Commonwealth v. Jones , 479 Mass. 1 ( 2018 )


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    SJC-10944
    COMMONWEALTH   vs.    RYAN JONES.
    Bristol.      November 10, 2017. - February 20, 2018.
    Present:   Gants, C.J., Gaziano, Lowy, Budd, & Cypher, JJ.
    Homicide. Mental Impairment. Developmentally Disabled Person.
    Constitutional Law, Sentence, Cruel and unusual punishment.
    Practice, Criminal, Competency to stand trial, Sentence.
    Indictment found and returned in the Superior Court
    Department on August 17, 2006.
    A hearing on the defendant's competency to stand trial was
    held before D. Lloyd Macdonald, J., and the case was tried
    before Gary A. Nickerson, J.
    Brett J. Vottero for the defendant.
    Shoshana E. Stern, Assistant District Attorney, for the
    Commonwealth.
    GAZIANO, J.   A Superior Court jury found the defendant
    guilty of murder in the first degree on theories of deliberate
    premeditation and extreme atrocity or cruelty in the death of
    Valerie Oransky on July 22, 2006.      Prior to and during trial,
    the defendant maintained that he was not competent to stand
    2
    trial due to an organic brain injury he had suffered as an
    infant and a current diagnosis of pervasive developmental
    disorder not otherwise specified.    The defendant was the subject
    of competency hearings before five different Superior Court
    judges, and was found competent to stand trial at the first,
    third, fourth, and fifth hearings.    At trial, his defense was
    that he was not criminally responsible.
    On appeal, the defendant argues that the judge who
    conducted his third competency hearing erred in finding him
    competent to stand trial notwithstanding testimony from both
    prosecution and defense experts that the defendant was not
    competent.   He also argues that a mandatory sentence of life in
    prison without the possibility of parole, imposed on a
    developmentally disabled individual, constitutes cruel and
    unusual punishment in violation of Federal and State
    constitutional rights.   Finally, the defendant asks us to use
    our extraordinary power under G. L. c. 278, § 33E, to order a
    new trial or reduce the verdict.    For the reasons that follow,
    we affirm the conviction and decline to exercise our authority
    to grant relief under G. L. c. 278, § 33E.
    1.    Procedural history.   In August, 2006, a grand jury
    indicted the defendant on one charge of murder in the first
    degree.   He was arraigned in the Superior Court in September,
    2006, and pleaded not guilty.   In October, 2007, defense counsel
    3
    filed a motion seeking an examination of the defendant for
    competency pursuant to G. L. c. 123, § 15 (a).    The defendant
    was evaluated for competency in December, 2007, and was found
    competent to stand trial.    In January, 2008, the defendant was
    committed to Bridgewater State Hospital (Bridgewater) for
    evaluation pursuant to G. L. c. 123, § 15 (b), after providing
    notice that he intended to rely on a defense of a lack of
    criminal responsibility.    In February, Bridgewater sought an
    extension of the commitment, pursuant to G. L. c. 123, § 15 (b).
    In January, 2009, shortly before the defendant's then-scheduled
    trial, the judge who was to have been the trial judge ordered
    the defendant again committed to Bridgewater for observation,
    pursuant to G. L. c. 123, § 15 (b).    Later that month, the
    Department of Mental Health filed a motion for an extension of
    the commitment.   That motion was allowed.   In March, 2009,
    following a competency hearing, a different judge found the
    defendant not competent to stand trial, stayed the trial, and
    ordered the defendant to be held in the Bristol County house of
    correction for a period of six months, with a status hearing to
    be conducted at that point.    In October, 2009, the Commonwealth
    sought a competency evaluation, and the judge who had ordered
    the defendant committed in January, 2009, again ordered him
    committed to Bridgewater for observation.    In February, 2010,
    after a competency hearing, that judge found the defendant
    4
    competent to stand trial.   In August, 2010, after a subsequent
    evaluation, another judge found the defendant competent.    During
    the course of the trial in October, 2010, the trial judge (who
    had not previously been involved in the case) ordered the
    defendant evaluated for competency based on his behavior in the
    court room and in a holding cell in the court house.   The judge
    then found the defendant competent.   At the close of the
    Commonwealth's case, and again at the close of all the evidence,
    the defendant moved for a required finding of not guilty by
    reason of insanity.
    Overall, the defendant was the subject of four competency
    hearings prior to trial, and a fifth competency hearing during
    trial.   He was found competent to stand trial after the first
    hearing, incompetent at the second hearing, and competent at the
    third, fourth, and fifth hearings.1
    The judge instructed the jury on murder in the first degree
    on theories of deliberate premeditation and extreme atrocity or
    cruelty, murder in the second degree, manslaughter, and the
    defense of not guilty by reason of insanity.   The jury convicted
    1
    Further details of the competency proceedings are
    discussed infra, in our consideration of the defendant's
    challenge of the finding of competency at his third hearing.
