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
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
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
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. …