IN THE COURT OF APPEALS OF IOWA
No. 16-1775
Filed May 16, 2018
STATE OF IOWA,
Plaintiff-Appellee,
vs.
NORMAN WADSWORTH,
Defendant-Appellant.
________________________________________________________________
Appeal from the Iowa District Court for Polk County, Richard G. Blane
(competency) and Paul D. Scott (trial), Judges.
A defendant appeals his conviction for murder in the second degree.
REVERSED AND REMANDED.
Angela L. Campbell of Dickey & Campbell Law Firm PLC, Des Moines, for
appellant.
Thomas J. Miller, Attorney General, Timothy M. Hau, Assistant Attorney
General, and Kelli A. Huser, Assistant Attorney General, for appellee.
Heard by Doyle, P.J., and Tabor and McDonald, JJ. Blane, S.J., takes no
part.
2
TABOR, Judge.
It is undisputed Norman Wadsworth killed Darlene Crook. What he disputes
on appeal is whether he did so with malice aforethought and whether he was
competent to stand trial. Wadsworth also contends his trial counsel was ineffective
in not raising an insanity defense. Finally, he argues the district court erred in
admitting autopsy photographs and evidence of a prior harassment conviction into
the record.
On our de novo review, we find Wadsworth did not have the ability, at the
time of trial, to assist his attorneys in his defense. Accordingly, we reverse and
remand for further proceedings. We also find the evidence presented at trial was
sufficient for the jury to reach a verdict of second-degree murder.
I. Facts and Prior Proceedings
Norman Wadsworth suffered from schizophrenia for decades and received
no treatment. He had a contentious relationship with the manager at his apartment
complex, Darlene Crook, who he believed was part of a government conspiracy to
kill him. Eventually, Wadsworth was evicted from his apartment. After being
homeless for several months, Wadsworth tried to take a bus to a motel. He
boarded the wrong bus and ended up just three blocks from his old apartment
complex. He walked to Crook’s office and attacked her with a knife. Crook died
of blood loss from the seventy-one distinct wounds inflicted by Wadsworth.
A resident of the apartment complex heard the commotion and restrained
Wadsworth until police could respond. Speaking with police officers, Wadsworth
admitted he knew he was killing Crook, had contemplated doing so for some time,
and entered the apartment complex for that reason. Wadsworth said competing
3
voices inside his head were telling him to either stab or not stab Crook. He
believed Crook could hear the voices too. The State charged Wadsworth with first-
degree murder.
Wadsworth’s attorneys moved for a hearing to determine their client’s
competency to stand trial. At the hearing, the defense presented the testimony of
psychologist Alan Goldstein, and the State countered with the testimony of
psychiatrist Michael Taylor. The district court found Wadsworth competent, and
the charges proceeded to a jury trial.1 The jury found Wadsworth guilty of murder
in the second degree. On appeal, Wadsworth argues he was not capable of
assisting in his defense, insufficient evidence supported the verdict, trial counsel
was ineffective for not raising an affirmative defense of insanity, and the autopsy
photographs and evidence of his harassment conviction were unfairly prejudicial.
II. Analysis
A. Sufficiency of the Evidence for Murder in the Second Degree
Although we ultimately conclude Wadsworth was not competent, we must
first address the sufficiency of the evidence for the conviction. We do this because
if the evidence was insufficient, Wadsworth would be entitled to acquittal on the
murder charge and double jeopardy would bar retrial. See United States v.
Gonzalez-Sanchez, 825 F.2d 572, 588 n.56 (1st Cir. 1987) (“The double jeopardy
clause does not prevent the retrial of a defendant after his conviction has been
reversed on appeal unless the reversal was grounded on the insufficiency of the
1
Before trial, defense counsel unsuccessfully sought interlocutory review of the
competency ruling and filed a second request for a competency exam, which was denied
by the district court.
4
evidence at trial. . . . Even if the appellate court finds alternative grounds for
reversal, it must consider the defendant’s challenge to this sufficiency of the
evidence to ensure that the prohibition against double jeopardy is upheld.”).
