Amicus Curiae Brief — Jeffrey Hutchinson, Petitioner v. Ricky D. Dixon, Secretary, Florida Department of Corrections

Supreme Court briefMay 1, 2025

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No. 24-7117

IN THE SUPREME COURT OF THE UNITED STATES

_________________________________________________________

JEFFREY GLENN HUTCHINSON,

Petitioner,

-vSECRETARY, FLORIDA DEPARTMENT OF CORRECTIONS,

Respondent.

__________________________________________________________

On Petition for a Writ of Certiorari to the

Eleventh Circuit Court of Appeals

__________________________________________________________

BRIEF OF MENTAL HEALTH ADVOCACY GROUPS AS AMICI CURIAE IN

SUPPORT OF PETITIONER

__________________________________________________________

JOHN R. MILLS

Counsel of Record

PHILLIPS BLACK, INC.

1721 Broadway, Suite 201

Oakland, CA 94612

888-532-0897

j.mills@phillipsblack.org

RAISA ELHADI

NATHALIE GREENFIELD

PHILLIPS BLACK, INC.

P.O. Box 3547

New York, NY 10008

MELANIE C. KALMANSON

NICOLE PERKINS

QUARLES & BRADY LLP

101 East Kennedy Blvd.,

Suite 3400

Tampa, FL 33602

COUNSEL FOR AMICI

TABLE OF CONTENTS

TABLE OF CONTENTS ..................................................................................................i

TABLE OF AUTHORITIES .......................................................................................... ii

BRIEF OF AMICI CURIAE ........................................................................................... 1

INTEREST OF AMICI.................................................................................................... 1

SUMMARY OF ARGUMENT ........................................................................................ 3

ARGUMENT ................................................................................................................... 4

PROPERLY UNDERSTANDING A PRISONER’S MENTAL

HEALTH IS CRITICAL FOR DETERMINING THE

CONSTITUTIONALITY OF AN EXECUTION .................................................. 4

The Eighth Amendment Prohibits Executing a Prisoner Who

Does Not Rationally Understand the Reason for His Execution................ 4

Military Service Like Mr. Hutchinson’s Has a Profound Impact

on Veterans’ Mental Health ................................................................................ 6

Delusional Disorder Can Be Difficult to Diagnose Without an

Adequate Examination ...................................................................................... 14

II.

THE PROCEEDINGS BELOW FAILED TO ADEQUATELY

CONSIDER MR. HUTCHINSON’S MENTAL ILLNESS............................... 17

The Governor’s Commission’s Examination of Mr. Hutchinson

Was Insufficient ................................................................................................... 17

The Lower Court’s Determination that Mr. Hutchinson Is

Competent to Be Executed Does Not Comport with the Record

or Science .............................................................................................................. 22

III.

EXECUTING MR. HUTCHINSON NOT ONLY VIOLATES THE

CONSTITUTION BUT DISCOUNTS THE SIGNIFICANCE OF

MENTAL ILLNESS................................................................................................. 24

CONCLUSION .............................................................................................................. 25

TABLE OF AUTHORITIES

Cases

Ford v. Wainwright, 477 U.S. 399 (1986) .................................................................. 4, 5

Hutchinson v. State, No. SC2025-0590, slip op. .......................................................... 17

Madison v. Alabama, 586 U.S. 265 (2019) .................................................................... 5

Panetti v. Quarterman, 551 U.S. 930 (2007) ................................................................. 5

Other Authorities

AM. PSYCHIATRIC ASS’N, THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL

DISORDERS (5th ed. 2013) .......................................................................................... 18

BESSEL VAN DER KOLK, THE BODY KEEPS THE SCORE (2014) .................................. 8, 18

Carolyn E. Fulco, et al., Gulf War and Health Volume 1. Depleted Uranium, Sarin,

Pyridostigmine Bromide, and Vaccines 199 (2000) ................................................. 16

Charles Hoge et al., Combat Duty in Iraq and Afghanistan, Mental Health

Problems, and Barriers to Care, 351 N. ENGLAND J. MED. 13 (2004) ............... 12, 18

Chemical & Biological Weapons during Gulf War, U.S. DEP’T OF VETERANS AFFS. .. 10

Committee on Gulf War and Health, Gulf War and Health: Volume 7: Long-Term

Consequences of Traumatic Brain Injury, NAT’L ACADS. OF SCIS., ENG’G, AND MED.

(2009 ..................................................................................................................... 11, 15

Committee on Gulf War and Health, Gulf War and Health: Volume 9: Long-Term

Effects of Blast Exposures, NAT’L ACADS. OF SCIS., ENG’G, AND MED. (2014) ............ 9

Ebele Compean & Mark Hamner, Posttraumatic Stress Disorder with Secondary

Psychotic Features (PTSD-SP): Diagnostic and Treatment Challenges, 88

PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSY. 265 (2019) ........ 13

Howard E. LeWine, MD, Delusional Disorder, HARVARD HEALTH PUBLISHING (Jan.

27, 2025) ..................................................................................................................... 21

James Binns et al., Gulf War Illness and the Health of Gulf War Veterans: Research

Update and Recommendations, 2009-2013, RSCH. ADVISORY COMM. ON GULF WAR

VETERANS’ ILLNESSES 1 (2014) .................................................................................. 13

Joel J. Silverman, The American Psychiatric Association Practice Guidelines for the

Psychiatric Evaluation of Adults, 172 AM. J. PSYCHIATRY 798 (2015) .............. 23, 25

Joel N. Meyer et al., Bioenergetic Function is Decreased in Peripheral Blood

Mononuclear Cells of Veterans with Gulf War Illness, PLOS ONE, 21 (Nov. 1,

2023) ........................................................................................................................... 14

JUDITH HERMAN, TRAUMA AND RECOVERY (1992) ........................................................... 9

Karen H. Seal et al., VA Mental Health Services Utilization in Iraq and Afghanistan

Veterans in the First Year of Receiving New Mental Health Diagnoses, 23 J.

