Fourth Circuit Decides Involuntary Medication Case

A former School of Government law fellow blogged here about the involuntary medication of death-sentenced prisoners. A recent Fourth Circuit case has moved me to think about the somewhat more common issue of the involuntary medication of incompetent defendants. Sell v. United States, 539 U.S. 166 (2003), held that the state is permitted “involuntarily to administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges in order to render that defendant competent to stand trial, but only if the treatment is medically appropriate,” in other words, is likely to work, “is substantially unlikely to have side effects that may undermine the fairness of the trial, and, taking account of less intrusive alternatives, is necessary significantly to further important governmental trial-related interests.” As to the last consideration, the Court noted that the government’s interest in trying a defendant for a serious crime – whether against persons or property – is normally significant, but that it may be lessened if, for example, the defendant’s refusal to accept medication is likely to result in a lengthy period of involuntary commitment. The Court stated that it will be “rare” that involuntary medication is permissible on competency grounds, and suggested that many involuntary medication issues are better addressed under the dangerousness analysis of Washington v. Harper, 494 U.S. 210 (1990) (holding that a prison inmate may be involuntarily medicated if necessary to stop the inmate from being a danger to himself or others). No reported North Carolina case has been decided under Sell, but [...]