Wadsworth contends the record does not contain sufficient evidence of
malice aforethought to support the verdict of murder in the second degree.2 The
jury was instructed malice aforethought is an element of murder in the first and
second degree. See Iowa Code §§ 707.2, 707.3. First-degree murder requires an
additional element that the defendant “acted willfully, deliberately, premeditatedly
and with a specific intent to kill Darlene Crook.” See Iowa Code § 707.2.
We review challenges to the sufficiency of the evidence for errors at law.
See State v. Hansen, 750 N.W.2d 111, 112 (Iowa 2008). We will uphold the jury’s
verdict if it is supported by substantial evidence. State v. Rooney, 862 N.W.2d
2
Wadsworth contends he preserved error on his sufficiency of the evidence claim by
moving for judgment of acquittal. The State responds Wadsworth did not preserve error
because he failed to challenge the element of malice aforethought in the district court.
A motion for judgment of acquittal will not preserve a sufficiency-of-the-evidence
issue for review unless it identifies the specific elements of the crime for which the defense
believes the evidence is lacking. State v. Williams, 695 N.W.2d 23, 27 (Iowa 2005) (citing
State v. Crone, 545 N.W.2d 267, 270 (Iowa 1996)). Our supreme court has recognized
an exception when “the record indicates that the grounds for a motion were obvious and
understood by the trial court and counsel.” Id.
At the close of the State’s case, defense counsel moved for judgment of acquittal
on the charges of murder in the first and second degree, asking the court to submit only a
lesser-included manslaughter charge. Defense counsel stated Wadsworth was suffering
from a mental illness such that “he was incapable of formulating malice aforethought.” At
the close of the defense case, counsel renewed the motion, stating, “This case should not
be submitted to the jury as to murder in the first degree and murder in the second degree”
because Wadsworth “did not have the requisite ability to form specific intent to commit the
act causing the death of Ms. Crook.” Defense counsel again asked the court to submit
only manslaughter to the jury.
In the context of the jury instructions and the first defense motion, we find the
second motion was a renewed attack on the malice aforethought element common to first-
and second-degree murder. The court specifically found the evidence presented was
sufficient to create a jury question on both first- and second-degree murder. Because it
was understood from the context that Wadsworth’s motion concerned the malice
aforethought element, he preserved error.
5
367, 371 (Iowa 2015). We view the evidence in the light most favorable to the
State, “including all reasonable inferences that may be fairly drawn from the
evidence.” State v. Sanford, 814 N.W.2d 611, 615 (Iowa 2012). We will deem the
evidence sufficient if it could convince a rational jury the defendant was guilty
beyond a reasonable doubt. Rooney, at 371. Evidence is not substantial if it raises
only suspicion, speculation, or conjecture. State v. Howse, 875 N.W.2d 684, 688
(Iowa 2016).
To convict on second-degree murder, the instructions required the jury to
find (1) Wadsworth stabbed Darlene Crook; (2) Crook died as a result of being
stabbed; and (3) Wadsworth acted with malice aforethought. Wadsworth
challenges only the third element. The court instructed the jury:
“Malice” is a state of mind which leads one to intentionally do a
wrongful act to the injury of another or in disregard for the rights of
another out of actual hatred, or with an evil or unlawful purpose. It
may be established by evidence of actual hatred, or by proof of a
deliberate or fixed intent to do injury. It may be found from the acts
and conduct of the defendant, and the means used in doing the
wrongful and injurious act.
The court further instructed, “‘Malice aforethought’ is a fixed purpose or design to
do some physical harm to another which exists before the act is committed. It does
not have to exist for any particular length of time.” The jury may properly consider
the “fierceness and atrocity of the attack, the circumstances under which it was
made, the nature and extent of the injury inflicted, the condition of the body and
wearing apparel, the deadly nature of the weapon used, and the manner of using
it.” State v. Nowlin, 244 N.W.2d 591, 593 (Iowa 1976).