    5
    the defendant of murder in the first degree on theories of
    deliberate premeditation and extreme atrocity or cruelty.2
    2.   Trial.    We recite the facts the jury could have found,
    reserving some facts for later discussion.
    a.   Commonwealth's case.    In July, 2006, the defendant was
    working as a dishwasher at a restaurant in Dartmouth.     He had
    been working at the restaurant for more than three years, and
    his performance was generally satisfactory, but he sometimes had
    disputes with the manager (victim) over his use of the
    dishwasher to wash pots and pans.     The defendant was supposed to
    use the dishwasher for silverware, glasses, and dishes, but was
    to wash pots and pans by hand.     The victim repeatedly told the
    defendant not to put the pots and pans in the dishwasher.     He
    often would do so anyway, and undertook various methods to
    conceal this from the victim.     The two argued about the use of
    the dishwasher on many occasions.
    At some point, the defendant began to express his anger
    about the victim's instructions on dishwashing to other
    employees.   The defendant told one coworker, "I'm going to kill
    that f'ing B."     Another coworker reported that, at least once a
    week, the defendant made gestures such as holding up his middle
    finger behind the victim's back.     Another coworker said that the
    2
    At sentencing, the judge ordered that prison authorities
    be apprised of the defendant's mental condition.
    6
    defendant would "have a bung[e]e cord in his hand and he would
    snap it like he was going to choke [the victim] with it."
    Approximately two weeks before the stabbing, the defendant told
    one of his coworkers that he was going to take the victim to the
    bathroom early in the morning before the restaurant got busy and
    stab or strangle her.    Several of the restaurant employees
    reported this statement to the victim, but she interpreted it as
    a joke.
    On July 22, 2006, the defendant arrived at work earlier
    than he did ordinarily.     He told the victim that something was
    wrong with one of the toilets, and they walked toward the
    women's restroom.   Shortly thereafter, the defendant left the
    restroom and told a coworker that she should telephone 911
    because someone had come through the back door with a knife and
    had stabbed the victim.     By the time paramedics arrived, the
    victim was not breathing.    She had been stabbed multiple times,
    strangled, and beaten.    The medical examiner determined that the
    cause of death was multiple stab wounds, with injury to the
    aorta, lung, and kidney, and blunt trauma with brain contusions.
    A knife, a bungee cord, and a pipe from the dishwasher were
    found in the bathroom stall where the victim's body was found.
    A membership card for a wholesale club with the name of someone
    who did not work for the restaurant also was found on the floor
    near the victim.
    7
    While many of the defendant's coworkers were visibly upset
    at news of what had happened to the victim, the defendant was
    described as being calm.   One of his coworkers noticed that he
    had blood spots on his face and glasses and was hiding his left
    hand.   The defendant told some coworkers and the investigating
    officers that the perpetrator was a black man wearing a white
    shirt, black pants, a dark hooded sweatshirt, white sneakers,
    leather gloves, and a black mask.   He said that the man had come
    through the back door with a knife and initially tried to stab
    him, before stabbing the victim and running out the back door.
    Some of the defendant's coworkers immediately left the
    restaurant to look for the perpetrator; they were unable to find
    anyone matching the defendant's description.   A police officer
    with a canine trained to track scents also was unable to locate
    the suspect the defendant had described.
    Several restaurant employees had seen the defendant heading
    toward the bathroom with the victim, and the investigation
    almost immediately focused on the defendant.   Dartmouth police
    officers brought the defendant to the police station on the day
    of the stabbing and interviewed him for a number of hours.     The
    defendant initially told police the same thing he had said at
    the scene, that an unknown man had burst in through the back
    door and stabbed the victim.   The defendant had visible cuts on
    one hand and on his left side, which he said he had sustained
    8
    when he attempted to defend himself from the victim's assailant.
    Ultimately, after what the investigating officer described as
    "confrontational" questioning, the defendant told police that he
    had stabbed the victim; it was a "mistake," but he did not know
    "what else . . . he [was] going to do" because she kept
    "nagging" him.
    Deoxyribonucleic acid (DNA) tests on the blood found on the
    defendant's glasses, socks, and watch matched the victim.    The
    defendant was a potential contributor to blood found on the
    knife, a handicapped stall in the women's bathroom that had its
    own sink, and the wholesale club card.
    b.   Defendant's case.    After the Commonwealth rested its
    case-in-chief, Dr. Ronald Ebert, a forensic psychologist,
    testified as to the defendant's lack of criminal responsibility
    on the day of the homicide.   The defendant's father also
    testified to the defendant's medical history, his developmental
    issues, and his attendance at special education courses
    throughout his schooling.
    The father provided background information on the
    defendant's mother's medical condition during pregnancy (a
    uterine infection), the defendant's hospitalization and coma as
    a result of spinal meningitis when he was six months old, and
    the first signs of the defendant's developmental deficits, when
    he was approximately two and one-half years old.    The father
    9
    described the defendant as testing above age level for certain
    skills and "well behind" for others.   Although he was placed in
    a special needs program, his ability to communicate verbally
    with others was "minuscule" and he was resistant to change.       The
    defendant's seizure disorder first became apparent when he was
    in first or second grade.   The defendant resisted taking his
    seizure medication and was hospitalized at least three times
    because of seizures.
