posted on June 16, 2003 12:21:57 PM new
WASHINGTON (Reuters) - A divided U.S. Supreme Court put limits on Monday on when the government may force defendants to take anti-psychotic drugs to make them competent to stand trial for serious, but nonviolent, crimes.
By a 6-3 vote, the high court allowed forced medication if the treatment was medically appropriate, substantially unlikely to have side effects that may undermine the trial's fairness and necessary to further important governmental trial-related interests, taking into account less intrusive alternatives.
Writing for the majority, Justice Stephen Breyer said the standard would permit forced medication solely to make defendants competent to stand trial only under certain limited circumstances.
Breyer said the number of instances may be rare.
The court ordered more proceedings in the case, which involved Dr. Charles Sell, a dentist from a suburb of St. Louis, Missouri, who was charged in 1997 with Medicaid and insurance fraud.
Government and defense psychologists diagnosed him as suffering from "delusional disorder, persecutory type." He was found to be suffering from mental illness that made him incompetent to stand trial.
Sell has been held in a mental health facility at a federal prison while awaiting trial. A U.S. appeals court upheld a federal judge's decision that Sell could be medicated against his will so he can stand trial.
Breyer said the appeals court was wrong in approving forced medication solely to render Sell competent to stand trial.
In setting aside the appeals court's ruling, Breyer said the appeals court did not find that the required circumstances existed in this case.
According to the U.S. Justice Department, there recently have been 59 criminal defendants forced to take antipsychotic medication.
In a recent 12-month period, 80 percent of 285 defendants found to be mentally incompetent to stand trial voluntarily accepted medication. Of the remaining 59 who were treated against their will, many of them did not seek judicial review, the department said.
Breyer said Sell had a long history of mental illness dating back to 1982, when he was hospitalized and treated with antipsychotic medication.
In 1997, Sell told law enforcement personnel that he "spoke to God last night" and was told "a soul will be saved" for every FBI person he kills.
In sending the case back for more hearings, Breyer said the lower courts failed to consider whether the medication's side effects were likely to undermine the fairness of Sell's trial.
He said the lower courts also did not consider that Sell already has been confined for a long time, and that his refusal to be medicated might result in further lengthy confinement. Those factors would moderate, but not eliminate, the importance of the government's interest in prosecution, Breyer said.
Justice Antonin Scalia, Sandra Day O'Connor and Clarence Thomas dissented from the ruling.
"Today's narrow holding will allow criminal defendants ... to engage in opportunistic behavior," Scalia said. "They can, for example, voluntarily take their medication until halfway through trial, then abruptly refuse and demand an ... appeal from the order that medication continue on a compulsory basis."
posted on June 16, 2003 12:27:08 PM new
I seem to recall a concept similar to the "not throwing the baby out with the bath water" when dealing with issues of personal freedoms and liberties.
Is it more important that a defendant may avoid a trial or that the state can force a citizen to take drugs ?
The implcations of state mandated "forced sanity" remind me more of the old Soviet Union than America.
While this issue may not seem very contraversial now, as genetic research and drugs are further developed that effect one's mind and thought processes, this ruling and the ones that follow will have huge effects on personal autonomy.
posted on June 16, 2003 01:49:56 PM new
I'd say this is more of a Solomon-like "splitting the baby." The concept of the government forcing an individual to take drugs is nothing new, but it's become increasingly common in a criminal setting. (Most state laws only allow forced drugs or "commitment" in the case of someone who poses an imminent threat to themselves or others.)
Prosecutors have distorted that language to argue that they are acting to protect the defendent when they seek an order to force medication, and they've done it without a lot of review by the higher courts. (Though there have been a few Law and Order episodes. ) Obviously, that isn't the case when you've got someone who, if declared competent, would be taken out of a mental hospital setting and placed into a prison, where they have no chance of getting treatment, or even on Death Row.
This decision may actually represent a scaling back of the government's ability to force an individual to take drugs, because Breyer sets out a fairly stringent test for making that determination. The medication must serve an important governmental interest, and Breyer was pretty clear that the interest wasn't met if, absent medication, someone would be confined in a mental institution until they were competant to stand trial. Medication can't be forced if the side effects would "significantly" interfere with someone's ability to assist in their representation. (For example, some drugs cause muscle spasms. Others cause deep depression or loss of expression.) And the prosecution has to prove that the meds are "likely" to make the defendant competent AND serve their "medical interest."
I'd be happier if the Supreme Court had banned the practice altogether in terms of forcing a defendant to become competent to stand trial. But barring that, some kind of balancing test was definitely needed.
------------------- We do not see things as they are. We see them as we are.
------------The Talmud
posted on June 16, 2003 01:51:08 PM new
One other thing .... The court also said a defendant had a right to challenge medication before being forced to take it.
This is kinda new! Usually, trial proceedings go forward with points like this one preserved for appeal. But Breyers' reasoning is that forcing someone to take drugs against their own interest automatically brings about the harm that's being fought against. It's interesting to see if the court intends to expand that right in other directions.
That's the point Scalia pounds in his screaming hissy fit of a dissent. (I never agree with Scalia - well, almost never - but he's always good readin') He's smoked because this allows a defendant to stop a trial in its tracks to pursue a possible Constitutional violation. (This case is still in pretrial.) It will be interesting if that "new procedural law" plays out in other decisions.
------------------- We do not see things as they are. We see them as we are.
------------The Talmud
posted on June 17, 2003 09:44:36 AM new
I'm not sure the charges matter, but at any rate, the court said the feds could NOT drug Dr. Sell, the defendent in this case - at least, not at this point - until the trial court has evaluated his case in light of the fairly stringent test set up in the opinion. I heard a report on NPR this morning suggesting that Sell's case would probably NOT meet the test. The decision is newsworthy because the majority said they could drug defendants in some cases.
It's funny how many major news outlets got this wrong. This ruling does not allow inmates to be drugged just so they can stand trial - that was already happening. It limits it.
The ironic thing is that the minute Dr. Sell becomes competant to stand trial - assuming he's found guilty (which is not a given) he'll probably be sentenced to time served and released. He's already been detained longer than he could possibly have been held on the fraud charges.
I don't like the forced-drug-taking aspect of the decision. I do think it could've been worse - they could have just said it's OK.
I am very interested in seeing how the expansion of pre-conviction appeals will work out - how they will define Breyer's "important constitutional issue" test.
-------------------
We do not see things as they are. We see them as we are.
------------The Talmud
[ edited by msincognito on Jun 17, 2003 09:50 AM ]
) Obviously, that isn't the case when you've got someone who, if declared competent, would be taken out of a mental hospital setting and placed into a prison, where they have no chance of getting treatment, or even on Death Row.