High Court Limits Forced Medication for Trial
By James Vicini
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."