Certiorari To The Court Of Criminal Appeals Of Texas

No. 15-797. Argued November 29, 2016--Decided March 28, 2017

Petitioner Moore was convicted of capital murder and sentenced to death for fatally shooting a store clerk during a botched robbery that occurred when Moore was 20 years old. A state habeas court subsequently determined that, under Atkins v. Virginia, 536 U. S. 304, and Hall v. Florida, 572 U. S. ___, Moore qualified as intellectually disabled and that his death sentence therefore violated the Eighth Amendment’s proscription of “cruel and unusual punishments.” The court consulted current medical diagnostic standards—the 11th edition of the American Association on Intellectual and Developmental Disabilities clinical manual (AAIDD–11) and the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. The habeas court followed the generally accepted intellectual-disability definition, which identifies three core elements: (1) intellectual-functioning deficits, (2) adaptive deficits, and (3) the onset of these deficits while still a minor. Moore’s IQ scores, the court determined, established subaverage intellectual functioning. The court credited six scores, the average of which (70.66) indicated mild intellectual disability. And relying on testimony from mental-health professionals, the court found significant adaptive deficits in all three skill sets (conceptual, social, and practical). Based on its findings, the habeas court recommended to the Texas Court of Criminal Appeals (CCA) that Moore be granted relief. The CCA declined to adopt the judgment recommended by the habeas court. The CCA held instead that the habeas court erred by not following the CCA’s 2004 decision in Ex parte Briseno, 135 S. W. 3d 1, which adopted the definition of, and standards for assessing, intellectual disability contained in the 1992 (ninth) edition of the American Association on Mental Retardation manual (AAMR–9), predecessor to the current AAIDD–11 manual. Briseno also incorporated the AAMR–9’s requirement that adaptive deficits must be “related” to intellectual-functioning deficits, and it recited, without citation to any medical or judicial authority, seven evidentiary factors relevant to the intellectual-disability inquiry. Based on only two of Moore’s IQ scores (of 74 and 78), the CCA concluded that Moore had not shown significantly subaverage intellectual functioning. And even if he had, the CCA continued, his adaptive strengths undercut any adaptive weaknesses. The habeas court also failed, the CCA determined, to inquire into relatedness. Among alternative causes for Moore’s adaptive deficits, the CCA suggested, were an abuse-filled childhood, undiagnosed learning disorders, multiple elementary-school transfers, racially motivated harassment and violence at school, and a history of academic failure, drug abuse, and absenteeism. Briseno’s seven evidentiary factors, the CCA further determined, weighed against finding that Moore had satisfied the relatedness requirement.

Held: By rejecting the habeas court’s application of medical guidance and by following the Briseno standard, including the nonclinical Briseno factors, the CCA’s decision does not comport with the Eighth Amendment and this Court’s precedents. Pp. 9–18.

(a) The Eighth Amendment, which “ ‘reaffirms the duty of the government to respect the dignity of all persons,’ ” Hall, 572 U. S., at ___, prohibits the execution of any intellectually disabled individual, Atkins, 536 U. S., at 321. While Atkins and Hall left to the States “the task of developing appropriate ways to enforce” the restriction on executing the intellectually disabled, Hall, 572 U. S., at ___ (internal quotation marks omitted), States’ discretion is not “unfettered,” id., at ___, and must be “informed by the medical community’s diagnostic framework,” id., at ___–___. Relying on the most recent (and still current) versions of the leading diagnostic manuals, the Court concluded in Hall that Florida had “disregard[ed] established medical practice,” id., at ___, and had parted ways with practices and trends in other States, id., at ___–___. Hall indicated that being informed by the medical community does not demand adherence to everything stated in the latest medical guide. But neither does precedent license disregard of current medical standards. Pp. 9–10.

(b) The CCA’s conclusion that Moore’s IQ scores established that he is not intellectually disabled is irreconcilable with Hall, which instructs that, where an IQ score is close to, but above, 70, courts must account for the test’s “standard error of measurement.” See 572 U. S., at ___–___, ___–___. Because the lower range of Moore’s adjusted IQ score of 74 falls at or below 70, the CCA had to move on to consider Moore’s adaptive functioning. Pp. 10–12.

(c) The CCA’s consideration of Moore’s adaptive functioning also deviated from prevailing clinical standards and from the older clinical standards the CCA deemed applicable. Pp. 12–16.

(1) The CCA overemphasized Moore’s perceived adaptive strengths—living on the streets, mowing lawns, and playing pool for money—when the medical community focuses the adaptive-functioning inquiry on adaptive deficits. The CCA also stressed Moore’s improved behavior in prison, but clinicians caution against reliance on adaptive strengths developed in controlled settings. Pp. 12–13.

(2) The CCA further concluded that Moore’s record of academic failure, along with a history of childhood abuse and suffering, detracted from a determination that his intellectual and adaptive deficits were related. The medical community, however, counts traumatic experiences as risk factors for intellectual disability. The CCA also departed from clinical practice by requiring Moore to show that his adaptive deficits were not related to “a personality disorder.” Mental-health professionals recognize that intellectually disabled people may have other co-existing mental or physical impairments, including, e.g., attention-deficit/hyperactivity disorder, depressive and bipolar disorders, and autism. Pp. 13–14.

(3) The CCA’s attachment to the seven Briseno evidentiary factors further impeded its assessment of Moore’s adaptive functioning. By design and in operation, the lay perceptions advanced by Briseno “creat[e] an unacceptable risk that persons with intellectual disability will be executed.” Hall, 572 U. S., at ___. The medical profession has endeavored to counter lay stereotypes, and the Briseno factors are an outlier, in comparison both to other States’ handling of intellectual-disability pleas and to Texas’ own practices in contexts other than the death penalty. Pp. 14–16.

(d) States have some flexibility, but not “unfettered discretion,” in enforcing Atkins’ holding, Hall, 572 U. S., at ___, and the medical community’s current standards, reflecting improved understanding over time, constrain States’ leeway in this area. Here, the habeas court applied current medical standards in reaching its conclusion, but the CCA adhered to the standard it laid out in Briseno, including the nonclinical Briseno factors. The CCA therefore failed adequately to inform itself of the “medical community’s diagnostic framework,” Hall, 572 U. S., at ___–___. Because Briseno pervasively infected the CCA’s analysis, the decision of that court cannot stand. Pp. 17–18.

470 S. W. 3d 481, vacated and remanded.

Ginsburg, J., delivered the opinion of the Court, in which Kennedy, Breyer, Sotomayor, and Kagan, JJ., joined. Roberts, C. J., filed a dissenting opinion, in which Thomas and Alito, JJ., joined.