Involuntary Medication for Defendants and Prisoners
Involuntary Medication for Defendants and Prisoners
Involuntary medication occurs when an individual is subjected to a medical procedure or treatment against their will and without their consent (Roesch & Zapf, 2013). The majority of cases involving involuntary medication arise from psychiatric treatment that is normally administered to patients who do not have the capacity to consent to the treatment. The holding in Washington v. Harper, 494 U.S. 210 (1990) was that mentally ill are normally considered to be a threat to themselves and to other individuals who they may come in contact with thus necessitating the need for the treatment (Roesch & Zapf, 2013).
For the case of prisoners and defendants, involuntary or forced medication occurs when the court rules that a defendant is subjected to medication for purposes that are aimed at reaching the conclusion of the case or to determine a defendant’s competence to stand trial. This can also happen to prisoners during their incarceration. The government’s interest in forcing medication in such cases is pegged on the reason of arriving at a fair decision by the courts without prejudice on the basis of any illness that may need medical attention (Roesch & Zapf, 2013).
With regard to the individual defendant or prisoner’s right to refuse medical treatment, the prisoner or defendant has a right to be subjected to a due process that is procedural to determine whether the said treatment is actually necessary. This was the holding of the United States Supreme Court in the case of Vitek v. Jones 445 U.S 480 (1980) where the court interpreted due process to mean that certain steps should be undertaken before defendants or prisoners are taken to a medical facility or mental institutions. An example of such procedures may include notices or availability of legal assistance from a qualified counsel. This means that if these procedures are not adhered to, then a defendant or a prisoner has the right to refuse such medical treatment. The U.S Supreme Court in the 1992 case of Riggins v. Nevada, 504 U.S. 792 (1992) also reaffirmed that medically appropriate means must always be used in involuntary medication.
In the case of Sell v. United States (2003), the court held that the U.S Constitution permits authorities to administer involuntary medication to a defendant who is mentally ill so as to determine whether such a defendant is competent enough to stand trial for serious nonviolent crimes (Gerbasi & Scott, 2004). The four part standard that the court discussed in this case is outlined as follows (Hayes, 2004):
The essential state interest in the case and whether it was paramount. Here the court held that the single charge of money laundering and sixty-two charges of fraud were very serious and the states interest was tenable.
Whether or not there were any other less intrusive means through which the government can attain its interest. There was no other alternative in this case.
The defendant’s competence to stand trial.
An Ethical Perspective on Involuntary Medication of Defendants
Generally, administering medication to an unwilling individual is unethical. This, however, comes with some exceptions. The American Bar Association provides for certain situations where defendants may be put through forced treatment for purposes of the proper running of the justice system. Prisoners may be treated involuntarily if they are suffering from a mental condition. This happens only when the prisoner is in a serious mental instability state and is likely to harm others around him, and there is no other less intrusive solution which is reasonably accessible (American Bar Association, 2015).
Based on the ethical standards of behavior and mental health treatment, if the condition of the defendant or prisoner does not affect those around him or her and does not also interfere with their performance at a hearing, the defendant should not be subjected to involuntary treatment. In a situation where the condition is not severe, the defendant or prisoner has the right to refuse treatment. Treatment should not be intrusive. Only mental health offices are allowed to violate this code of ethics. They are allowed to offer their expert opinion on the state of the defendant and recommend whether or not they ought to be put through mental treatment whether or not it is against the defendant’s will. Courts should not use their powers to forcefully drug individuals they feel a threat to them if they are non-violent.
Should the Courts Force a Defendant to take Medication?
The American Bar Association sets the standards for involuntary medication. Courts can only force defendants to take anti-psychotic drugs under limited circumstances, where they are physically dangerous to others close to them (American Bar Association, 2015). In Sell’s case, for instance, his lawyer argued that Sell was not mentally incompetent. He simply refused to continue taking his anti-psychotic drugs for fear of detrimental side effects. A defendant who is termed as mentally incompetent may be forced by the courts to take medication for their condition. Non- violent but mentally ill defendants do not fall in this bracket. Prisoners should also only be forcefully treated if they pose a threat to fellow prisoners and prison officials.
Should The Standards be Different than what they are now?
The case presently is that a defendant may be put through involuntary medical treatment if the medication is not likely to have bad effect on them, and that there are important interests of the state at stake, such as competency for trial. To a certain extent, this is ambiguous since the courts may use the clause “the interests of the state being at stake” for selfish reasons. Also, defendants may use this as a loophole to non-violently assault other people (Mears, 2003).
What should the Standards be? Should they be Different for Different Standards?
Mental health experts should be called upon to determine the mental state of defendants and prisoners. All prisoners and defendants who are found to be mentally ill should be put on medication. There should be no division set by the courts for seriously mentally ill patients and those who are non-violent. The courts should prescribe that mentally ill prisoners and defendants be put on medication for the sake of competency during the trial. This is, however, sensitive as it touches directly on the right of s defendant not to be forced to take a defense of insanity. The case of Frendak v. U.S 408 A.2d 364 (D.C. 1979) acted as the foundation of this right. It is thus up to the behavioral health professionals to assess the competency of defendants during a trial.
American Bar Association. (2015). Mental Health | Criminal Justice Section. Retrieved from http://www.americanbar.org/publications/criminal_justice_section_archive/crimjust_standards_mentalhealth_blk.html
Mears, B. (2003, June 16). CNN.com - Supreme Court limits forced medication of non-violent defendants - Jun. 16, 2003. Retrieved from http://edition.cnn.com/2003/LAW/06/16/scotus.forced.medication/
Gerbasi, J. B., & Scott, C. L. (2004). Sell v. U.S.: Involuntary Medication to Restore Trial Competency?A Workable Standard? The Journal of the American Academy of Psychiatry and the Law, 32(1).
Hayes, J. R. (2004). Sell v. United States: Is Competency Enough to Forcibly Medicate a Criminal Defendant. Journal of Criminal Law and Criminology, 94(3). Retrieved from http://scholarlycommons.law.northwestern.edu/cgi/viewcontent.cgi?article=7161&context=jclc
Roesch, R., & Zapf, P. A. (2013). Forensic assessments in criminal and civil law: A handbook for lawyers. New York: Oxford University Press.