United States v. Ruiz-Gaxiola: When Criminal Defendants Say No to Drugs

I. INTRODUCTION In light of the "significant liberty interest in avoiding the unwanted administration of antipsychotic drugs,"1 the Ninth Circuit joined several other circuits2 in requiring the government to meet the higher standard of clear and convincing evidence when it wants to forcibly medicate criminal defendants to make them competent to stand trial.3 If the government wants to medicate a criminal defendant against his will, it must proceed in one of two ways, depending on whether the defendant is dangerous. First, the government can seek to medicate a dangerous defendant in what is called a Harper* hearing. This is the simpler method because "the inquiry ... is usually more Objective and manageable,'"5 and the Supreme Court has held that an elevated standard is not needed in this kind of inquiry.6 Second, the government can seek to forcibly medicate a nondangerous defendant for the sole purpose of restoring competency to stand trial. This second situation is called a Self inquiry and is the focus of the Ruiz-Gaxiola case. In United States v. Ruiz-Gaxiola, defendant Vincente RuizGaxiola was charged with unlawful reentry and was found to be incompetent to stand trial due to a rare mental disorder.8 He refused medication that was intended to restore his competency, and the district court ordered that he be forcibly medicated.9 On review, the Ninth Circuit held that the government had not proven by clear and convincing evidence that the proposed treatment was medically appropriate or that it would significantly further the government's prosecutorial interest.10 The court's decision was correct, but it missed an opportunity to simplify applying these decisions by closing the door on Sell inquiries in situations in which defendants are accused of nonserious crimes. The court should have determined that the government never has an important enough interest in prosecuting nonviolent individuals to justify forcible medication; the goals of prosecution and punishment either cannot be accomplished with these types of defendants or will be accomplished better by some other means that do not require forced administration of antipsychotic drugs. Part II of this Note gives a short background on the law of forced medication, followed by a discussion of the facts and analysis of the Ruiz-Gaxiola case. Part III explains the retributivist and utilitarian rationales for punishment and discusses why these justifications may not apply to defendants who are found to be incompetent. Part IV discusses the more humane alternatives that can accomplish these utilitarian goals. Part V concludes. II. RUIZ-GAXIOLA AND THE LAW OF FORCED MEDICATION A. The Cases Up Through Sell It is a violation of due process to convict a mentally incompetent person.11 The standard for competency to stand trial requires that a person have "sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding - and [that] he [have] a rational as well as factual understanding of the proceedings against him."12 Prosecutors and courts have adopted different methods of restoring a defendant to a level of competency that would allow him to stand trial. In some cases, they have attempted to commit the defendant to a mental health ward, even though the defendant was not dangerous, in an effort to restore him to competency.13 These commitments were often indefinite and would sometimes extend well beyond the statutory-maximum sentence of the alleged crime.14 The Supreme Court invalidated these indefinite commitments because they were based solely on a defendant's incompetence to stand trial.15 If a defendant is held in an institution to restore him to competency, he can only be held for a reasonable period of time necessary to determine "whether there is a substantial chance of his attaining the capacity to stand trial in the foreseeable future."16 If the state does not determine that a person would regain competence, then it must undertake a standard civil commitment to continue to hold the defendant. …