Taken in the light most favorable to the State, the record contained
substantial evidence for a rational jury to conclude beyond a reasonable doubt
6
Wadsworth acted with malice aforethought. Wadsworth had a long-standing
conflict with Crook. He believed she was responsible for his eviction and involved
in a plot to kill him. The jury could reasonably infer he exhibited actual hatred
against her or acted with an unlawful purpose of seeking revenge for his
circumstances. When he found himself just three blocks from his old apartment
complex, he chose to walk there, go to her office, and attack her with a knife he
carried. The evidence may not support Wadsworth had a fixed purpose to kill
Crook before the opportunity presented itself—because he took the wrong bus and
told officers he carried a knife routinely for protection—but a reasonable jury could
infer he developed a fixed purpose on the walk to the apartment complex. Crook
died from seventy-one distinct wounds Wadsworth inflicted on her. He did not stop
his attack until another resident intervened and restrained him. The attack was
sufficiently fierce and atrocious to give a reasonable inference of malice.
Although a psychologist testified for the defense that Wadsworth could not
have undergone a rational thought process to develop an intent to kill Crook, the
jury was free to give that evidence less weight or disregard it. During a police
interview, Wadsworth said he had contemplated killing Crook for some time and
entered the building for that purpose. The evidence was sufficient to support a
verdict of murder in the second degree.
B. Competency
Although we conclude the evidence was sufficient to convict Wadsworth of
second-degree murder, there is a predicate issue that supersedes that question.
Wadsworth argues his mental illness left him incapable of aiding in his own
defense. The State responds Wadsworth could assist trial counsel and evidence
7
to the contrary is explained by his stubborn refusal to cooperate with the defense
competency expert.3 We find Wadsworth sufficiently demonstrated he was not
competent to stand trial.
We review a competency determination de novo because it implicates
constitutional rights.4 State v. Lyman, 776 N.W.2d 865, 872–73 (Iowa 2010),
overruled on other grounds by Alcala v. Marriot Int’l, Inc., 880 N.W.2d 699, 708,
n.3 (Iowa 2016). “[C]onviction of an incompetent defendant violates due process.”
State v. Einfeldt, ___ N.W.2d ___, ___, 2018 WL 1980676, at *4 (Iowa 2018) (citing
Pate v. Robinson, 383 U.S. 375, 378 (1966)). “We presume a defendant is
competent to stand trial.” Lyman, 776 N.W.2d at 874. Wadsworth bears the
burden of proving his incompetency by a preponderance of the evidence. See id.
“If the evidence is in equipoise, the presumption of competency prevails.” Id.
“Moreover, once a court finds a defendant competent to stand trial, the
presumption of competency continues unless and until the defendant produces
new evidence to the contrary.” Id.
The test for competency is whether “the defendant is suffering from a mental
disorder which prevents the defendant from appreciating the charge,
3
In his reply brief, Wadsworth takes issue with the State’s argument that he was merely
“stubborn” and refused to cooperate. At oral argument, the State clarified it did not contest
Wadsworth’s diagnosis of schizophrenia. We read the State’s argument to mean
Wadsworth’s mental illness did not affect his ability to assist in his defense.
4
We evaluate the totality of the circumstances. State v. Pedersen, 309 N.W.2d 490, 495
(Iowa 1981). Generally, this means we consider pretrial proceedings and trial evidence.
Id. But, in the present case we are limited in our review to the evidence presented at the
competency hearing. See State v. Jackson, 305 N.W.2d 420, 425 (Iowa 1981) (finding,
in a case where there were two pre-trial competency motions and the court found there
was no new evidence for a second hearing, review was limited to the record from the first
hearing). Although there was a second motion for a competency hearing shortly before
trial, the trial court declined to hold one, finding no new evidence was offered.
8
understanding the proceedings, or assisting effectively in the defense.” Iowa Code
§ 812.3(1). “The critical question is ‘whether [the defendant] has sufficient present
ability to consult with his lawyer with a reasonable degree of rational
understanding—and whether he has a rational as well as factual understanding of
the proceedings against him.’” State v. Lucas, 323 N.W.2d 228, 232–33 (Iowa
1982) (quoting Dusky v. United States, 362 U.S. 402, 402 (1960)).5 The
competency inquiry accomplishes the dual goals of reducing the likelihood of
wrongful conviction and “ensur[ing] that an accused can remain actively and
meaningfully involved in making decisions regarding his defense.” See 3
Constitutional Rights of the Accused 3d § 21:1 (2017) (emphasis added).