    In elementary school, the defendant would at times act
    inappropriately, throwing tantrums and sometimes barking and
    crawling around on all fours.   The defendant was prescribed
    medication for attention deficit disorder.   In fourth grade, the
    defendant transferred to a new school, where he was regularly
    bullied and beaten up by older students.   After that, the
    defendant began to shut down and interacted with others even
    less.   The defendant's parents were separated when he was ten
    years old, and were divorced when he was thirteen; after the
    separation, he lived primarily with his mother.   In high school,
    also in a special needs program, the defendant had "decent"
    grades and did well in writing, while still demonstrating
    difficulties with verbal communication.
    After graduation, the defendant worked for brief periods at
    a number of jobs that he obtained through an agency that helped
    disabled people get jobs and then provided job coaching.     He
    10
    also qualified for supplemental security income benefits because
    of his development delays and seizure disorder.      The dishwasher
    position at the restaurant was the defendant's first long-term
    job.       The defendant's father drove him to work in the morning,
    and his mother picked him up in the afternoon; his father picked
    him up when his mother could not.      The defendant's father would
    take the defendant to a movie almost every week and noted that
    there were times when the defendant was unable to distinguish
    between the fictional people and events in the movies and
    reality.
    Ebert testified to the defendant's medical and educational
    history, and to the defendant's probable mental state at the
    time of the crime.      Based on interviews with the defendant,
    reviews of past records, neurological testing, and other
    information, Ebert concluded that, at the time of the stabbing,
    the defendant had been suffering from a mental defect that
    impaired his ability to conform his conduct to the law or to
    appreciate the criminality of his actions.      Ebert testified that
    the defendant suffers from pervasive developmental disorder not
    otherwise specified, which is a variation of autism.3      Although
    3
    The version of the Diagnostic and Statistical Manual of
    Mental Disorders in effect at the time of the defendant's
    diagnosis, the DSM-IV, defines pervasive developmental disorder
    not otherwise specified as
    11
    there was evidence that the defendant had planned the crime in
    advance, it was a result of his disability, and he had been
    unable to control his thought processes or behavior.
    In rebuttal, the Commonwealth called Dr. Karin Towers, a
    forensic psychologist who also had interviewed the defendant and
    had reviewed the relevant records while working as a forensic
    evaluator at Bridgewater.    Towers testified that, in her
    opinion, the defendant understood the wrongfulness of his
    actions and had substantial capacity to conform his conduct to
    the requirements of the law despite his pervasive developmental
    disorder.    She noted that the defendant had made decisions to
    take the victim into the bathroom where no one could see what
    was happening and to fabricate the story of the unknown
    assailant.   The defendant also told Towers that he had
    "a severe and pervasive impairment in the development of
    reciprocal social interaction associated with impairment in
    either verbal or nonverbal communication skills or with the
    presence of stereotyped behavior, interests and activities
    where the criteria are not met for a specific Pervasive
    Developmental Disorder, Schizophrenia, Schizotypal
    Personality Disorder, or Avoidant Personality Disorder."
    American Psychiatric Association, Diagnostic and Statistical
    Manual of Mental Disorders 84 (4th ed. 2000).
    The DSM-IV indicates that "this category includes 'atypical
    autism.'" Id. The most recent edition of the Diagnostic and
    Statistical Manual of Mental Disorders, the DSM-V, notes that
    "[i]ndividuals with a well-established DSM-IV diagnosis of . . .
    pervasive developmental disorder not otherwise specified should
    be given the diagnosis of autism spectrum disorder." American
    Psychiatric Association, Diagnostic and Statistical Manual of
    Mental Disorders 51 (5th ed. 2013).
    12
    considered whether to take the knife with him or to leave it,
    and that, previously, he had controlled his anger toward the
    victim.
    3.    Discussion.    In this direct appeal, the defendant
    raises two claims.   First, he challenges the finding that he was
    competent to stand trial.    He focuses particularly on the third
    competency hearing, and contends that it was error for the judge
    to find him competent given that both the prosecution and
    defense experts testified that he was not competent.     Second,
    the defendant challenges the imposition of a mandatory sentence
    of life imprisonment without the possibility of parole on a
    developmentally disabled person; he argues that such a sentence
    is a violation of the Eighth and Fourteenth Amendments to the
    United States Constitution and art. 26 of the Massachusetts
    Declaration of Rights.
    a.    Finding of competency.    The defendant specifically
    challenges the finding of competency after the third hearing.
    To review adequately the appropriateness of the finding of
    competency to stand trial at the third hearing, it is necessary
    to consider the psychiatric evaluations, the previous hearings,
    and testimony prior to the judge's decision, as well as the two
    competency hearings that took place after the third hearing.
    i.    Initial evaluations and proceedings.    Following his
    arraignment, the defendant was ordered to be examined for
    13
    competency pursuant to G. L. c. 123, § 15 (a).    In anticipation
    of the competency hearings, the defendant met with multiple
    clinicians, who also reviewed his medical and educational
    history.    Notably, the defendant contracted spinal meningitis
    when he was six months old; he was hospitalized for several
    weeks, first in a "stupor" and later in a coma.   The illness
    resulted in permanent, organic brain injury.   In addition, he
    has suffered from a seizure disorder since he was a very young
    child.    While the defendant has tested as being in the
    borderline to low-average range on intelligence quotient (IQ)
    tests, he has demonstrated significant impairment in language
    processing and verbal communication and understanding from the
    age of two years old.   He has had difficulty in interacting with
    people, was bullied as a child because of his lack of social
    skills and inability to communicate, and exhibited outbursts and
    uncontrollable behavior as a child.   The defendant initially was
    diagnosed with attention deficit disorder and oppositional
    defiant disorder, and was treated with medication for
    hyperactivity.   The defendant attended special education classes
    throughout his school career, but was able to graduate from high
    school.
