To Stand Trial, Defendants Can Be Medicated by Force ; High Court Rules That State Can Use Drugs When Mentally Ill Defendant Is Facing Trial

Article excerpt

The US government can forcibly administer mind-altering drugs to render criminal defendants competent to stand trial, but only under certain limited circumstances.

In a case with potential implications for those opposed to conventional medical care, the US Supreme Court ruled 6 to 3 Monday that the government's interest in bringing defendants to trial outweighs an individual's decision to be free from forced medication.

The high court declined to find that individuals possess a fundamental right under the Constitution to reject forced medication. The decision doesn't discuss this issue. Instead, the majority concluded that the government has the power to take action when a defendant is "mentally ill" and facing "serious criminal charges."

In the majority opinion, Justice Stephen Breyer established a new legal standard that substantially narrows the permissible circumstances for such government action. "This standard will permit involuntary administration of drugs solely for trial competence purposes in certain instances. But those instances may be rare," Justice Breyer writes.

The high court outlined four conditions that a court must meet to approve the forcible medication of a defendant. First, the court must find important government interests are at stake. Second, it must conclude that involuntary medication will significantly further those government interests. Third, the court must conclude that involuntary medication is necessary to further those interests. And fourth, it must conclude that administration of the drugs is medically appropriate in light of the patient's best medical interests.

The justices also noted that a court must find administration of the drugs is substantially unlikely to have side effects that will significantly interfere with a defendant's ability to assist in his or her defense at trial.

Breyer was joined in the majority opinion by Chief Justice William Rehnquist and Justices John Paul Stevens, Anthony Kennedy, David Souter, and Ruth Bader Ginsburg.

The decision comes in the case of a St. Louis dentist, Charles Sell. He was charged in 1997 with running a Medicaid insurance fraud scheme. Dr. Sell has been diagnosed with a mental illness, called delusional disorder - persecutory type, which has rendered him incompetent to stand trial.

Medical experts hired by the government say that certain antipsychotic drugs could restore Sell's competence and permit him to stand trial. …