TRAUMATIC STRESS 5 (2010) ...................................................................................... 18

Lea Steele et al., Brain–Immune Interactions as the Basis of Gulf War Illness:

Clinical Assessment and Deployment Profile of 1990–1991 Gulf War Veterans in

the Gulf War Illness Consortium (GWIC) Multisite Case-Control Study, 11 BRAIN

SCI. 1132 (2021). ........................................................................................................ 15

Melanie Kalmanson & Bridget Maloney, Repairing the “Sea of Disorganized”

Procedures Used for Determining Competency for Execution, 49 L. & PSY. REV.

(forthcoming 2025) .................................................................................................... 23

Nagesh Pai & Shae-Leigh Vella, Delusional Disorder: A Comprehensive Narrative

Review, 24 INT’L J. OF CLINICAL STUDIES & MED. CASE REP. 1 (2023) .................... 19

NAT’L TOXICOLOGY PROGRAM, PUB. HEATH SERV., U.S. DEP’T OF HEALTH & HUM.

SERVS., NTP Monograph on the Systematic Review of Long-term Neurological

Effects Following Acute Exposure to Sarin at G-15 (2019)...................................... 17

Raymond R. Crowe & Marc-Andre Roy, Delusional Disorders, in S.H. FATEMI & P.J.

CLAYTON, EDS., THE MEDICAL BASIS OF PSYCHIATRY 127 (2008) ....................... 19, 21

Richard Dieter, Battle Scars: Military Veterans and the Death Penalty, DEATH

PENALTY INFO. CTR. 10 (2015) ..................................................................................... 7

Salla Konopen et al., MRI findings and Axis I and II psychiatricdisorders after

traumatic brain injury: A 30-year retrospective follow-up study, 146 PSYCHIATRY:

NEUROIMAGING RSCH. 263 (2006) ............................................................................ 21

Salla Koponen et al, MRI findings and Axis I and II psychiatric disorders after

traumatic brain injury: A 30-year retrospective follow-up study, 146 PSYCHIATRY

RSCH: NEUROIMAGING 263 (2006) ............................................................................. 10

iii

Sean X. Naughton et al., Permethrin Exposure Primes Neuroinflammatory Stress

Response to Drive Depression-like Behavior Through Microglial Activation in a

Mouse Model of Gulf War Illness, 21 J. NEUROINFLAMMATION 222 (2024) ............. 16

Shawn M. Joseph & Waquar Siddiqui, Delusional Disorder, NIH (Mar. 27, 2023) .. 20

U.S. Dep’t of Veterans Affs., Gulf War Veterans’ Medically Unexplained Illnesses –

Public Health 36-37 (Jan. 31, 2025) ......................................................................... 14

U.S. Dep’t Veterans Affairs, Airborne Hazards and Burn Pit Exposures,................... 8

William Brown, Spinning the Bottle: A Comparative Analysis of Veteran-Defendants

and Veterans Not Entangled in Criminal Justice, in BROCKTON HUNTER AND RYAN

ELSE (EDS.) THE ATTORNEYS GUIDE TO DEFENDING VETERANS IN CRIMINAL COURT

128–30 (2014) ............................................................................................................... 7

Rules

S. Ct. Rule 37................................................................................................................... 1

BRIEF OF AMICI CURIAE1

INTEREST OF AMICI

Collectively, amici possess a deep knowledge of the operation of legal

practices affecting the administration of criminal law and capital punishment in the

United States. In particular, they are familiar with the intersection of severe

mental health concerns and competency to be executed. They offer this brief to

explicate their concerns that Jefferey Hutchinson may be executed despite lacking a

rational understanding of why the State of Florida seeks to kill him.

Advancing Real Change Inc.: Advancing Real Change, Inc. (“ARC”) is a national

not-for-profit organization that seeks to create a more just world through advancing

empathy, dignity, and equity within and beyond the legal system. It

provides mitigation investigation in criminal cases, with a focus on capital cases in

Florida and throughout the country. A significant part of the organization’s

programming involves training and education of over 2,000 criminal defense

practitioners annually regarding the effective collection and presentation of

mitigating evidence through a trauma-informed lens. ARC has focused trainings on

understanding the experiences of veterans and the impacts military service has on

those who face capital and other criminal charges especially as it relates to mental

health concerns.

Pursuant to Rules 37.2(a) and 37.6, Amici certify that no party or party’s counsel authored this

brief in whole or in part and that no party or party’s counsel made a monetary contribution intended

to fund the preparation or submission of this brief. All counsel of record received timely notice of

Amici’s intent to file this brief more than ten days prior to its due date.

Conservatives Concerned: Conservatives Concerned is a network of political and

social conservatives who question the alignment of capital punishment with

conservative principles and values. Their programs include educating conservatives

about the failed death penalty system.

Dr. Joseph Thornton, MD: Dr. Thornton is a board-certified psychiatrist and a

Distinguished Fellow of the American Psychiatric Association, who teaches patient

safety and ethical practice. Dr. Thornton is interested in maintaining the integrity

of ethical practice in circumstances of clinical uncertainty, including a decision that

preserves life.

Florida Justice Institute: Florida Justice Institute is a non-profit public interest

law firm that uses impact litigation to improve the lives of Florida’s poor and

disenfranchised residents, while focusing on criminal justice reform, homelessness

and poverty, disability access, and other civil rights issues.