    The general consensus of all the experts who testified at
    the competency hearings, as well as many of the clinicians who
    examined him as a child and as a teenager, was that the
    14
    defendant suffers from what is now known as "pervasive
    developmental disorder not otherwise specified."
    Ebert evaluated the defendant in January, 2007, at the
    request of the defendant's attorney; Ebert's October, 2007,
    report was considered at all the pretrial competency hearings.
    Ebert also referred the defendant to Dr. Nancy Hebben for a
    neuropsychological evaluation; Hebben conducted an evaluation of
    the defendant in May, 2007.   Ebert testified at the second,
    third, and fourth competency hearings, and at trial, on behalf
    of the defendant.   Dr. Karin Towers and Dr. Sara Beszterczey
    performed evaluations as ordered by the court; their reports
    were also reviewed in conjunction with each of the competency
    hearings.
    Hebben administered a series of tests during the
    neuropsychological evaluation, which she described in her
    report.   The defendant tested "low normal" or "borderline" in
    many areas of cognitive functioning, but demonstrated a
    significant deficit in verbal comprehension ability.
    Considering all of the results in concert, she concluded that
    the defendant's most appropriate diagnosis was pervasive
    developmental disorder not otherwise specified, given his
    impairments in verbal comprehension and social interaction.
    Ebert had reached the same diagnosis.   He also determined that
    the defendant suffered from deficits in receptive and expressive
    15
    language, poor social skills, and rigidity in his behavior and
    interests.   Ebert concluded that, because of these impairments
    and the defendant's inability rationally to understand the
    proceedings against him and to assist his attorney, the
    defendant was not competent to stand trial.   While the defendant
    could explain theoretically some of the roles of the
    participants at a trial, he had difficulty in attempting to
    apply those general concepts to his own situation, suggesting,
    for example, that if he apologized for his behavior he could go
    home.
    At the first competency hearing, in December, 2007, a court
    clinician, Dr. Barbara McElroy, testified, based on a brief
    interview with the defendant and the reports by Ebert and
    Hebben, that the defendant had a factual and rational
    understanding of the proceedings against him and therefore was
    competent to stand trial.   McElroy indicated that she had two
    main concerns:   the defendant was not aware of the specific
    charges he was facing, and did not seem to understand the
    concept of plea bargains.   McElroy concluded, however, that her
    concerns were minor overall, and that they could be addressed
    with continued education of the defendant by his attorney.     To
    support this finding, she noted that the defendant had a better
    understanding when she met with him than he did when he
    16
    initially was evaluated by Ebert in January, 2007.     The judge
    found the defendant competent.
    The case was assigned for trial in January, 2009.       At the
    end of December, 2008, the defendant requested another
    competency examination.   After an evaluation, a licensed
    psychologist recommended further evaluation, and the defendant
    was committed to Bridgewater for observation, pursuant to G. L.
    c. 123, § 15 (b).   In January, 2009, the Department of Mental
    Health moved to extend the commitment, and a different Superior
    Court judge allowed the motion.   In February, 2009, Towers
    conducted an evaluation of the defendant as ordered by the court
    In February, 2009, Towers issued a report in which she noted
    that the defendant possessed a superficial understanding of
    court proceedings, but that it was unclear whether he truly
    understood.   A second competency hearing was scheduled.
    At the second hearing, in March, 2009, Towers and Ebert
    both testified that the defendant had a basic factual
    understanding, but that they were concerned about his ability to
    make decisions rationally regarding his case.   At times, the
    defendant would answer their questions without fully
    understanding what was being asked.   Towers opined that the
    defendant might be able to overcome his deficits through
    continued education.   Ebert disagreed, testifying that, although
    the defendant could repeat information given to him, his
    17
    processing of the information and his beliefs would not
    necessarily change in response to new information.    As an
    example, Ebert referred to the defendant's belief that he would
    be able to go home if he apologized to the judge.    The judge
    noted the difference in the experts' opinions as to possible
    future competency, but concluded based on the consensus of
    Towers and Ebert that the defendant was at that time not
    competent to stand trial.
    ii.    Determination of competency at the third hearing.       The
    third competency hearing took place over the course of three
    days in January and February, 2010.    In October, 2009,
    Beszterczey performed an evaluation of the defendant as ordered
    by the court.    She and Ebert testified at the hearing, along
    with three of the defendant's former coworkers and the
    defendant's former job coach.    The lay witnesses testified that,
    other than his decision to put pots and pans in the dishwasher,
    the defendant was able to perform his job well, and that they
    occasionally would have casual conversations with him.     Ebert
    again opined that the defendant was not competent to stand
    trial.    Beszterczey commented that she believed the defendant
    might not be cooperating fully, interfering with her ability to
    complete a full competency interview, but she did not think that
    any potential malingering necessarily meant that the defendant
    was competent.   She concluded that the defendant was presenting
    18
    with significant deficits in abilities associated with
    competency to stand trial, but that it was possible he could
    become competent with further education.
