Opinion ID: 3033156
Heading Depth: 2
Heading Rank: 1

Heading: The Sell Framework

Text: In the instant appeal, Grape seeks relief from the District Court’s order allowing the Government to forcibly medicate him to render him competent to stand trial pursuant to Sell, but the Government already forcibly medicated him in Fall 2007 pursuant to Harper. Harper allows the involuntary administration of drugs to a prisoner with serious mental illness under limited circumstances if: (1) the inmate is dangerous to himself or others, and (2) the treatment is in the inmate’s “medical interest.” 494 U.S. at 227. In deciding Harper, the Supreme Court found that although an inmate “possesses a significant liberty interest in avoiding the unwanted administration of antipsychotic drugs under the Due Process Clause of the Fourteenth Amendment,” this interest can be overcome by a “legitimate” and “important” government interest in “providing appropriate medical treatment to reduce the danger” the inmate presents. Id. at 221-22, 236. We do not reach consideration of the four-factor Sell test unless an inmate does not qualify for forcible medication under Harper, as determined at a Harper hearing generally held within convincing evidence); Evans, 404 F.3d at 236 n.5 (stating that Evans argued that the “Due Process Clause requires the Government to prove its case under Sell by clear and convincing evidence,” but that in failing to raise this argument before the district court, he waived it on appeal). 17 the inmate’s medical center. Because Dr. Tomelleri found at Grape’s first Harper hearing in Spring 2007 that he did not meet the Harper standard for involuntary medication, the Government continued to pursue Grape’s forcible medication through Sell. We distinguish here between the two methods of involuntary medication because, although Grape appeals only his Sell order, the details of his eventual medication pursuant to Harper, as determined at his Fall 2007 Harper hearing, are relevant to our Sell analysis. In Sell, the Supreme Court explicitly allowed the forcible medication of an inmate “solely for trial competence purposes” in certain “rare” instances. 539 U.S. at 180. The Court set a standard that the government must meet in order to overcome the inmate’s liberty interest, as laid out in a four-factor test. First, “a court must find that important governmental interests are at stake,” though “[s]pecial circumstances may lessen the importance of that interest.” Id. Second, “the court must conclude that involuntary medication will significantly further those concomitant state interests.” Id. at 181. This includes finding that “administration of the drugs is substantially likely to render the defendant competent to stand trial,” and “[a]t the same time, . . . that administration of the drugs is substantially unlikely to have side effects that will interfere significantly with the defendant’s ability to assist counsel in conducting a trial defense, thereby rendering the trial unfair.” Id. Third, “the court must conclude that involuntary medication is necessary to further those interests” and that “any alternative, less intrusive treatments are unlikely to achieve substantially the same results.” Id. Fourth, and finally, “the court must conclude that administration of the drugs is medically appropriate, i.e., in the 18 patient’s best medical interest in light of his medical condition.” Id. The Court then emphasized that the goal of this test is “to determine whether involuntary administration of drugs is necessary significantly to further a particular governmental interest, namely, the interest in rendering the defendant competent to stand trial.” Id. In this appeal, Grape challenges only the first two Sell factors, arguing that the Government has not met its burden on either. This is an issue of first impression in this Court.