Dr. Romaro had asked the prosecutor for all available childhood mental health or

Dr. Romaro had asked the prosecutor for all available childhood mental health or

 

school records to determine if John meets these criteria. No formal educational

 

or psychological evaluations were included in the materials he received. The

 

records indicated that John had a poor academic record, was retained in fifth

 

grade, was suspended several times for coming to school drunk, and had left

 

school when he was 15. State criteria also include an IQ score less than 70 and

 

poor adaptive skills.

 

That evening Dr. Romaro scores the test battery. John’s IQ score is 71, his performance

 

on other cognitive tests fell close to the intellectual disability cutoff score

 

(some above, some below). His adaptive functioning score is a standard deviation

 

below average. However, given the prisoner’s age, without a more detailed set of

 

childhood records, it is difficult to clearly conclude that he meets the DSM-IV-TR

 

or state legal criteria for intellectual disability. Dr. Romaro had not been asked to

 

administer assessments for mood, schizophrenia, or other psychotic disorders that

 

might impair intellectual and adaptive performance.

 

Ethical Dilemma

 

Dr. Romaro is not sure what forensic opinion to give regarding whether or not

 

John meets the legal criteria for intellectual disability. Without evidence of intellectual

 

disability in his youth, a diagnosis of intellectual disability may not be possible

 

and, thus, could not be used to support John’s death penalty appeal. He is also

 

unsure whether he has an ethical responsibility to include in his report John’s

 

“confession” or John’s statement about the “boy waiting for a bus.”