    In a nine-page memorandum and order, a judge who had not
    previously been involved in the case ruled that the defendant
    was competent to stand trial.   The judge pointed to the
    defendant's low-average IQ score; his "satisfactory three[-]year
    job history, where he impressed his [coworkers] by his diligence
    and essential normality"; the experts' testimony that the
    defendant's diagnosis had not changed since the time of the
    killing; and the comments in Beszterczey's evaluation about
    potential malingering.
    iii.   Final pretrial competency hearing.   Approximately six
    months later, during a hearing before a different judge, defense
    counsel requested another competency hearing.   The defendant was
    examined for competency for a fourth time at the end of August,
    2010.   Dr. Leah Logan, a court-based clinical psychologist,
    testified after reviewing the defendant's records and meeting
    with him for approximately one hour.   Logan concluded that,
    while the defendant had needed some questions explained again in
    simpler terms, he did not have significant deficits, and there
    was no evidence that his condition had deteriorated since the
    previous hearing.   She suggested that any deficits in
    understanding the defendant did have could be overcome through
    19
    communication with his attorney, repetition and further
    explanation, and sufficient time for him to process and
    understand questions he might be asked on cross-examination.
    The judge determined that there had been no material change
    since the previous hearing, and therefore that the defendant was
    still competent to stand trial.   He found that the defendant's
    acknowledged mental impairments did not affect his competency,
    and that any potential issues could be addressed through
    preparation prior to trial.
    iv.   Midtrial competency hearing.   On the third day of
    trial, after the audio-video recording of the defendant's
    interrogation was played for the jury, a court officer reported
    to the judge that, during the lunch break, the defendant had
    begun apparently interacting with an invisible dog.   The judge
    became concerned that the defendant might be decompensating, and
    decided to bring in the court clinician to examine the
    defendant, and to review whatever records the clinician felt
    necessary, in order to determine whether the defendant remained
    competent.   On inquiry by the judge, the defendant's attorney
    observed that the defendant seemed to "decompensate" more in
    times of stress, and had been manifesting small signs of stress,
    such as writing notes to himself and repeating words, while
    sitting at counsel table during and after the playing of the
    recording of the interview.
    20
    The defendant was examined briefly by Logan.      She testified
    that she thought the defendant wanted the judge and the
    attorneys to believe that he was seeing a dog, but that she
    thought he was not actually having a visual hallucination.    She
    concluded that the defendant was simply experiencing stress, and
    provided some recommendations for measures that the defendant
    might use to handle the trial environment.   The judge concluded,
    with an oral explanation on the record, that the Commonwealth
    had fulfilled its burden of proving competency by a
    preponderance of the evidence.   In reaching that finding, he
    noted that Logan was a clinical psychologist with forensic
    experience who was aware of the defendant's history.    The judge
    additionally relied on his own observations of the defendant
    over the course of the trial, as well as during the competency
    hearing, and the reports and findings from the previous
    competency hearings.
    v.   Whether the Commonwealth established the defendant's
    competency to stand trial.   The defendant appeals from the
    finding of competency at the third hearing; he contends that the
    judge abused his discretion by disregarding the experts'
    consensus that the defendant was not at that time competent to
    stand trial.   The defendant additionally contends that the judge
    inappropriately relied on evidence from lay witnesses, who could
    testify to the defendant's behavior only at the time of the
    21
    incident and not at the time of the competency hearing, and that
    the judge used an improper balancing test by considering the
    public interest in the prosecution of those who commit crimes to
    be of equal significance to the due process concern of
    competency to stand trial.
    "It has long been accepted that a person whose mental
    condition is such that he lacks the capacity to understand the
    nature and object of the proceedings against him, to consult
    with counsel, and to assist in preparing his defense may not be
    subjected to a trial."    Commonwealth v. Crowley, 
    393 Mass. 393
    ,
    398 (1984), quoting Drope v. Missouri, 
    420 U.S. 162
    , 171 (1975).
    In the Commonwealth, G. L. c. 123, § 15, allows the examination
    of a defendant whose competency is called into question.4    If a
    trial judge doubts whether a defendant is competent to stand
    trial, he or she must, on his or her own initiative, conduct a
    4
    General Laws c. 123, § 15 (a), provides, in relevant part:
    "Whenever a court of competent jurisdiction doubts
    whether a defendant in a criminal case is competent to
    stand trial or is criminally responsible by reason of
    mental illness or mental defect, it may at any stage of the
    proceedings after the return of an indictment or the
    issuance of a criminal complaint against the defendant,
    order an examination of such defendant to be conducted by
    one or more qualified physicians or one or more qualified
    psychologists. . . . When an examination is ordered, the
    court shall instruct the examining physician or
    psychologist in the law for determining mental competence
    to stand trial and criminal responsibility."
