Case Study One Worksheet Dr. Eduardo Romaro, a clinically trained forensic psychologist, was retained by the prosecution to evaluate the intellectual competence of John Stone, a 50-year-old man convicted of first-degree murder of a guard during a bank robbery. John had claimed he was innocent throughout the trial. In the state in which the trial was conducted, individuals convicted of such an offense face the death penalty. John’s attorney challenged the death penalty option for his client, claiming that the defendant is intellectually disabled. The U.S. Supreme Court ruled in Atkins v. Virginia (2002) that the execution of those with intellectual disability (formerly known as mental retardation) is unconstitutional. Dr. Romaro had worked with the prosecution before on intellectual disability cases, but this is the first time he had been retained for a capital punishment case. He is personally ambivalent about whether states should implement the death penalty. The psychologist meets John in a private room in the prison and administers a battery of intellectual and adaptive behavior tests with proven psychometric validity for determining forensically relevant intellectual ability. Just as he ends the formal test administration, John becomes distraught and appears to be experiencing an anxiety attack. In his distress the psychologist hears the prisoner repeatedly asking 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 an emergency 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 murder but 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 retardation developmental disability”) requires that individuals demonstrate significantly sub-average intellectual functioning, impairments in adaptive functioning, and onset before 18 years of age. Similarly, the state standard for intellectual disability includes 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——355 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.

1. Case Study One Worksheet
Dr. Eduardo Romaro, a clinically trained forensic psychologist,
was retained by the
prosecution to evaluate the intellectual competence of John
Stone, a 50-year-old
man convicted of first-degree murder of a guard during a bank
robbery. John had
claimed he was innocent throughout the trial. In the state in
which the trial was
conducted, individuals convicted of such an offense face the
death penalty. John’s
attorney challenged the death penalty option for his client,
claiming that the defendant
is intellectually disabled. The U.S. Supreme Court ruled in
Atkins v. Virginia
(2002) that the execution of those with intellectual disability
(formerly known as
mental retardation) is unconstitutional. Dr. Romaro had worked
with the prosecution
before on intellectual disability cases, but this is the first time
he had been
retained for a capital punishment case. He is personally
ambivalent about whether
states should implement the death penalty.
The psychologist meets John in a private room in the prison and
administers a
battery of intellectual and adaptive behavior tests with proven
psychometric validity
for determining forensically relevant intellectual ability. Just as
he ends the formal
test administration, John becomes distraught and appears to be
experiencing
an anxiety attack. In his distress the psychologist hears the
prisoner repeatedly
asking God for forgiveness for killing the guard and for

2. murdering another person,
who he keeps calling “the boy waiting for the bus.” The
psychologist shifts into an
emergency 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 murder
but 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 retardation
developmental disability”) requires that individuals demonstrate
significantly
sub-average intellectual functioning, impairments in adaptive
functioning,
and onset before 18 years of age. Similarly, the state standard
for intellectual disability
includes 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——355
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,

3. 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.”
Respond to the following questions in 300 words each question

4. 1.
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?
Reference
http://www.apa.org/ethics/

5. Fisher, C. B. (2013).
Decoding the ethics code: A practical guide for psychologists
. Thousand Oaks, CA: Sage.