Revolution Therapy: Revolution Therapy is a clinical and forensic mental

health organization providing specialization in trauma therapy and relational

health as well as the provision of capital and non-capital sentencing mitigation and

assessments. Revolution Therapy has an interest in promoting an informed and

accurate understanding between the legal system and the field of clinical mental

health practice and research, with the goal of supporting the healthy functioning

and overall well-being of individuals with mental illness who come into contact with

the legal system in any capacity.

SUMMARY OF ARGUMENT

This Court has made very clear that the Eighth Amendment to the U.S.

Constitution prohibits executing a prisoner who does not rationally understand the

reason for his execution. Yet its current caselaw is too ambiguous, allowing for the

severely mentally ill to be wrongly executed. Jeffrey Hutchinson does not rationally

understand why Florida seeks to execute him, and his execution should not be

allowed to proceed based on the current record.

Mr. Hutchinson served our country in the U.S. military, first in the U.S.

National Guard and then in the U.S. Army, where he saw combat duty as an Army

Ranger. He served in the 1990 Gulf War, where he experienced brutal violence,

exposure to chemical weapons and toxic substances, and multiple artillery

explosions in combat. His service to our nation resulted in long-term physical and

mental disabilities, including post-traumatic stress disorder, Gulf War Illness, and

traumatic brain injury, all of which left him with significant cognitive defects.

Additionally, since returning from war, Mr. Hutchinson has suffered from

delusions related to his military service. For over 20 years—his entire time on

Florida’s death row—Mr. Hutchinson has believed that the crimes underlying his

conviction and death sentence were part of a government conspiracy meant to

silence him from speaking about the horrors he experienced during the Gulf War.

The lower court’s decision that Mr. Hutchinson is competent for execution is

based on a flawed and medically deficient examination by the Governor’s

Commission—the fastest on record and contrary to years of evidence in the record

that Mr. Hutchinson does not rationally understand the reason for his imminent

execution. Allowing Mr. Hutchinson’s execution to proceed would result in the most

extreme and irreversible Eighth Amendment violation and a blatant disregard for

persons suffering from mental illness across the country, including those with

illnesses caused by their service to our country.

ARGUMENT

PROPERLY UNDERSTANDING A PRISONER’S MENTAL

HEALTH

CRITICAL

FOR

DETERMINING

THE

CONSTITUTIONALITY OF AN EXECUTION

The Eighth Amendment Prohibits Executing a Prisoner

Who Does Not Rationally Understand the Reason for His

Execution

In response to Alvin Bernard Ford’s challenge to Florida’s attempt to execute

him, another case from Florida, this Court established that it violates the Eighth

Amendment to execute a person who is insane at the time of execution. Ford v.

Wainwright, 477 U.S. 399, 409-10 (1986); see also U.S. CONST. amend. VIII. The

Court reasoned that when a prisoner “has no comprehension of why he has been

singled out and stripped of his fundamental right to life,” the execution serves no

legitimate retributive purpose. Ford, 477 U.S. at 409. Recognizing the severity and

finality of capital punishment, the Court emphasized that procedures used to

determine a prisoner’s competency for execution must meet heightened standards of

fairness and reliability. Id. at 411.

While the Ford majority declined to define the precise standard for

competency, Justice Powell’s concurring opinion articulated that the Eighth

Amendment forbids the execution of those “who are unaware of the punishment

they are about to suffer and why they are to suffer it.” Id. at 422 (Powell, J.,

concurring). More than two decades later, the Court revisited the Ford standard in

Panetti v. Quarterman, 551 U.S. 930 (2007). There, the Court clarified that the

Eighth Amendment protects not only prisoners who are unaware of their

punishment, but also those whose mental illness distorts their understanding of the

reason for their execution. Specifically, the Court held that the Eighth Amendment

bars the execution of a prisoner whose mental illness prevents him from having a

“rational understanding of the reason for the execution.” Id. at 958–59. The Court

rejected the Fifth Circuit’s narrower test, which had focused only on factual

awareness, explaining that delusions may “put an awareness of a link between a

crime and its punishment in a context so far removed from reality that the

punishment can serve no proper purpose.” Id. at 960.

The Court further clarified this standard in Madison v. Alabama, 586 U.S.

265 (2019), where it considered whether the protections of Ford and Panetti extend

to prisoners whose mental incompetency stems not from psychotic delusions but

from other conditions, such as dementia. See id. at 274-78. The Court determined

that it does, holding that the relevant inquiry is whether the prisoner has a rational

understanding of the reason for his execution—not whether he suffers from a

particular mental illness. Id. at 267–68.

Together, Ford, Panetti, and Madison establish that the Eighth Amendment

forbids executing individuals who, due to serious mental illness or cognitive decline,

lack a rational understanding of the reason the State seeks to carry out their death

sentence.

prisoner’s

mental

illness—whether

psychosis,

delusions,

schizophrenia, or dementia—prevents him from comprehending the link between

his crime and the punishment, the execution violates the Constitution.

Military Service Like Mr. Hutchinson’s Has a Profound

Impact on Veterans’ Mental Health

Combat veterans make immense sacrifices to serve their country. In combat

zones, death and injury are daily and brutal occurrences. Combat servicemen and

women see people blown apart before their eyes, have to kill and injure others, and

endure the loss of friends, superiors, and fellow soldiers. Richard Dieter, Battle

Scars: Military Veterans and the Death Penalty, DEATH PENALTY INFO. CTR. 10

(2015). A study of the traumatic experiences of veterans in Iraq found that 88.5% of

veterans witnessed dead bodies or human remains during their tour of duty, 83.8%

witnessed the death or serious injury of an American soldier, and 31.2% directly

caused the death of an enemy combatant. William Brown, Spinning the Bottle: A

Comparative Analysis of Veteran-Defendants and Veterans Not Entangled in

Criminal Justice, in BROCKTON HUNTER AND RYAN ELSE (EDS.) THE ATTORNEYS

GUIDE TO DEFENDING VETERANS IN CRIMINAL COURT 128–30 (2014).