    22
    full hearing.5   See Commonwealth v. Nickerson, 
    388 Mass. 246
    , 250
    (1983); Commonwealth v. Scionti, 
    81 Mass. App. Ct. 266
    , 272-273
    (2012).    At a competency hearing, the judge should determine
    5
    General Laws c. 123, § 15 (b), (c), provide, in relevant
    part:
    "(b) After the examination described in paragraph (a),
    the court may order that the person be hospitalized at a
    facility or, if such person is a male and appears to
    require strict security, at the Bridgewater state hospital,
    for a period not to exceed twenty days for observation and
    further examination, if the court has reason to believe
    that such observation and further examination are necessary
    in order to determine whether mental illness or mental
    defect have so affected a person that he is not competent
    to stand trial or not criminally responsible for the crime
    or crimes with which he has been charged. . . . If, before
    the expiration of such twenty day period, an examining
    qualified physician or an examining qualified psychologist
    believes that observation for more than twenty days is
    necessary, he shall so notify the court and shall request
    in writing an extension of the twenty day period,
    specifying the reason or reasons for which such further
    observation is necessary. Upon the receipt of such
    request, the court may extend said observation period, but
    in no event shall the period exceed forty days from the
    date of the initial court order of hospitalization;
    provided, however, if the person requests continued care
    and treatment during the pendency of the criminal
    proceedings against him and the superintendent or medical
    director agrees to provide such care and treatment, the
    court may order the further hospitalization of such person
    at the facility or the Bridgewater state hospital.
    "(c) At the conclusion of the examination or the
    observation period, the examining physician or psychologist
    shall forthwith give to the court written signed reports of
    their findings, including the clinical findings bearing on
    the issue of competence to stand trial or criminal
    responsibility. Such reports shall also contain an
    opinion, supported by clinical findings, as to whether the
    defendant is in need of treatment and care offered by the
    [Department of Mental Health]."
    23
    whether the defendant has "sufficient present ability to consult
    with his lawyer with a reasonable degree of rational
    understanding and . . . a rational as well as factual
    understanding of the proceedings against him."6    Commonwealth v.
    Vailes, 
    360 Mass. 522
    , 524 (1971), quoting Dusky v. United
    States, 
    362 U.S. 402
    , 402 (1960).    The Commonwealth has the
    burden to prove competency by a preponderance of the evidence.
    Crowley, 
    393 Mass. at 400-401
    .    A judge's competency
    determination is reviewed for abuse of discretion.    See
    Commonwealth v. Hung Tan Vo, 
    427 Mass. 464
    , 468-469 (1998).
    In reaching such a determination, judges may consider their
    own "observations of the defendant's demeanor and behavior
    . . . , reports of psychiatric examinations of the defendant,
    statements to the judge about the defendant's conduct and mental
    condition, and the testimony of expert witnesses."       Commonwealth
    v. Hill, 
    375 Mass. 50
    , 54-55 (1978).    Observations made closest
    6
    General Laws c. 123, § 15 (d), provides, in relevant part:
    "If on the basis of such reports the court is
    satisfied that the defendant is competent to stand trial,
    the case shall continue according to the usual course of
    criminal proceedings; otherwise the court shall hold a
    hearing on whether the defendant is competent to stand
    trial; provided that at any time before trial any party to
    the case may request a hearing on whether the defendant is
    competent to stand trial. A finding of incompetency shall
    require a preponderance of the evidence. If the defendant
    is found incompetent to stand trial, trial of the case
    shall be stayed until such time as the defendant becomes
    competent to stand trial, unless the case is dismissed."
    24
    to the time of trial are the most appropriate in determining
    competency.    See Commonwealth v. Companonio, 
    445 Mass. 39
    , 52
    (2005) ("The time frame for determining a defendant's competency
    to stand trial is 'the condition of the defendant at the time of
    trial'" [citation omitted]).
    While it may be useful for a judge to hear opinions from
    medical experts, the determination is ultimately a legal, not a
    medical, judgment.     See Kansas v. Hendricks, 
    521 U.S. 346
    , 359
    (1997) (noting that legal definition of "competency" need not
    mirror its medical definition).    "The law should not, and does
    not, give the opinions of experts on either side of . . . [an]
    issue the benefit of conclusiveness."     Commonwealth v. DiMinico,
    
    408 Mass. 230
    , 235 (1990), quoting Commonwealth v. Lamb, 
    372 Mass. 17
    , 24 (1977).    Cf. Commonwealth v. Kappler, 
    416 Mass. 574
    , 579 (1993) (fact finders are not required to accept
    "uncontroverted testimony of experts"); Commonwealth v. Shelley,
    
    381 Mass. 340
    , 347 (1980) (fact finder is "not obliged to
    believe the testimony of any of the expert witnesses").
    The judge who conducted the third competency hearing had
    the authority to exercise his discretion and choose not to
    credit the experts' conclusions that the defendant was not
    competent.    He used the correct standard to determine
    competency, appropriately placed the burden on the Commonwealth
    to prove competency by a preponderance of the evidence, and
    25
    wrote a thorough memorandum explaining the reasons for his
    conclusion.    Moreover, after that hearing, at subsequent
    hearings, two other judges found the defendant competent to
    stand trial.   Because competency may be fluid and should be
    determined as close to trial as possible, it is most significant
    that the defendant was found competent in a hearing during the
    trial.    In sum, we discern no error in the judge's determination
    at the third competency hearing.
    b.   Mandatory imposition of life sentence without
    possibility of parole on a developmentally disabled defendant.
