULTIPLE
DISABILITIES TO DIE: DUAL DIAGNOSIS OF
SUBSTANCE ABUSE AND INTELLECTUAL
DISABILITY IN CAPITAL SENTENCING
PROCEEDINGS
Aliya Sternstein* and John R. Mills***
I. INTRODUCTION
Ernest Johnson scored significantly below average on intelligence tests at
age twelve; he grew up in a family that subjected him to sexual abuse, violence,
poverty, and a ready supply of drugs; he failed multiple grade levels; and he could
not connect with people socially or care for himself.' Mr. Johnson should not have
been eligible for a sentence of death. The onset of his significantly subaverage
intellectual functioning and struggles to adapt his behavior to his environment
during the developmental period meet the medical criteria for an intellectual
disability (ID)2 diagnosis.3 Nonetheless, Mr. Johnson was convicted and sentenced
to death in Missouri for killing three convenience store employees.'
The Eighth Amendment's protection from cruel and unusual punishments
prohibits executing defendants with ID. This prohibition is rooted in both a
nationwide consensus against the practice and the absence of any justification or
purpose for the punishment.' Therefore, Mr. Johnson's life depended on whether
he was able to prove in court that his condition met the criteria for ID.
But the Missouri Supreme Court read the ID criteria described above to
mean that any of his alleged deficits in adapting behavior must be caused by
intellectual deficits, rather than by struggles with substance abuse.6 Because Mr.
Johnson was unable to prove which specific impairment caused or did not cause
* Aliya Sternstein, JD, is the manager of financial aid programs and research at Georgetown
University Law Center, a contributing author at Georgetown Law's O'Neill Institute for National
and Global Health Law, and an investigative journalist who has written for Atlantic Media, The
Christian Science Monitor, Congressional Quarterly, and Daily Beast, among others. **John R. Mills
is an adjunct professor of law at University of California College of Law, San Francisco, and a
Principal Attorney at Phillips Black, Inc.
I State ex rel. Johnson v. Blair, 628 S.W.3d 375, 386-87 (Mo. 2021).
2 The American Association of Intellectual and Developmental Disabilities (AAIDD) refers to
Intellectual and Developmental Disabilities as an umbrella of disabilities, but references
intellectual disability as the diagnosis of relevance to our paper. See AAIDD, INTELLECTUAL
DISABILITY: DEFINITION, DIAGNOSIS, CLASSIFICATION, AND SYSTEMS OF SUPPORTS 1 (12th ed. 2021).
The DSM uses the language Intellectual Disability (Intellectual Developmental Disorder). See
generally American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders
(5th ed. 2013) (DSM-5). The relevant Supreme Court jurisprudence uses the term intellectual
disability. Hall v. Florida, 572 U.S. 701, 704-05 (2014); Moore v. Texas, 581 U.S. 1, 5, (2017)
(Moore I); Moore v. Texas, 139 S. Ct. 666, 667-72 (2019) (Moore I).
3 Johnson, 628 S.W.3d at 386-87.
4 Id.
5 See Atkins v. Virginia, 536 U.S. 304, 306-07 (2002).
6 Johnson, 628 S.W.3d at 386-87.

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