Drugging Defendants

Supreme Court sets limits, but is that enough?

A Monday Supreme Court decision sets limits on the practice of forcing medication on mentally ill defendants to make them competent to stand trial. The decision, while possibly influencing only a tiny portion of trials, could give weight to what appears to be an expanding notion that government can override the constitutional liberty of individuals on medical matters.

The high court's narrow interest in this case was simply to establish a review procedure before a federal judge can order nonviolent defendants to be given antipsychotic drugs for the sole purpose of making them well enough to participate in their trial. The case involved a Missouri dentist charged with Medicaid fraud who was diagnosed with mental illness and found incompetent to stand trial. He was able to appeal a lower court order that he be given drugs involuntarily.

The Supreme Court ruled that government must first find "important" government interests are at stake (i.e., ensuring a trial on serious criminal charges, even for nonviolent offenses), while also judging the "efficacy, the side effects, the possible alternatives, and the medical appropriateness" of the drug treatment.

This decision adds to previous ones that allow government to ignore a constitutional "liberty interest" and forcibly drug prisoners if they are proved to be a danger to themselves or others.

This case had the potential to address a deeper question over whether government manipulation of someone's mental capacity through drugs relies on false assumptions about what constitutes a person's individuality. The court chose to sidestep that basic issue.

Still, the court did try to restrain the practice. While some of its language is vague enough to invite more such cases, the decision at least raises a small caution flag for a society that, to its detriment, turns more and more often to drugs to solve its problems.