    The defendant argues also that the mandatory imposition of a
    sentence of life imprisonment without the possibility of parole
    on a defendant who is developmentally disabled constitutes cruel
    and unusual punishment under the Eighth and Fourteenth
    Amendments and cruel or unusual punishment under art. 26.      The
    defendant asks that we extend the United States Supreme Court's
    holding in Atkins v. Virginia, 
    536 U.S. 304
    , 321 (2002), that
    imposition of the death penalty on a person with an intellectual
    disability violates the United States Constitution,7 to
    imposition of a mandatory sentence of life in prison without the
    7
    Atkins v. Virginia, 
    536 U.S. 304
     (2002), uses the language
    "mentally retarded." That term subsequently has been replaced
    by the term "intellectually disabled." See Hall v. Florida, 
    134 S. Ct. 1986
    , 1990 (2014); Commonwealth v. St. Louis, 
    473 Mass. 350
    , 357 (2015); Pub. L. 111–256, 111th Cong., 
    124 Stat. 2643
    (2010) (Rosa's Law).
    26
    possibility of parole on defendants with developmental
    disabilities.8
    8
    General Laws c. 123B, § 1, distinguishes between
    intellectual and developmental disabilities as follows:
    "[A] [p]erson with a developmental disability [is] (1)
    an individual [five] years of age or older with a severe,
    chronic disability that: (i) is attributable to a mental
    or physical impairment resulting from intellectual
    disability, autism, [S]mith-[M]agenis syndrome or Prader-
    Willi syndrome; (ii) is manifested before the individual
    attains age [twenty-two]; (iii) is likely to continue
    indefinitely; (iv) results in substantial functional
    limitations in [three] or more of the following areas of
    major life activity: (1) self-care; (2) receptive and
    expressive language; (3) learning; (4) mobility; (5) self-
    direction; (6) capacity for independent living; and (7)
    economic self-sufficiency; and (v) reflects the
    individual's need for a combination and sequence of
    special, interdisciplinary or generic services, supports or
    other assistance that is of a lifelong or extended duration
    and is individually planned and coordinated; or (2) an
    individual under the age of [five] who has a substantial
    developmental delay or specific congenital or acquired
    condition with a high probability that the condition will
    result in a developmental disability if services are not
    provided. . . ."
    "[A] [p]erson with an intellectual disability [is] a
    person who has an intellectual disability, characterized by
    significant limitations in both intellectual functioning
    and adaptive behavior as expressed in conceptual, social
    and practical adaptive skills and beginning before age 18,
    and consistent with the most recent definition provided by
    the American Association on Intellectual and Developmental
    Disabilities; provided, that in applying this definition
    the following shall be considered: (i) limitations in
    present functioning within the context of community
    environments typical of the individual's age, peers and
    culture; (ii) cultural and linguistic diversity and
    differences in communication, sensory, motor and behavioral
    factors; (iii) limitations often coexist with strengths
    within an individual; (iv) an important purpose of
    describing limitations is to develop a profile of needed
    27
    In support of this argument, the defendant relies on cases
    from the United States Supreme Court holding that imposition of
    the death penalty on juveniles is unconstitutional, Roper v.
    Simmons, 
    543 U.S. 551
    , 578 (2005); that a mandatory sentence of
    life without the possibility of parole for nonhomicide offenses
    committed by juveniles violates the Federal Constitution, Graham
    v. Florida, 
    560 U.S. 48
    , 75 (2010); and that a mandatory
    sentence of life in prison without the possibility of parole for
    juveniles who commit murder is unconstitutional, Miller v.
    Alabama, 
    567 U.S. 460
    , 470 (2012).   We have extended the Court's
    holding in Miller, 
    supra,
     in deciding that even the
    discretionary imposition of a sentence of life without the
    possibility of parole on juveniles is in violation of art. 26.
    See Diatchenko v. District Attorney for the Suffolk Dist., 
    466 Mass. 655
    , 674 (2013), S.C., 
    471 Mass. 12
     (2015).
    The Commonwealth contends that the defendant's argument
    would require significant extrapolation from existing precedent,
    given that the defendant is not a juvenile and is not subject to
    the death penalty; there is no precedent in this court or the
    United States Supreme Court concerning prison sentences for
    developmentally disabled individuals.   Furthermore, the
    supports; and (v) with appropriate personalized supports
    over a sustained period, the life functioning of a person
    with an intellectual disability will generally
    improve . . . ."
    28
    Commonwealth argues, adults with intellectual or developmental
    disabilities may not have the same prospects for rehabilitation
    as do juveniles, whose brains have not yet fully matured.    The
    Commonwealth maintains that much of the reasoning underlying the
    United States Supreme Court's and this court's jurisprudence on
    sentences for juveniles does not apply in this case because,
    unlike juveniles, who act impulsively and are unduly influenced
    by others due to their lack of maturity, the defendant has an
    immutable condition, did not act impulsively, and was not unduly
    influenced by others.
