Charles Laverne Singleton, a delusional inmate on death row in Arkansas, believes the woman he was convicted of killing in 1979 is still alive. He also thinks his prison cell is possessed by demons and that doctors planted a chip in his ear. Drugs help control some of the hallucinations. But after a disturbing federal ruling last week, the drugs that treat his disease might now be administered with grave consequence. The Eighth Circuit Court of Appeals held that Arkansas officials can force a prisoner to take medication to make him sane enough to execute. The decision overturned a ruling which had commuted Singleton’s death sentence because, without drugs, he could not understand his punishment.

The prospect of the state-sanctioned killing of a man suffering from a serious mental illness is shameful. It underscores the cruel inhumanity of the U.S. institution that most of the civilized world has discarded as a relic of a brutal past. The death penalty remains, in the words of Justice Thurgood Marshall, as the “barbarity of exacting mindless vengeance.” And that vengeance is most often visited upon the nation’s most vulnerable – the poor and the mentally ill.

Yet most Americans continue to favor it, according to opinion polls, as a matter of deterrence and to offer victims a sense of retribution. Many are, however, increasingly skeptical of its fairness in application, and with good reason. A Columbia University report found 68 percent of all death sentences reviewed by appellate courts between 1973 and 1995 had been reversed because of serious error. DNA evidence in several cases in Illinois cast enough doubt to prompt the former governor to commute the death sentences of the state’s 164 prisoners.

Retribution or mindless vengeance, it is a crime and morbidly ironic, that, while many of the 2.5 million law-abiding Americans suffering from schizophrenia do not receive treatment, Singleton will receive medication so he can be killed. Given the bitter debate and severe questions residing in the application of the death penalty, this could be the cruelest cut of all.