Finding it difficult to get relevant information from Wadsworth, his trial
counsel obtained an evaluation from a psychologist. Dr. Goldstein is a licensed
and board-certified forensic psychologist who spent eight hours with Wadsworth
over two days.6 He interviewed Wadsworth about his family, employment,
educational background, and his prior criminal record, in the presence of counsel.
5
The Dusky standard, despite being nearly sixty years old,
has escaped significant elaboration by courts and theorists. It is also highly
unpredictable in application, in large part because the task of implementing
Dusky generally falls to forensic experts, to whom courts defer heavily but
to whom firm guidance as to the legal standard is seldom given. These
experts—typically psychologists and psychiatrists, but sometimes
specialists in other areas of medicine and the mind sciences—may differ
wildly in approach, theoretical framework, understanding of the relevant
legal constructs, and conclusions. Factually similar cases therefore may
meet different outcomes; indeed, it is common for different experts to reach
diametrically opposed conclusions in the same case.
Terry A. Maroney, Emotional Competence, “Rational Understanding,” and the Criminal
Defendant, Am. Crim. L. Rev. 1375, 1379–80 (2006).
6
Goldstein testified the two-day schedule enabled him to see variability in Wadsworth’s
behavior over time.
9
Goldstein administered numerous psychological tests.7 He also examined legal
records, police investigation reports, medical records, and the video recording of
Wadsworth’s police interrogation. Goldstein concluded Wadsworth was delusional
and in need of medication. Goldstein submitted a twelve-page written report and
testified at the competency hearing regarding his conclusion that Wadsworth was
not competent to assist in his defense.
The defense expert reported Wadsworth became defensive, irritated, and
frustrated when asked questions, even with counsel present, and at one point
terminated their interview by walking out. When answering questions, Wadsworth
became disoriented and had difficulty answering in a logical and chronological
manner. Although sometimes he was coherent and emotionally appropriate, he
was also paranoid and delusional at times. Goldstein found Wadsworth’s
statements “didn’t make much sense” and were contradictory. But Wadsworth
denied mental-health symptoms and had no insight into his behavior. He also
objected strenuously when Goldstein suggested he begin taking medication for his
mental-health symptoms.
Goldstein also interviewed Wadsworth’s brother, Herman, who confirmed
Wadsworth’s long history of mental illness, noting Wadsworth had received Social
Security disability benefits for thirty years based on his mental disorder. Goldstein
opined Wadsworth had “virtually no frustration tolerance” when questioned about
his delusions, but viewed the trial “as his attempt to get up on a soap box and
7
Goldstein administered the Wechsler Adult Intelligence Scale—IV; Stroop
Neuropsychological Screening Test; Symbol Digit Modalities Test; and Structured
Interview of Reported Symptoms—Second Edition.
10
explain how the victim in this case did everything to evict him, had attempted to kill
him, and he’d been set up by the police.”
In his written report, Goldstein noted Wadsworth’s tendency to ramble when
discussing the murder charge and a prior harassment charge, “merg[ing] his last
two arrests,” and that he tended to “‘become lost’ in his belief that he had been set
up by the victim and others who plan to ‘kill him.’” Goldstein found Wadsworth was
“unable to provide a rational, logical link between his delusions and hallucinations
and the instant offense” and “did not allow himself to be pressed for information,
clarification, or for additional details that might be helpful to his attorney.”
Goldstein also related Wadsworth’s theories that police set him up thirty
years ago when he spent time in Fort Madison, that a “secret” machine implanted
the voices in his head at that time, and that his case involved a government
conspiracy. Wadsworth admitted to Goldstein he had been hearing voices for
more than three decades, but Wadsworth did not view them as symptoms of
mental illness. Instead, Wadsworth believed he was mentally normal and became
agitated when pressed further. Wadsworth also told Goldstein being thrown out of
his apartment was part of a plan—that the voices had “set him up,” and Crook was
able to hear the voices. Goldstein testified Wadsworth was incapable of explaining
the voices he heard or how they fit into his life.