    The Eighth Amendment and art. 26 "draw [their] meaning from
    the evolving standards of decency that mark the progress of a
    maturing society."   Atkins, 
    536 U.S. at 311-312
    , quoting Trop v.
    Dulles, 
    356 U.S. 86
    , 101 (1958).   See Diatchenko, supra at 669;
    Libby v. Commissioner of Correction, 
    385 Mass. 421
    , 435 (1982)
    ("Article 26, like the Eighth Amendment, bars punishments which
    are 'unacceptable under contemporary moral standards'" [citation
    omitted]).   In deciding whether a punishment is cruel and
    unusual, courts look to "'objective indicia of society's
    standards' . . . to determine whether there is a national
    consensus against the sentencing practice at issue."   Graham,
    560 U.S. at 61, quoting Roper v. Simmons, 
    543 U.S. at 563
    .     See
    Good v. Commissioner of Correction, 
    417 Mass. 329
    , 335 (1994)
    ("In divining contemporary standards of decency, we may look to
    29
    State statutes and regulations, which reflect the public
    attitude as to what those standards are").    Courts also
    "determine in the exercise of [their] own independent judgment
    whether the punishment in question violates" contemporary moral
    standards to the extent that it is a constitutional violation.
    See Graham, supra.
    "[T]he clearest and most reliable objective evidence of
    contemporary values is the legislation enacted by the country's
    legislatures" (quotations and citation omitted).    Atkins, 
    536 U.S. at 312
    .   Courts that have addressed this issue to date have
    declined to extend Atkins, 
    supra,
     and Miller, 
    supra,
     to disallow
    mandatory sentences of life without parole for people with
    intellectual or developmental disabilities, largely in
    unpublished or unreported opinions.   See State v. Little, 
    200 So. 3d 400
    , 405 (La. Ct. App. 2016) (rejecting downward
    departure from mandatory sentence of life without parole for
    defendant with developmental disability).    See also Pifer, Is
    Life the Same as Death?:    Implications of Graham v. Florida,
    Roper v. Simmons, and Atkins v. Virginia on Life Without Parole
    Sentences for Juvenile and Mentally Retarded Offenders, 
    43 Loy. L.A. L. Rev. 1495
     (2010).
    This court has "the inherent authority to interpret [S]tate
    constitutional provisions to accord greater protection to
    individual rights than do similar provisions of the United
    30
    States Constitution" (quotations and citation omitted).
    Diatchenko, 466 Mass. at 668.     We did so in Diatchenko, supra at
    669, where we held that "the imposition of a sentence of life in
    prison without the possibility of parole for the commission of
    murder in the first degree by a juvenile under the age of
    eighteen is disproportionate not with respect to the offense
    itself, but with regard to the particular offender."     In that
    case, we considered scientific evidence on adolescent brain
    development and how it may affect a juvenile's personality and
    behavior.    Id. at 669-671.
    Similarly, in Atkins, 
    536 U.S. at 318
    , the United States
    Supreme Court determined that intellectually disabled
    individuals "have diminished capacities to understand and
    process information, to communicate, to abstract from mistakes
    and learn from experience, to engage in logical reasoning, to
    control impulses, and to understand the reactions of others,"
    leading them to be less culpable than other offenders.     The
    Court therefore focused on two reasons categorically to exclude
    individuals with intellectual disabilities from execution.        
    Id. at 318
    .     First, neither justification for the death penalty,
    retribution or deterrence, applies to intellectually disabled
    defendants.    
    Id. at 318-319
    .   Because intellectually disabled
    individuals are less culpable, their actions do not merit that
    level of retribution, and their impairments make it less likely
    31
    that they can be deterred by the possibility of the death
    penalty.   
    Id. at 319-320
    .   Second, intellectually disabled
    individuals may receive the death penalty more frequently than
    they should, based on the facts of their cases, because of the
    increased possibility of false confessions and the lesser
    ability of intellectually disabled defendants to make a
    persuasive showing of mitigation.    
    Id. at 320-321
    .   These
    concerns are less extreme, however, when an individual is facing
    a prison sentence, even when it is life without parole, than
    when an individual faces the death penalty.
    At this time, we decline to extend Atkins, 
    supra,
     and
    Miller, 
    supra,
     either to eliminate sentences of life in prison
    without the possibility of parole for people with developmental
    disabilities or to require that such sentences be discretionary
    rather than mandatory.    Whether it is cruel and unusual under
    the Eighth and Fourteenth Amendments or cruel or unusual under
    art. 26 to impose a mandatory sentence of life without parole on
    a person with an intellectual disability is a difficult question
    that is not before us here, where the defendant has been
    diagnosed with a developmental disability.
    c.     Relief pursuant to G. L. c. 278, § 33E.   The defendant
    asks that we exercise our extraordinary power pursuant to G. L.
    c. 278, § 33E, to order a new trial or reduce the verdict to
    murder in the second degree.   After carefully reviewing the
    32
    record pursuant to our duty under G. L. c. 278, § 33E, we
    decline to set aside the verdict or to reduce the degree of
    guilt.
    Judgment affirmed.