Academic journal article Journal of Criminal Law and Criminology

Sell V. United States: Is Competency Enough to Forcibly Medicate a Criminal Defendant?

Academic journal article Journal of Criminal Law and Criminology

Sell V. United States: Is Competency Enough to Forcibly Medicate a Criminal Defendant?

Article excerpt

Sell v. United States, 123 S. Ct. 2174 (2003)

I. INTRODUCTION

In Sell v. United States, the United States Supreme Court found that the Constitution allows for governmental administration of antipsychotic drugs involuntarily to a mentally ill criminal defendant in order to render the defendant competent to stand trial for nonviolent but serious crimes, in limited circumstances. (1) The Supreme Court examined whether the forcible administration of antipsychotic drugs to render a defendant competent to stand trial is constitutional, specifically whether the defendant was deprived of an important "liberty" guaranteed by the Fifth Amendment. (2) The Court vacated the Eighth Circuit's decision upholding the decision of the District Court allowing the administration of antipsychotic drugs involuntarily to a mentally ill patient. (3)

This Note criticizes the decision in Sell in light of the precedents set forth in Harper (4) and Riggins. (5) The Court should have completely prohibited involuntary medication of a mentally ill criminal defendant with antipsychotic drugs solely to render the defendant competent to stand trial. An individual has a constitutionally protected liberty interest to be free from any unwanted bodily intrusion that will override a state's interest in bringing a defendant to trial. The decision was wrong because a criminal defendant also has a constitutionally guaranteed right to a fair trial that is undermined by forcible administration of antipsychotic drugs due to their significant and harmful side effects. Furthermore, Sell's crimes were not serious enough to warrant forcible administration of antipsychotic drugs, assuming that forcible administration of medication should be allowed at all. Finally, the dissent by Justice Scalia will be criticized for its failure to adhere to the collateral order doctrine and its narrow interpretation of the final judgment rule, thereby depriving a criminal defendant of his right to a fair trial.

II. BACKGROUND

A. ANTIPSYCHOTIC MEDICATION

Two broad general categories of antipsychotic drugs exist: the older "conventional" drugs, and the more recently developed "atypical" drugs. (6) Common side effects of conventional antipsychotic drugs include extrapyramidal reactions along with the extremely serious tardive dyskinesia. (7) Extrapyramidal reactions can include nervous ticks, tremors, spasms, and the need to be in constant motion. These reactions have been found to occur in fifty to seventy-five percent of patients treated with conventional antipsychotic drugs. (8) Tardive dyskinesia is a vicious form of an extrapyramidal reaction and is characterized by involuntary and jerky movement of the facial and oral muscles, along with the upper and lower extremities and trunk. (9) Furthermore, the seriousness of this condition is demonstrated by the fact that it often manifests itself after treatment with the antipsychotic drugs has ceased and is potentially irreversible. (10) Even the Supreme Court has observed that the proportion of patients treated with antipsychotic drugs who exhibit the symptoms of tardive dyskinesia ranges from ten to twenty-five percent. (11) In addition to these extrapyramidal reactions, conventional antipsychotic drugs can often produce other harmful side effects such as sedation, interference with an individual's concentration, blurred vision, dry mouth and throat, constipation, urine retention, weakness, and dizziness. (12)

The newer "atypical" antipsychotic drugs have been reported to have a more favorable side effect profile than conventional antipsychotic drugs. (13) The American Psychiatric Association noted that major progress had been made, particularly in reducing the traditionally most troublesome side effects through the introduction of the newer atypical medications in the last decade. (14) However, these atypical antipsychotic drugs have their own side effects. (15) These side effects can include the potentially fatal disappearance of white blood cells, extrapyramidal effects, cataracts, heart rhythm irregularities, sedation, seizures, hypotension, and weight gain. …

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