Added to these horrors are the dangerous environmental conditions endured

by Gulf War veterans. Those deployed during the Gulf War were frequently exposed

to burn pits, which create airborne hazards so dangerous that the Department of

Defense has since closed all burn pits. See U.S. Dep’t Veterans Affairs, Airborne

Hazards

and

Burn

Pit

Exposures,

https://www.publichealth.va.gov/exposures/burnpits/index.asp (last accessed Apr.

12, 2024). The health risks of exposure to these burn pits were sufficiently direct

and expansive that the U.S. Department of Veterans Affairs (“the VA”) designated a

broad range of “presumptive conditions” resulting from a veteran’s exposure to burn

pits, including multiple cancer forms—among them glioblastoma, genitourinary

cancers, and respiratory cancers—pulmonary fibrosis, and bronchitis. See id.

Likewise, the adverse health impact was so ubiquitous that the VA advises all

veterans who served in the Gulf to seek medical care and apply for compensation.

See id.

Veterans who served in the Gulf War, as Mr. Hutchinson did, have made

vital contributions to national and international security, often at a heavy cost to

their lives and livelihoods. The returning veteran is different from the soldier who

left home. See BESSEL VAN DER KOLK, THE BODY KEEPS THE SCORE 223 (2014)

(American soldiers “perform[] very well in combat” but “cannot tolerate being

home.”).

That cost includes a toll on their mental health. Returning veterans “[bring]

with them indelible experiences of the battlefield [and are] left to traverse as best

they [can] the immense divide between knowing and not knowing, between military

and civilian life.” JUDITH HERMAN, TRAUMA AND RECOVERY 347–48 (1992). These

wounds manifest in the form of damaged bodies and scarred psyches.2 Indeed, the

record in this case is replete with statements from Mr. Hutchinson’s family

members stating that he came back from war a different person—that the

difference was “like night and day.” Aff. of Alison Brown (Apr. 14, 2025) (attached to

Hutchinson’s motion filed in Bradford County on April 24, 2025 (“Hutchinson’s

Motion”), as Exhibit G); accord Aff. of Jennifer Short (attached to Hutchinson’s

Motion as Exhibit H), at 1.

Veterans carry both physical and psychological scars, including Traumatic

Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD), and Gulf War Illness

(GWI). Gulf War veterans experience high rates of “severe or moderate TBI” due to

the conditions of their service. Committee on Gulf War and Health, Gulf War and

Health: Volume 9: Long-Term Effects of Blast Exposures, NAT’L ACADS. OF SCIS.,

The U.S. Army has concluded that the likelihood of combat-induced

psychological trauma increases with each deployment. Mental Health Advisory

Team (MHAT) V, Operation Iraqi Freedom 06-08, OFFICE OF THE SURGEON, MULTINATIONAL FORCE-IRAQ & OFFICE OF THE SURGEON GENERAL, 34, 42 (Feb. 14, 2008).

ENG’G, AND MED. (2014) at 6. Incidence of TBI can be linked to the development of

other psychiatric disorders such as Delusional Disorder (DD), dementia, and

personality syndromes. Salla Koponen et al, MRI findings and Axis I and II

psychiatric disorders after traumatic brain injury: A 30-year retrospective follow-up

study, 146 PSYCHIATRY RSCH: NEUROIMAGING 263 (2006).

Soldiers’ proximity to roadside bomb blasts and IEDs during the Gulf War,

including the Khamisiyah blast3 left many with permanent damage. Soldiers risked

injury caused by exposure blast debris, blast waves, and blast winds that exposed

soldiers to burns, toxic substances, and psychological trauma. Id. at 1–2. Returning

veterans also experience “permanent neurologic disability, including cognitive

dysfunction, unprovoked seizures, and headache,” and, in cases of recurrent

exposure to blasts, can experience “chronic traumatic encephalopathy with

progressive cognitive and behavioral decline.” Id. at 6, 7.

Because of the exposure to blasts, Gulf War veterans often suffer from a

range of long-term conditions that require ongoing treatment. The VA has found

links between Gulf War TBI and multiple adverse psychiatric disorders, including

In March 1991, U.S. troops detonated an Iraqi army ammunition depot

located in Khamisiyah, Iraq, approximately fifteen miles southeast of An Nasiriyah

(the site of a separate ammunition bunker explosion). The weapons, at the time

thought to contain only ammunition, were destroyed using open air methods. Later,

a United Nations Special Commission found the depot held rockets containing the

nerve agents sarin and cyclosarin. Chemical & Biological Weapons during Gulf War,

U.S.

DEP’T

VETERANS

AFFS.,

https://www.publichealth.va.gov/exposures/gulfwar/sources/chem-bio-weapons.asp

(last visited Apr. 11, 2025).

depression, PTSD, and aggressive behaviors—the ramifications of which can occur

up to 15 years after injury. Committee on Gulf War and Health, Gulf War and

Health: Volume 7: Long-Term Consequences of Traumatic Brain Injury, NAT’L

ACADS. OF SCIS., ENG’G, AND MED. (2009), at 6–7.

The devastating conditions of service in the Gulf War have also led to

widespread PTSD among surviving veterans. Multiple studies have found that the

experiences common to those serving in the Gulf War—such as being shot at,

handling dead bodies, witnessing their comrades being killed, knowing someone

who

was

killed,

killing

enemy

combatants—correlate

with

long-term

psychological consequences like PTSD. See Charles Hoge et al., Combat Duty in

Iraq and Afghanistan, Mental Health Problems, and Barriers to Care, 351 N.

