The crisis: Can a defendant be forcibly drugged, even when he has not yet been convicted of any charges? How about if medical professionals testify the defendant is in need of medication because he presents with acute dystonia -- a severe involuntary spasm of the upper body, tongue, throat, or eyes -- and has a delusional disorder. Which means, without treatment, the defendant is not mentally competent to stand trial. And, what if the trial court was informed that the patient’s condition may be treated and reversed within a few minutes through use of medication, making him competent for trial?

There is even more to this yet: The defendant had already been confined for a longer period of time than if he had pled guilty for the crime for which he was charged and the judge was evidently thinking enough is about enough with this case. Also, the defendant/mental patient had already threatened to kill a couple people, namely an FBI agent working the case and a witness. (footnote #8)

The trial judge received expert testimony from physicians who see the patient often. They said the patient would respond to medication well. But, meanwhile, the patient/defendant is incompetent for trial. Conversely, the defendant’s attorney said that the defendant reserves his right to not be medicated.

What is the correct decision here?

The trial judge approved medicating the patient and the defendant appealed the decision to the Federal Eighth Circuit Court of Appeals.

The Appeals Court noted that: "The district court appropriately considered Sell’s medical interest. The court noted that Sell’s delusions interfere with his ability to make sound judgments about his life and his treatment, and that his disorder currently impairs and misleads his interpretation of reality and his reasoning. The government presented evidence that antipsychotic medication is commonly used to help reduce delusions and their impact on an individual’s life, and the court found that these benefits outweighed the risks associated with antipsychotic drugs."

Much of the opinion discusses current case law and the differences between districts. Then, the court rules:

"The government has an essential interest in bringing a defendant to trial. Not all charges, however, are sufficient to justify forcible medication of a defendant; rather, the charges must be serious. Here, the sixty-two charges of fraud and the single charge of money-laundering are serious, a fact not denied by the defendant. Despite Sell’s significant liberty interest in refusing antipsychotic medication, in view of the seriousness of the charges, we believe that the government’s interest in restoring his competency so that he may be brought to trial is paramount."

That reasoning is a very difficult to agree with!

"Second, the government proved that the side- effects produced by the medication could be minimized through careful treatment and changing medications and dosages. Although Dr. Wolfson did not name a specific medication, he did name the two he would most likely use. Therefore, we reject Sell’s contention that he was not given the opportunity to make specific objections to specific drugs. Furthermore, we reject Sell’s argument that the court erred in basing its opinion in part on the availability of atypical antipsychotic drugs which can only be administered orally. The availability of the atypical medications was not determinative to the district court’s findings, and the evidence supports the conclusion that the doctors treating Sell will be able to reduce the incidence of unpleasant and harmful side-effects produced by typical antipsychotic medication as well."

That is not a comfortable decision, either. However, it at least begins to discuss the welfare of the patient.

"Finally, the district court appropriately considered Sell’s medical interest. The court noted that Sell’s delusions interfere with his ability to make sound judgments about his life and his treatment, and that his disorder currently impairs and misleads his interpretation of reality and his reasoning. The government presented evidence that antipsychotic medication is commonly used to help reduce delusions and their impact on an individual’s life, and the court found that these benefits outweighed the risks associated with antipsychotic drugs."

We think the government’s clock has ticked too many times in this matter. Time’s up. The defendant is delusional and has other conditions that are not easily managed medically. Good medical treatment is definitely appropriate -- in a hospital, not a jail. That should have been the order of the court. Any other legal action can wait a couple years.