Source: https://www.ucmjdefense.com/resources/jurisdiction-and-competence-of-court-martial/competency-to-stand-trial/hospitalization-of-the-accused.html
Timestamp: 2019-04-21 12:51:01+00:00

Document:
Upon a finding of incompetence, if the convening authority agrees, there is nodiscretion regarding commitment. United States. v. Salahuddin , 54 M.J. 918 (A.F. Ct. Crim. App. 2001); see also RCM 909(e)(3) and 18 U.S.C. § 4241(d).
The four-month time period may be extended. To justify extended commitment, theGovernment must prove by clear and convincing evidence that “a substantial probability exists that the continued administration of antipsychotic medication will result in a defendant attaining the capacity to permit the trial to proceed in the foreseeable future.” United States v. Weston , 260 F. Supp. 2d 147, 154 (D.D.C. 2003) (approving a year-long extension from the case below in (3)(a)).
United States v. Weston , 255 F.3d 873 (D.C. Cir. 2001). Defendant indicted for the murders and attempted murder of federal law enforcement officers. A court-appointed forensic psychiatrist diagnosed defendant with paranoid schizophrenia, the severity of which rendered him incompetent to stand trial. Because he refused treatment with antipsychotic medication, he was simply placed in solitary confinement under constant supervision. The government sought a court order authorizing the involuntary administration of medication to render him competent to stand trial. The Circuit Court held that there was no basis to believe that defendant’s worsening condition rendered him more dangerous, given his near-total incapacitation. However, the court affirmed the District Court’s decision that the government’s interest in administering antipsychotic drugs overrode his liberty interest and that restoring his competence in this way did not violate his right to a fair trial.
Sell v. United States , 539 U.S. 166 (2003). Defendant was charged with fraud. A federal magistrate found him incompetent to stand trial and ordered his hospitalization to determine whether he would attain capacity to allow his trial to proceed. Sell refused to take antipsychotic drugs. The magistrate found involuntary medication appropriate because Sell was a danger to himself and others, that medication was the only way to render him less dangerous, that any serious side effects could be ameliorated, that the benefits to him outweighed the risks, and that the drugs were substantially likely to return Sell to competence. The District Court, although determining that the Magistrate’s conclusion regarding Sell’s dangerousness was clearly erroneous, nonetheless affirmed the decision because it found that the medication was the only viable hope of rendering Sell competent and was necessary to serve the government’s interest in adjudicating his guilt or innocence. The Circuit Court affirmed, finding that the government had an essential interest in bringing Sell to trial, that treatment was medically appropriate, and that the medical evidence indicated a reasonably probability that Sell would fairly be able to participate in his defense. The Supreme Court vacated and remanded the case. Determining that forced medication solely for trial competency purposes may be rare, the Court held that the Constitution permits involuntary medication to render a mentally ill defendant competent to stand trial on serious criminal charges if the treatment is medically appropriate, is substantially unlikely to have side effects that may undermine the trial’s fairness, and, taking account of less intrusive alternatives, is necessary to significantly further important governmental trial-related interests.
United States v. Bush , 585 F.3d 806 (4th Cir. 2009). The court finds that the government must establish all of the Sell factors by clear and convincing evidence. The court also held that even where a defendant has been in an institution longer than the maximum punishment for the underlying offense, the government still has an important interest in bringing the defendant to trial. Certain consequences that convictions bring (such as firearms restrictions) are important governmental interests justifying continued prosecution and potential involuntary medication.

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