Goldstein expressed concern about Wadsworth’s ability to “sit through a
trial, to listen to what’s going on, to understand in a rationale manner what
witnesses are saying.” Goldstein further doubted whether Wadsworth could “sit
quietly at trial without being disruptive and without arguing with [trial counsel] or
shouting at witnesses.” When asked whether Wadsworth could be “faking” a
11
mental illness, Goldstein observed Wadsworth “is totally invested in presenting
himself as someone who has no mental illness whatsoever.” He cited the
Structured Interview of Reported Symptoms assessment, which measures the
subject’s attempts to exaggerate or malinger regarding mental illness. Goldstein
observed Wadsworth’s score to be “exceedingly low.” Goldstein admitted
Wadsworth understood the legal process and what would happen at trial, including
the role of the judge and jury, plea bargaining, and the evidence against him—
Goldstein stated Wadsworth “gets an A” on that measure. Goldstein further
explained Wadsworth was able to communicate effectively about the substance of
his delusions. But he was a “total failure” in “his ability to assist [counsel],
communicate in a reasonably rational manner.”
Goldstein suggested Wadsworth was “intellectually impaired” and his IQ fell
within a borderline range; Goldstein noted Wadsworth had taken remedial classes
throughout his school career and exhibited “overly simplistic” thinking. Goldstein
concluded, Wadsworth’s “mental confusion, his distractibility, his denial of obvious
emotional difficulties, and his inability to tolerate discomfort when being
questioned, significantly interfered with his ability to confide in his attorney and to
provide information to me and to her that may help in the handling of this case.”
The State’s expert witness took a more hands-off approach and reached
very different conclusions. At the time of the competency hearing, Dr. Michael
Taylor was a licensed psychiatrist.8 He reviewed the trial information, police
reports, the video recording of Wadsworth’s police interrogation, and
8
Before trial, Taylor lost his license to practice medicine for failure to keep required
medical records.
12
Dr. Goldstein’s report, as well as the results of Goldstein’s psychological tests.
Taylor interviewed Wadsworth at the Polk County Jail for about ninety minutes and
produced a two-page report, as well as testifying at the competency hearing.
At the outset of the interview, Taylor explained to Wadsworth he did not
need to answer questions he did not wish to answer and could end the interview
at any time. Taylor described Wadsworth as calm, polite, and cooperative. Taylor
did not see any agitation or irritability. Wadsworth told Taylor about the competing
voices in his head trying to persuade him to do things but added, “I just brush them
off.” As Wadsworth approached Crook’s office, the voices were arguing about
whether Wadsworth should stab her. But Wadsworth vehemently denied to Taylor
that the voices had any influence in his stabbing Crook. Taylor reported
Wadsworth displayed no other types of “pathological thought content.” His mental
status examination was “within normal limits,” and he displayed no abnormalities
or impairments as described in Goldstein’s report.9 According to Taylor,
Wadsworth described the harassment incident and the stabbing in a concise
manner, “clearly separated chronologically” without any confusion between the
two. Taylor concluded:
Mr. Wadsworth is fully knowledgeable about the charges pending
against him and the roles of the various parties involved in any
pending legal proceedings. He stated that he fully understands the
information and explanations provided to him by [trial counsel], and
expressed his relief “that I have a lawyer that I trust.” Additionally,
he is fully capable of cooperating with his counsel in a rational and
meaningful manner in presenting a defense. Mr. Wadsworth is
clearly competent to stand trial.
9
In a less than professional passage in his report, Dr. Taylor stated: “There is no way in
hell that this man has any degree of Mental Retardation.”
13
At the competency hearing, Taylor reiterated he saw nothing indicating
impairment to Wadsworth’s abilities to communicate, concentrate, or maintain
attention. He opined Wadsworth understood the charges and the roles of the
parties. Taylor professed he had no difficulty getting Wadsworth to discuss his
mental-health symptoms. In contrast to Goldstein, Taylor stated it was
unnecessary to interview a subject at different times because psychiatric
conditions do not vary significantly from day to day. Taylor opined Wadsworth was
“stubborn” and angry at Goldstein and, therefore, did not put significant effort into
Goldstein’s evaluation. But, Taylor also offered no alternative explanation for
Wadsworth’s delusions or auditory hallucinations and did not suggest Wadsworth
was malingering or faking any symptoms for his own benefit.