ENGLAND J. MED. 13, 16 (2004). The “severity of combat exposure [is] the single

most important factor in determining whether a soldier would develop symptoms of

PTSD.” HERMAN, supra at 350.

When left untreated, PTSD can have fatal consequences. As one of the

nation’s leading trauma experts explains, “reliving trauma reactivates the brain’s

alarm system and knocks out critical brain areas necessary for reintegrating the

past, making it likely that patients will relive rather than resolve the trauma.” VAN

DER KOLK, supra at 223. For veterans, PTSD typically manifests itself by forcing

the former soldier to “repeatedly relive traumatic combat situations” and to “remain

in a hyper-vigilant, ready-for-battle state of mind. [Veterans’] military training and

skills, once necessary and honorable when in the service of our country overseas,

are troubling upon their return stateside.” American Bar Association (ABA), Report

105A, (adopted by the House of Delegates Feb. 8-9, 2010) at 3. PTSD can be a

lifelong condition that requires ongoing treatment. See HERMAN, supra at 352.

PTSD can also be accompanied by secondary psychiatric features, and the

likelihood of developing psychosis increases with lifetime PTSD. Ebele Compean &

Mark Hamner, Posttraumatic Stress Disorder with Secondary Psychotic Features

(PTSD-SP): Diagnostic and Treatment Challenges, 88 PROGRESS

NEURO-

PSYCHOPHARMACOLOGY & BIOLOGICAL PSY. 265 at 267 (2019).

GWI adds to the prolonged harm from Gulf War veterans suffer. As the

Government has recognized, GWI “is a serious physical disease, affecting at least

175,000 veterans of the 1990-91 Gulf War, that resulted from hazardous exposures

in the Gulf War. James Binns et al., Gulf War Illness and the Health of Gulf War

Veterans: Research Update and Recommendations, 2009-2013, RSCH. ADVISORY

COMM. ON GULF WAR VETERANS’ ILLNESSES 1 (2014) https://www.va.gov/RACGWVI/RACReport2014Final.pdf. Symptoms of GWI “typically include some

combination of widespread pain, headache, persistent problems with memory and

thinking, fatigue, breathing problems, stomach and intestinal symptoms, and skin

abnormalities.” Id. at 2 (emphasis added). These symptoms are particularly severe

for veterans who were exposed to the release of nerve gas by the Khamisiyah blast

(which Mr. Hutchinson was), and veterans who had high levels of exposure to

contaminants from oil well fires. Id. For many veterans, these symptoms persist for

decades, with little to no spontaneous recovery or effective treatment identified to

date. See U.S. Dep’t of Veterans Affs., Gulf War Veterans’ Medically Unexplained

Illnesses – Public Health 36-37 (Jan. 31, 2025). The VA recognizes several

presumptive conditions, such as chronic fatigue syndrome, fibromyalgia, and

functional gastrointestinal disorders for veterans with qualifying Gulf War service.

Scientific findings increasingly support a physiological basis for GWI. A 2023

study revealed that veterans with GWI exhibit impaired mitochondrial function in

their white blood cells, significantly reducing cellular energy production—pointing

to a measurable biochemical dysfunction. See Joel N. Meyer et al., Bioenergetic

Function is Decreased in Peripheral Blood Mononuclear Cells of Veterans with Gulf

War Illness, PLOS ONE, 21 (Nov. 1, 2023). While the exact cause remains under

investigation, strong evidence links GWI to neurotoxic exposures during the war,

particularly the use of pyridostigmine bromide (a nerve agent pretreatment) and

pesticides. See Gulf War Illness and the Health of Gulf War Veterans, supra, at 7–9.

These exposures show consistent dose-response relationships with GWI prevalence

and are considered likely causal factors. Id. at 40–48.

GWI can lead to significant neuropsychological effects, including increased

aggression. Veterans with GWI frequently report mood disturbances, irritability,

and angry outbursts. These symptoms may be linked to neuroinflammatory

processes and central nervous system dysfunction resulting from deployment-

related exposures, including pesticides and pyridostigmine bromide. See Lea Steele

et al., Brain–Immune Interactions as the Basis of Gulf War Illness: Clinical

Assessment and Deployment Profile of 1990–1991 Gulf War Veterans in the Gulf War

Illness Consortium (GWIC) Multisite Case-Control Study, 11 BRAIN SCI. 1132 (2021).

Animal studies modeling Gulf War-toxicant exposure have found that chronic

exposure to permethrin, followed by stress, primes neuroinflammatory responses in

the hippocampus through microglial activation and leads to depression-like

behaviors.

See

Sean

Naughton

al.,

Permethrin

Exposure

Primes

Neuroinflammatory Stress Response to Drive Depression-like Behavior Through

Microglial

Activation

Mouse

Model

Gulf

War

Illness,

NEUROINFLAMMATION 222 (2024).

Human-based studies conducted in the 1980s and 1990s found that low-level

exposure to organophosphate (“OP”) insecticides used in Khamisiyah—which are

chemically similar to sarin—resulted in an increased prevalence of “neurological

and psychiatric symptom reporting.” Carolyn E. Fulco, et al., Gulf War and Health

Volume 1. Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines 199,

366 (2000). Animal-based studies have shown that there is a positive correlation

between exposure to OP insecticides and adverse health effects. Id. Using human

and animal data, a June 2019 study found that exposure to sarin was “suspected to

be a neurological hazard to humans” over intermediate and extended time periods.

NAT’L TOXICOLOGY PROGRAM, PUB. HEATH SERV., U.S. DEP’T OF HEALTH & HUM.

