Prisoners sentenced to death must be competent for execution before they can actually be executed (Ford v. Wainwright, 1986). The decision for many mental health professionals whether to conduct competence for execution evaluations may be fraught with complex ethical issues. Mental health professionals who do not personally support capital punishment may have a particularly difficult decision to make in this regard but should seriously consider the consequences of their decisions. This article applies Bush, Connell, and Denney’s (2006) eight-step ethical decision-making model to the ethicality of deciding to or abstaining from conducting competence for execution evaluations. This article does not propose what decisions an individual evaluator should make regarding this work, but rather presents a systematic guide for mental health professionals (particularly those who do not support capital punishment) to consider.