The district court found Wadsworth competent to stand trial. The court
included no rationale in its ruling as to how it weighed the conflicting expert
opinions but noted Wadsworth’s conduct during the hearing required no
intervention from the court or his attorneys.10 In our de novo review, we place less
significance on Wadsworth’s outward demeanor and more on his inability to
meaningfully assist his attorneys in effectively defending the murder charge
because of his untreated schizophrenia.
10
Missing from our record are professional statements from Wadsworth’s attorneys as to
the concerns they had about his ability to assist them. The Supreme Court has recognized
“defense counsel will often have the best-informed view of the defendant’s ability to
participate in his defense.” Medina v. California, 505 U.S. 437, 450 (1992). But often
counsel is constrained by concerns of protecting the attorney-client privilege or threatening
a strained attorney-client relationship, “especially if the attorney believes the defendant is
incompetent and the defendant believes to the contrary.” See Grant H. Morris et. al.,
Competency to Stand Trial on Trial, 4 Hous. J. Health L. & Pol’y 193, 199 (2004). Even
though the current record does not contain statements from Wadsworth’s trial counsel
about the difficulties they were having, those concerns were conveyed to Dr. Goldstein
and his examination took them into consideration.
14
The State encourages us to apply the rationale of State v. Johnson, 784
N.W.2d 192 (Iowa 2010) (finding defendant failed to prove he was incompetent to
stand trial where competing experts drew opposite conclusions). After thoroughly
reviewing Johnson’s medical history and administering psychological tests, as well
as conducting an extensive interview, the defense expert found Johnson was
unable to effectively assist his attorneys. Johnson, 784 N.W.2d at 194–95. The
State’s expert spent less time assessing Johnson but reviewed documents,
including the defense expert’s report, and interviewed Johnson for several hours.
Id. The State’s expert concluded Johnson’s responses were “self-serving” and
calculated to “help his case.” Id. The trial court also observed Johnson’s behavior
and noted his appropriate courtroom demeanor and that he consulted several
times with his attorneys during the proceedings. Id. Persuaded by the testimony
of the State’s expert, our supreme court affirmed, concluding Johnson failed to
meet his burden. Id. at 194-96.
We find Johnson distinguishable for two reasons. First, the State’s expert
suggested Johnson exaggerated the impact of his borderline personality disorder
on his ability to consult with counsel to gain an advantage in the legal proceedings.
Id. Here, Wadsworth minimized the symptoms of his mental disturbance and was
“massively invested” in denying he had a mental illness. Even Dr. Taylor
acknowledged Wadsworth denied his need for psychiatric treatment, despite his
long-time schizophrenia diagnosis and current delusions. We agree with Dr.
Goldstein that Wadsworth’s lack of insight into his mental illness would interfere
with his ability to assist in his defense. Second, in Johnson our supreme court
found an equivalency between the time and attention devoted to their evaluations
15
by the experts for the State and for the defense. Id. Here, we give greater weight
to Dr. Goldstein’s conclusions because his evaluation was far more thorough and
comprehensive than the interview performed by Dr. Taylor. See United States v.
Casteel, 717 F.3d 635, 642–43 (8th Cir. 2013) (noting trial court appropriately gave
more credit to the expert who spent significantly more time evaluating the
defendant).
Competency decisions often hinge on a “battle of the experts.” Where, as
in Johnson, the experts conduct substantially equivalent reviews of the case, it is
“within a district court’s province to choose one expert’s opinion over a competing
qualified expert’s opinion.” See United States v. Ghane, 593 F.3d 775, 781 (8th
Cir. 2010). But, the reviewing court must “look closely at the rationale underlying”
the district court’s conclusion as to which expert to credit. See id. “[E]xpert opinion
on competency rises no higher than the reasons on which it is based.” United
States v. Whittington, 586 F.3d 613, 618 (8th Cir. 2009) (quoting Feguer v. United
States, 302 F.2d 214, 236 (8th Cir. 1962)).
