Opinion ID: 2062379
Heading Depth: 2
Heading Rank: 2

Heading: Khiem's Interest in Bodily Integrity.

Text: As we indicated in A.C., the common law liberty interest in one's own bodily integrity is an important one. The Supreme Court, speaking through Chief Justice Rehnquist, recently reiterated its view, initially articulated more than a century ago, that [n]o right is held more sacred, or is more carefully guarded, by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear and unquestionable authority of law. Cruzan v. Missouri Dep't of Health, 497 U.S. 261, ___, 110 S.Ct. 2841, 2846, 111 L.Ed.2d 224 (1990) (quoting Union Pac. R. Co. v. Botsford, 141 U.S. 250, 251, 11 S.Ct. 1000, 1001, 35 L.Ed. 734 (1891)); see also Schloendorff v. Society of New York Hospital, 211 N.Y. 125, 129-30, 105 N.E. 92, 93 (1914) (Cardozo, J.). That right embraces a significant liberty interest in avoiding the unwanted administration of antipsychotic drugs, Harper, supra, 494 U.S. at 221, 110 S.Ct. at 1036 for [t]he forcible injection of medication into a nonconsenting person's body represents a substantial interference with that person's liberty. Id. at 229, 110 S.Ct. at 1041; accord, Riggins v. Nevada, ___ U.S. ___, ___, 112 S.Ct. 1810, 1815, 118 L.Ed.2d 479 (1992). We also agree with Khiem that his rights under the common law were not extinguished by his commitment to the lawful custody of the hospital. In Harper, supra, the Court recognized that a mentally ill individual who has been sentenced to imprisonment retains a right, both under state law and under the Due Process Clause of the Fourteenth Amendment, to be free from the arbitrary administration of antipsychotic medication. Id. at 221, 110 S.Ct. at 1036. See also Boyd, supra, 403 A.2d at 750-52 (ordering substituted judgment inquiry where civilly committed incompetent individual raised religious objection to administration of psychotropic drugs). But our recognition of this important aspect of individual autonomy in a free society does not lead us to accord it the absolute and preemptive character which Khiem claims for it. The government cannot intrude upon Khiem's bodily integrity without a showing of overriding justification and medical appropriateness. Riggins, supra, ___ U.S. at ___, 112 S.Ct. at 1815. Once such a showing has been made, however, Khiem enjoys common law or due process protection only from an unreasonable or arbitrary determination that involuntary medication is appropriate. See Harper, supra, 494 U.S. at 221, 110 S.Ct. at 1036; Charters, supra, 863 F.2d at 305. Dean Prosser has remarked in a different but related context that [a]s with `medical paternalism,' the notion of patient sovereignty can be carried too far. W. PAGE KEETON, PROSSER AND KEETON ON THE LAW OF TORTS, § 32, at 190 n. 60 (5th ed. 1984). Khiem's common law interest, like his due process protections, must be weighed against any legitimate interests asserted by the state, Harper, supra, 494 U.S. at 223, 110 S.Ct. at 1037, and a reasoned accommodation must be made between the competing interests. Id. at 236, 110 S.Ct. at 1044. [8] Moreover, Khiem having been lawfully committed to the hospital, the extent of his rights must be assessed in the context of his confinement. Id. at 222, 110 S.Ct. at 1037; Charters, supra, 863 F.2d at 305. The statute under which Khiem was committed, D.C.Code § 24-301(a) (1989), provides that the court may commit an apparently incompetent criminal defendant to a mental hospital for care and treatment in order to enable him to regain his competency. See Williams v. Overholser, 104 U.S.App.D.C. 18, 20, 259 F.2d 175, 177 (1958). It would surely be incongruous, in light of § 24-301(a), to hold that the court, after committing an accused for treatment to render him competent so that he can stand trial for the offenses with which he has been charged, is obliged to withhold treatment at the accused's sole option. The Corporation Counsel contends in his brief that § 24-301(a) abrogates any common law right of [committed defendants] to refuse treatment. He claims that under that provision, courts may review treatment decisions by the hospital only to make sure that it has made a permissible and reasonable decision in view of the relevant information and within a broad range of discretion. See Tribby v. Cameron, 126 U.S.App.D.C. 327, 328, 379 F.2d 104, 105 (1967). Khiem responds that a statute in derogation of the common law must be strictly construed, and that common law rights remain in effect unless expressly repealed or modified. See United States v. Jackson, 528 A.2d 1211, 1215 (D.C.1987); O'Connor v. United States, 399 A.2d 21, 26 (D.C.1979). In our view, however, the common law provides Khiem with essentially the same rights as those recognized by the court in Tribby, but no more. Section 24-301(a), as heretofore construed, is thus not in derogation of the common law. Finally, Khiem contends that the prosecution is required to prove that its interest in medicating him over his objection is so compelling that no reasonable alternative exists. The availability of reasonable alternatives to the proposed treatment, if shown, would be a relevant factor in the overall inquiry, but this does not necessarily mean that the government must set up and then shoot down every conceivable alternative method of accommodating the claimant's constitutional [or common law] complaint. Harper, supra, 494 U.S. at 225, 110 S.Ct. at 1038 (quoting Turner v. Safley, 482 U.S. 78, 90-91, 107 S.Ct. 2254, 2262, 96 L.Ed.2d 64 (1987)). In any event, as we show below, the law enforcement interest asserted by the government in the present case, which involves two alleged murders, is an especially compelling one. Riggins, supra, ___ U.S. at ___, 112 S.Ct. at 1815.