SERVS., NTP Monograph on the Systematic Review of Long-term Neurological Effects

Following

Acute

Exposure

Sarin

G-15

(2019),

https://ntp.niehs.nih.gov/sites/default/files/ntp/ohat/sarin/sarin_508.pdf.

As a result of their bravery, skill, and endurance in combat, many Gulf War

veterans (including Mr. Hutchinson) returned home with debilitating medical

conditions, many of which were not even recognized or treated for decades. And

returning veterans’ physical and psychological wounds of battle do not—and

cannot—heal on their own. Many veterans do not seek support when they return

home. Veterans who do seek help often cannot complete treatment. One study found

that of almost 50,000 veterans diagnosed with PTSD from tours of duty in Iraq,

fewer that one in ten completed their treatment. Karen H. Seal et al., VA Mental

Health Services Utilization in Iraq and Afghanistan Veterans in the First Year of

Receiving New Mental Health Diagnoses, 23 J. TRAUMATIC STRESS 5 (2010).

Complicating this issue, treatments are often ill-suited to veterans’ needs. VAN DER

KOLK, supra at 225. Sometimes stigma is difficult for veterans to overcome. Hoge,

supra at 20. At other times, there are simply no treatments available—as in the

case of GWI in the years following the war.

Delusional Disorder Can Be Difficult to Diagnose Without

an Adequate Examination

Delusional Disorder is a very rare psychiatric disorder, affecting only .02% of

the population. AM. PSYCHIATRIC ASS’N, THE DIAGNOSTIC AND STATISTICAL MANUAL

MENTAL DISORDERS (5th ed. 2013). Consequently, the disorder is under-

researched and poorly understood. Accordingly, DD is often misdiagnosed. The only

diagnostic criterion for DD is the presence of a non-bizarre delusional thought for at

least one month. Nagesh Pai & Shae-Leigh Vella, Delusional Disorder: A

Comprehensive Narrative Review, 24 INT’L J. OF CLINICAL STUDIES & MED. CASE REP.

1 (2023). Non-bizarre means that the delusional thought is not impossible but also

is not a reality. Id. For example, someone believes they are being followed,

conspired against, or drugged. All of these scenarios are possible, but they are not

actually happening to the individual.

Those with DD will rigidly adhere to the delusion, often misinterpreting the

facts to fit the delusion rather than morphing the delusion to fit the facts. Raymond

R. Crowe & Marc-Andre Roy, Delusional Disorders, in S.H. FATEMI & P.J. CLAYTON,

EDS., THE MEDICAL BASIS OF PSYCHIATRY 127 (2008). The delusion remains the same

and those with DD are unwavering in its existence.

Because the delusions are “non-bizarre,” those suffering from DD can still

function normally and have an understanding that others find their delusions

unreasonable, but they cannot accept this reality. Pai & Vella, supra, at 1. Further,

because of this partial rational understanding, those with DD can appear

completely normal when not discussing their delusions. Shawn M. Joseph &

Waquar Siddiqui, Delusional Disorder, NIH (Mar. 27, 2023),

https://www.ncbi.nlm.nih.gov/sites/books/NBK539855/. The areas of life outside of

the delusional system are unaffected and individuals with DD can maintain

housework, occupational performance, and social relationships. Crowe, et al., supra

at 127. There are various subtypes of DD based on the contents of the delusion. One

subtype is persecutory, which pertains to the individual being fixated on the

delusion that they are being conspired against. Raymond R. Crowe, et al., supra, at

128. These delusions can originate out of a situation where some degree of suspicion

is warranted, but the delusion develops to expand “beyond the bounds of reason.”

Id. Importantly, those with DD are capable of understanding that others find their

beliefs to be delusional, but they are unable to accept that reality themselves. Id.

This contributes to why those with DD do not seek help.

While much about the cause of DD is unknown,4 those who have experienced

TBI (as Mr. Hutchinson has) have a higher prevalence of DD. Salla Konopen et al.,

MRI findings and Axis I and II psychiatricdisorders after traumatic brain injury: A

30-year retrospective follow-up study, 146 PSYCHIATRY: NEUROIMAGING RSCH. 263

(2006).

Diagnosing DD can be difficult. Those with DD do not believe they are ill, and

therefore are not forthcoming with details about their illness. There are no set labs

to establish a DD diagnosis; therefore, it is crucial to carefully conduct a clinical

evaluation. Id. Those with persecutory DD are especially difficult because they are

4 Like GWI, research on DD is scarce and the disorder is poorly understood; it was

only classified as its own disorder in 1987. Pai & Vella, supra, at 1.

predisposed to being distrusting and can hide their thoughts about their delusions.

Crowe, at al., supra, at 127; Howard E. LeWine, MD, Delusional Disorder, HARVARD

HEALTH PUBLISHING (Jan. 27, 2025). Therefore, in addition to a thorough clinical

exam, conversation with friends and family is also helpful. Id.

II.

THE PROCEEDINGS BELOW FAILED TO ADEQUATELY

CONSIDER MR. HUTCHINSON’S MENTAL ILLNESS

The determination below that Mr. Hutchinson is competent can be

characterized as nothing but part of the State of Florida’s race to execution. The

proceedings below were the fastest in the State of Florida for determining a

prisoner’s competency for execution. See Hutchinson v. State, No. SC2025-0590, slip

op. at 16 (Labarga, J., dissenting) (“[T]his death warrant case has had a procedural

path unlike any in recent history. It is because of this that I continue to believe that

a stay would be beneficial to the consideration of the issues raised.”).

The Governor’s Commission’s

Hutchinson Was Insufficient

Examination

Mr.