Here, both experts made strikingly similar observations as to Wadsworth’s
diagnosis and symptoms but came to opposite conclusions as to whether
Wadsworth was able to assist counsel in his defense. Both agreed Wadsworth
had a long history of untreated schizophrenia. Both found Wadsworth exhibited
delusional thinking about the crime and the circumstances surrounding it. Both
observed that Wadsworth believed in a decades-long conspiracy orchestrated by
the government and Crook to evict and kill him. Both agreed he heard voices that
encouraged him to stab Crook. Both agreed Wadsworth had a functional
16
knowledge of the trial process, the role of various actors at trial, and the charges
and evidence against him.
But then the experts parted ways. Taylor concluded Wadsworth’s ability to
follow trial procedures showed he was competent to assist his attorneys. In
contradiction, Goldstein opined, although Wadsworth was able to follow the
technical aspects of the trial, his inability to communicate in a rational manner
about the factual circumstances of the killing or about his own mental illness and
how it affected his conduct rendered him unable to “meaningfully participate in his
trial, to make informed decisions about his case, and to reveal information to his
attorneys.” Taylor’s conclusion addresses only the “factual understanding” prong
of the Dusky test, while Goldstein’s opinion tackles the separate notion of a
“rational understanding” of the proceedings. See Pedersen, 309 N.W.2d at 501
(reversing conviction because although the defendant appeared to have a factual
understanding of the proceedings against him, delusions fueled by schizophrenia
prevented him from cooperating with defense counsel, rendering him “unable to
assist effectively in his defense”); see also United States v. Ghane, 490 F.3d 1036,
1040 (8th Cir. 2007) (affirming trial court order finding defendant incompetent to
stand trial because although he “had a factual understanding of the charges
against him, his understanding was not rational because he believed the charges
were part of a wide ranging government conspiracy”); Lafferty v. Cook, 949 F.2d
1546, 1552–55 (10th Cir. 1991) (holding competency finding could not be based
only on petitioner’s factual understanding of proceedings against him, but also had
to be based on finding that he had rational understanding and Lafferty’s persistent
delusions did not allow him to cooperate rationally with his attorney). Furthermore,
17
our supreme court has recently reemphasized that “the ‘rational understanding’
required under Dusky means more than being ‘oriented to time and place’ but
includes accurate perception of reality and proper response to the world around
the defendant.” Einfeldt, ___ N.W.2d at ___ (quoting Lafferty, 949 F.2d at 1550).
We find deficient support for Dr. Taylor’s conclusion Wadsworth was
capable of effectively assisting in his own defense. Taylor insisted Wadsworth
denied the voices swayed him to stab Crook or that he experienced any other
“pathological thought content.” But that opinion sprang from Wadsworth’s own
reports, not an objective inquiry by Taylor. Taylor told Wadsworth before their
interview he was free to decline to answer any question, and Taylor did not press
Wadsworth on his delusional thinking. Taylor accepted Wadsworth’s explanation
he was able to ignore the voices without further interrogation, while Goldstein’s
further inquiry into these issues pushed Wadsworth to become defensive, irritable,
and taciturn. We are concerned about the defects in his perception and
understanding that may have impeded Wadsworth’s ability to consult with counsel
and make rational decisions, even though he appeared to have a factual
understanding of the technical trial proceedings.
Overall, Goldstein’s testing and interview were far more rigorous and
exposed significant problems Wadsworth had communicating about issues critical
to his defense, including his delusions and his thought processes surrounding the
crime. Wadsworth exhibited these difficulties even though the exam was
conducted in the presence of his attorneys. Goldstein pressed Wadsworth on his
mental-health issues and delusional thought content to the point Wadsworth grew
frustrated and, at one point, ended their interview. But such pointed conversations
18
between Wadsworth and his counsel would have been essential to formulate and
put on a vigorous defense. We assign Goldstein’s report and testimony greater
weight than Taylor’s view.
In our de novo review, we accept Goldstein’s conclusion Wadsworth did not
portray a rational understanding of the proceedings against him. Neither did
Wadsworth have a rational view of his own mental state during or after the crime.
