Case Study One WorksheetDr. Eduardo Romaro, a clinically trained forensic psychologist, was retained by theprosecution to evaluate the intellectual competence of John Stone, a 50-year-oldman convicted of first-degree murder of a guard during a bank robbery. John hadclaimed he was innocent throughout the trial. In the state in which the trial wasconducted, individuals convicted of such an offense face the death penalty. John’sattorney challenged the death penalty option for his client, claiming that the defendantis intellectually disabled. The U.S. Supreme Court ruled in Atkins v. Virginia(2002) that the execution of those with intellectual disability (formerly known asmental retardation) is unconstitutional. Dr. Romaro had worked with the prosecutionbefore on intellectual disability cases, but this is the first time he had beenretained for a capital punishment case. He is personally ambivalent about whetherstates should implement the death penalty.The psychologist meets John in a private room in the prison and administers abattery of intellectual and adaptive behavior tests with proven psychometric validityfor determining forensically relevant intellectual ability. Just as he ends the formaltest administration, John becomes distraught and appears to be experiencingan anxiety attack. In his distress the psychologist hears the prisoner repeatedlyasking God for forgiveness for killing the guard and for murdering another person,who he keeps calling “the boy waiting for the bus.” The psychologist shifts into anemergency crisis intervention mode to help calm the defendant and rings for assistance.Dr. Romaro was shocked to hear John “confess” not only to the bank murderbut also to the murder of a “boy waiting for a bus.”The Diagnostic and Statistical Manual of Mental Disorders, fourth edition(DSM-IV-TR) diagnosis of intellectual disability (currently termed “mental retardationdevelopmental disability”) requires that individuals demonstrate significantlysub-average intellectual functioning, impairments in adaptive functioning,and onset before 18 years of age. Similarly, the state standard for intellectual disabilityincludes a developmental history of intellectual impairment. Prior to testing,FOR THE USE OF UNIVERSITY OF PHOENIX STUDENTS AND FACULTY ONLY.NOT FOR DISTRIBUTION, SALE, OR REPRINTING.ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED.Copyright © 2013 by SAGE Publications, Inc.Appendix B——355Dr. Romaro had asked the prosecutor for all available childhood mental health orschool records to determine if John meets these criteria. No formal educationalor psychological evaluations were included in the materials he received. Therecords indicated that John had a poor academic record, was retained in fifthgrade, was suspended several times for coming to school drunk, and had leftschool when he was 15. State criteria also include an IQ score less than 70 andpoor adaptive skills.That evening Dr. Romaro scores the test battery. John’s IQ score is 71, his performanceon other cognitive tests fell close to the intellectual disability cutoff score(some above, some below). His adaptive functioning score is a standard deviationbelow average. However, given the prisoner’s age, without a more detailed set ofchildhood records, it is difficult to clearly conclude that he meets the DSM-IV-TRor state legal criteria for intellectual disability. Dr. Romaro had not been asked toadminister assessments for mood, schizophrenia, or other psychotic disorders thatmight impair intellectual and adaptive performance.Ethical DilemmaDr. Romaro is not sure what forensic opinion to give regarding whether or notJohn meets the legal criteria for intellectual disability. Without evidence of intellectualdisability in his youth, a diagnosis of intellectual disability may not be possibleand, thus, could not be used to support John’s death penalty appeal. He is alsounsure 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.”Respond to the following questions in 300 words each question1.     Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma?2.     How might Dr. Romaro’s ambivalence toward the death penalty influence his decision to offer a forensic diagnosis of intellectual disability? How might John’s “confession” or his comment about the “boy waiting for the bus” influence the decision? To what extent should these factors play a role in Dr. Romaro’s report?3.     How are APA Ethical Standards 2.0f, 3.06, 4.04, 4.05, 5.01, 9.01a and 9.06 relevant to this case? Which other standards might apply?http://www.apa.org/ethics/4.     What steps should Dr. Romaro take to ethically implement his decision and monitor its effect?Referencehttp://www.apa.org/ethics/Fisher, C. B. (2013). Decoding the ethics code: A practical guide for psychologists. Thousand Oaks, CA: Sage.

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