The lower court’s determination that Mr. Hutchinson is competent for

execution stems from the report of a three-doctor Commission that spent a mere 90

minutes with Mr. Hutchinson just days before his scheduled execution.5 Science

5 The doctors on the Governor’s Commission were Dr. Wade C. Myers, Dr. Emily

Lazarou, and Dr. Tonia Werner. Only Drs. Myers and Werner testified at the

hearing in Bradford County on April 25, 2025.

It is important to note that this format of evaluation is specific to this

context. “[T]here is no clinical setting outside of this legal context where three

indicates that the Commission’s “examination” of Mr. Hutchinson is insufficient to

adequately assess his mental health for purposes of determining whether his

execution comports with the Eighth Amendment.

The Commission spent only 90 minutes with Mr. Hutchinson

before rendering its opinion

The American Psychiatric Association Practice (“APA”) Guidelines for the

Psychiatric Evaluation recommend that a sufficient psychiatric evaluation includes

review of psychiatric symptoms, trauma history, and treatment history; a substance

abuse assessment; assessment for suicide risk; assessment of risk for aggressive

behaviors; assessment of cultural factors; assessment of medical health; qualitative

assessment; involvement of the patient in treatment decision making; and

documenting the evaluation. Joel J. Silverman, The American Psychiatric

Association Practice Guidelines for the Psychiatric Evaluation of Adults, 172 AM. J.

PSYCHIATRY 798, 800 (2015). The APA also recognizes the importance of

understanding the patient’s background, relationships, life circumstances, strengths

and vulnerabilities. Id. at 798. It can be difficult to obtain this information in one

session, and multiple sessions may be necessary. Id. The amount of time required to

obtain the necessary information can differ between patients depending on the

circumstances. Id.

psychiatrists would evaluate one patient at the same time.” Melanie Kalmanson &

Bridget Maloney, Repairing the “Sea of Disorganized” Procedures Used for

Determining Competency for Execution, 49 L. & PSY. REV. (forthcoming 2025).

As discussed supra, DD is difficult to diagnose, especially in a short amount

of time. The Commission failed to take this into account when examining Mr.

Hutchinson and rendering its opinion.

The Commission spent only 90 minutes evaluating Mr. Hutchinson before

rendering its opinion that he is competent to be executed. Report, at 1.6 The experts

hired by Mr. Hutchinson’s attorneys—who opined that Mr. Hutchinson has PTSD,

DD, and other mental illnesses that render him incompetent for execution—spent

much longer with Mr. Hutchinson before rendering their decision. Dr. Agharkar

spent almost 4 hours with Mr. Hutchinson. Letter from Agharkar and Associates to

Chelsea Shirley, Esq. (Apr. 12, 2025), at 1 (“I spent approximately 3.65 hours with

Mr. Hutchinson.”) (attached to Hutchinson’s Motion as Exhibit D). Dr. Barry Crown

examined Mr. Hutchinson twice. Report of Barry M. Crown, PhD and Associates,

P.A. (Apr. 12, 2025), at 2-3 (attached to Hutchinson’s Motion as Exhibit E)

[hereinafter Crown Report].

The Commission’s 90 minutes was insufficient to adequately assess Mr.

Hutchinson. In fact, testimony at the evidentiary hearing in Bradford County

revealed (consistent with medical research on DD) that Mr. Hutchinson only began

speaking about his delusions halfway through the exam. Hearing Tr. (Apr. 25,

2025), at 218. Mr. Hutchinson’s delusion is that he believes the government is “after

6 The Commission’s report dated April 22, 2025, is in the record attached to Mr.

Hutchinson’s Motion as Exhibit B. It is cited herein as “Report.”

him.” Aff. of Alison Brown (Apr. 14, 2025) (attached to Hutchinson’s Motion as

Exhibit G). Multiple letters written by Mr. Hutchinson throughout the life of his

case show that he is distrusting of the court system, the government, and even his

own lawyers. E.g., Undated Letter (attached to Hutchinson’s Motion as Exhibit K).

Thus, it follows that Mr. Hutchinson would also be distrusting of the Commission’s

doctors who are working with the government and appointed by the Governor who

signed his death warrant.

Further, Mr. Hutchinson and those with DD do not believe that they are ill,

so they are not forthcoming with their delusions. Therefore, the Commission’s mere

90 minutes with Mr. Hutchinson just days before the State of Florida intends to

execute him was woefully insufficient to adequately conduct an examination and

determine Mr. Hutchinson’s competency.

ii.

The Commission did not perform any testing before rendering

its opinion that Mr. Hutchinson is competent to be executed

The APA has also explained that information necessary for conducting a

proper evaluation may be gathered through diagnostic testing. Silverman, The

American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation

of Adults, 172 AM. J. PSYCHIATRY at 800. Standardized diagnostic tests provide

helpful information in the clinical setting. See, e.g., Amanda Jensen-Doss & Kristin

M. Hawley, Understanding Clinicians’ Diagnostic Practices: Attitudes Toward the

Utility of Diagnosis and Standardized Diagnostic Tools, 38 ADMIN. & POL’Y IN

MENTAL HEALTH & MENTAL HEALTH SERVS. RSCH. 476, 477 (2011); see also

Kalmanson & Maloney, supra note 5.

Indeed, Dr. Werner and Dr. Myers testified that the Commission usually

conducts testing in these circumstances. Hearing Tr. (Apr. 25, 2025), at 239, 293.

However, in Mr. Hutchinson’s examination, the Commission was not able to

because the prison warden stopped Dr. Myers from bringing his laptop used for the

testing. Id.

This further prevented the Commission from conducting a thorough exam. In

fact, Dr. Werner testified that she may have been able to diagnose Mr. Hutchinson

with PTSD if she had more information. Hearing Tr. (Apr. 25, 2025), at 253 (“I don’t

know that I had enough information. “We didn’t include it [in the Report.”).