He denies any symptoms of mental illness, while admitting to hearing voices for
thirty years. He believed he could ignore the voices. Yet, voices told him to stab
Crook and he did so. He saw the trial as an opportunity to expose the existence
of a government conspiracy to kill him, in which he believed Crook participated. It
is unlikely trial counsel could have a meaningful discussion about the facts of the
case with Wadsworth given his entrenched delusions or that Wadsworth could
participate “actively and meaningfully” in making decisions about his defense.
Discussions of Wadsworth’s mental state and the circumstances leading up to the
killing were particularly critical given the mental elements of the murder charge.
Because of difficulties communicating with Wadsworth, his trial attorneys
sought a competency evaluation—advising Dr. Goldstein that Wadsworth avoided
discussing details of the offense, which would assist them in representing him. We
find it significant Wadsworth could not rationally discuss with his attorneys the role
his delusions and psychotic symptoms may have played in his actions. When they
pressed Wadsworth for details, he shut down the conversation.
We acknowledge some of Dr. Goldstein’s fears about Wadsworth’s ability
to sit through a trial without being disruptive did not come to fruition. In its ruling,
the district court emphasized Wadsworth did not engage in any conduct at the
19
competency hearing requiring intervention by the court or counsel. We appreciate
the district court’s ability to observe the defendant, but an inability to sit quietly in
court is not the only danger contemplated when we discuss a defendant’s capacity
to assist counsel in the defense. Drope v. Missouri, 420 U.S. 162, 179 (1975). We
are more concerned with the defendant’s comprehension of the proceedings, his
ability to assess his options and inform his counsel’s strategies regarding the
factual circumstances of the case.11 At oral argument, Wadsworth’s appellate
counsel asserted proving insanity was the only way to defend against the murder
charge. See Iowa Code § 701.4. Insanity is an affirmative defense that the
defendant must prove by a preponderance of the evidence. See Iowa R. Crim. P.
2.11(11). Because Wadsworth’s untreated mental illness hindered his ability to
assist counsel in raising the most potent available defense, we conclude he lacked
a rational understanding of the proceedings and was not competent to stand trial.
An uncooperative defendant makes mounting a vigorous defense difficult,
but where that difficulty stems from delusions caused by mental illness, a
competency issue arises and due process is violated if the defendant is forced to
11
Wadsworth’s attorneys requested a second competency hearing and brought forward
as additional evidence letters Wadsworth had handwritten and sent to the judge. In a
September 5, 2015 letter, Wadsworth told the judge, even though he had waived speedy
trial, his understanding was, “[B]y law I am to be Released after a year.” Later, in April
2016, Wadsworth told the judge he had been set up on the homicide charge and “for the
pas[t] 35 years by Polk County.” Although Wadsworth does not now assert an error in
failing to hold a second competency hearing, it is consistent with our reading of the
evidence that Wadsworth continued to display delusions and irrational misconceptions
throughout the pre-trial period. But the duty to attend to competency issues throughout
the proceedings persists: in Einfeldt, our supreme court emphasized, “‘[E]ven when a
defendant is competent at the commencement of his trial, the trial court must always be
alert to circumstances suggesting a change that would render the accused unable to meet
the standards of competence to stand trial.’” ___ N.W.2d at ___ (quoting Drope, 420 U.S.
at 181).
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proceed without the capacity to aid his attorney. Given his strongly held delusions
and his related aversion to discussing his mental health status candidly, we cannot
find Wadsworth had sufficient present ability to consult with counsel with a
reasonable degree of rational understanding. The evidence tipped in favor of
finding Wadsworth incompetent to stand trial.
We need not address Wadsworth’s other arguments. But because
substantial evidence supported his second-degree murder conviction, Wadsworth
is not entitled to acquittal on that offense. See Pedersen, 309 N.W.2d at 501
(remanding case to district court for further proceedings including trial when
defendant regains competency); 3 Constitutional Rights of the Accused 3d § 29:1,
29. We reverse the conviction and sentence and remand for further proceedings
consistent with this opinion.
REVERSED AND REMANDED.
State of Iowa v. Norman Wadsworth
Combined Opinion