Commutation of death sentence
This is a problem that has faced a number of doctors in the USA. The advice from the American Medical Association is that doctors should not treat to restore competence in a condemned prisoner unless a commutation order is issued, or the prisoner experiences extreme suffering as a result of psychosis or other illness and where the treatment is given to mitigate suffering. Generally speaking this is helpful, but to protect the doctor from the dichotomy of goals of restoring them to health for execution, must mean that doctors should press for seriously mentally ill condemned prisoners to have their death sentences commuted.
In the recent case of Charles Singleton outlined above, the courts refused to commute the death sentence. They ordered that treatment should be forced on the prisoner to relieve the suffering caused by his mental illness. The courts recognised that in returning him to competence this would allow his execution but stated that this was not the purpose of the treatment and was therefore not material in the decision. It is exactly this dichotomy that leads to the ethical advice to doctors to insist on the death sentence being commuted.