Dr. Crown, an expert hired by the defense, conducted a battery of tests on

Mr. Hutchinson in 2024, which showed that Mr. Hutchinson “has a significant

neuropsychological impairment (organic brain damage) as well as a complex Post

Traumatic Stress Disorder (PTSD) as a result of multiple etiologies.” Crown Report,

at 3. Dr. Crown then performed further testing in 2025, but “a number of

neuropsychological tests could not be administered” because Mr. Hutchinson’s

hands were restrained. Id.

The Commission’s examination was rushed due to the short warrant period

assigned by the Governor and stunted by prison personnel. As a result, the

Commission’s report is inaccurate, or at best incomplete. Therefore, the lower

court’s determination that Mr. Hutchinson is competent for execution is based on

unreliable information (as discussed further infra).

The Lower Court’s Determination that Mr. Hutchinson Is

Competent to Be Executed Does Not Comport with the

Record or Science

The Eleventh Circuit’s determination that Mr. Hutchinson’s incompetence is

no barrier to his execution arises from the Bradford County circuit court’s ruling,

which relied on the Commission’s report. But the Commission’s report and,

therefore, the opinions flowing from it do not comport with the record or science.

At the outset, the Commission’s report indicates that the Commission

emphasized irrelevant factors in assessing Mr. Hutchinson and ignored many of the

symptom presentations associated with DD. For example, in making its

determination, the Commission relied on Mr. Hutchinson’s appearance (that he is

well-groomed) and that he keeps a tidy cell. Report, at 1-2. But research shows that

persons with DD can present normally and maintain daily functions. Part I.C

supra. Their daily lives are not affected outside the delusion. Part I.C supra. For the

same reason, the Commission’s emphasis on Mr. Hutchinson’s good prison record is

also irrelevant. See Report, at 2.

Further, the Commission reasoned that Mr. Hutchinson’s delusion is not

genuine because it has changed over the years. This is inconsistent with medical

research on DD. At the core of DD is a fixed delusion, which will not change, but

those with DD will morph the facts around them to fit the delusion. Part I.C supra.

Mr. Hutchinson’s fixed delusion is that the government is conspiring against

him—that the government is trying to silence him from speaking about what he

witnessed during the Gulf War. Mr. Hutchinson has maintained this delusion since

his arrest, claiming that the government is framing him for the murders. The

testimony at the hearing was clear that Mr. Hutchinson’s delusion has not changed

for over 20 years. Hearing Tr. (Apr. 25, 2025), at 31-32, 42-43. Other evidence—

including Mr. Hutchinson’s letters to friends and family throughout the entirety of

this case—confirms he has been consistent in his delusion. E.g., Undated Letter

(attached to Hutchinson’s Motion as Exhibit K) (“I am a Gulf War Veteran that is

being railroaded straight to Death Row for a crime that I did not commit.”); see also

Aff. of Alison Brown, supra; Aff. of Jennifer Short, supra. He maintains this

delusion today, as reflected in the Commission’s report. See Report, at 1-2.

While Mr. Hutchinson understands that he has been convicted of murder,

and if sentenced to death it will be because he was convicted of murder, he does not

(and cannot) understand that he committed the murders. The Commission’s failure

to diagnose Mr. Hutchinson with DD illustrates the difficulty with diagnosing this

condition, discussed supra.

Ultimately, the lower court’s determination contradicts medical research that

proves the increased prevalence of psychiatric disorders in Gulf War veterans. Part

I.B supra. While the Commission recognized Mr. Hutchinson was diagnosed with

GWI, the Commission dismissed this significant fact because he stopped taking his

medications. Report, at 1. The Commission’s determination that Mr. Hutchinson

does not suffer from any “mental illness” belies scientific research on the effects of

serving in the Gulf War, as Mr. Hutchinson did. Part I.B supra. Science has

recognized the severe, chronic, and often unexplained effects of GWI on veterans.

III.

EXECUTING MR. HUTCHINSON NOT ONLY VIOLATES THE

CONSTITUTION BUT DISCOUNTS THE SIGNIFICANCE OF

MENTAL ILLNESS

Mr. Hutchinson served bravely in the U.S. military. As a result of his service

to the nation, Mr. Hutchinson has lasting physical and psychological scars. Like

many other Gulf War veterans, Mr. Hutchinson was diagnosed with PTSD, GWI,

DD and TBI. These conditions are a direct result of the sacrifices he made in

serving our nation. They have also rendered him unable to rationally understand

the reason for his execution. The lasting psychological effects of Mr. Hutchinson’s

military service should not be ignored—or dismissed.

Many scholars agree that DD is not well understood and difficult to diagnose.

Given the limited scope of the research on DD, it can be easily misunderstood. To

continue with executing Mr. Hutchinson despite his symptoms of DD would not only

violate his Eighth Amendment rights but also disregard the importance of DD and

further perpetuate the lack of understanding of DD. Moreover, PTSD itself can

cause psychosis and delusions. Regardless of the medical source of Mr. Hutchinson’s

delusions, execution on the current record threatens a grave injustice that cannot be

undone.

CONCLUSION

Amici respectfully submit that the Court should grant the petition and

application for stay of execution.

JOHN R. MILLS

Counsel of Record

PHILLIPS BLACK, INC.

1721 Broadway, Suite 201

Oakland, CA 94612

888-532-0897

j.mills@phillipsblack.org

RAISA ELHADI

NATHALIE GREENFIELD

PHILLIPS BLACK, INC.

P.O. Box 3547

New York, NY 10008

MELANIE C. KALMANSON

NICOLE PERKINS

QUARLES & BRADY LLP

101 East Kennedy Blvd.,

Suite 3400

Tampa, FL 33602

COUNSEL FOR AMICI

May 1, 2025

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.