Opinion ID: 2062379
Heading Depth: 2
Heading Rank: 4

Heading: When Competing Interests Collide: Involuntary Administration of Medication to Restore a Defendant's Competency.

Text: Although the issue does not appear to have been squarely decided in this jurisdiction, most of the courts which have been asked to do so have upheld the involuntary administration of psychotropic drugs to restore or maintain a defendant's competency for trial. In holding that the hospital may treat Khiem with such medication without his consent, the trial judge relied not only on Harper but also on Charters. In Charters, the United States Court of Appeals for the Fourth Circuit, sitting en banc, affirmed a trial court order authorizing the involuntary treatment with psychotropic medication of a mentally ill defendant who had been indicted for allegedly threatening the President of the United States. Charters had been found incompetent and committed to a prison mental health facility for psychiatric examination and treatment. The court held that although an individual so committed was not thereby stripped of all of his liberty interests, those interests which he retained were afforded protection only against arbitrary and capricious state action, and were adequately secured by the exercise of the professional judgment of the prison facility's medical personnel. 863 F.2d at 304-05. The court recognized that the government's interest in maintaining a pretrial detainee in a competent condition to stand trial was a legitimate incident of institutionalization to which Charters' interest must yield. Id. at 305-06. [11] In State v. Law, supra , the Supreme Court of South Carolina rejected a contention very similar to that made by Khiem here: Counsel for the appellant apparently takes the position that under no circumstances can medication be administered a defendant without his consent. They contend that such would be violative of his bodily integrity. We do not feel that such an absolute right exists. It is our view that medication may be administered without the consent of a defendant under compelling circumstances, including those where the medication is necessary to render a defendant competent to stand trial. 270 S.C. at 674, 244 S.E.2d at 307 (emphasis added). [12] Accord, Ybarra v. State, 103 Nev. 8, 13, 731 P.2d 353, 356 (1987) (the majority of courts that have considered the issue have held that competency may be attained through the use of [involuntary] medication); State v. Lover, 41 Wash. App. 685, 689, 707 P.2d 1351, 1353 (1985) (psychotropic medication may be administered without the consent of a defendant to render him or her competent to stand trial) (citing Law, supra, 270 S.C. at 674, 244 S.E.2d at 307); State v. Hayes, 118 N.H. 458, 389 A.2d 1379, 1382 (1978) (the trial court may compel the defendant to be under medication at least four weeks prior to trial if the jury is [appropriately] instructed...); see also People v. Hardesty, 139 Mich.App. 124, 362 N.W.2d 787, 793 (1985). [13] Khiem relies on Bee v. Greaves, 744 F.2d 1387 (10th Cir.1984) for the proposition that his interest in bodily integrity trumps all competing state interests. As the court explained in Bee, the jail contends that it was entitled to inject Bee forcibly with thorazine in order to keep him competent for trial. As we noted initially, however, the state court found after a hearing that Daniel H. Bee is not mentally ill and is competent to stand trial. Rec., vol. I, at 132 (emphasis added). Given this determination, the state's asserted interest in keeping Bee competent to stand trial is not implicated in this case; therefore it cannot serve to override Bee's interest in avoiding forcible medication with antipsychotic drugs. Id. at 1395 (emphasis in original as to words is competent, added as to remainder). The issue raised here by Khiem was thus not before the court in Bee. [14] Khiem also relies on Boyd, supra, in which this court applied the substituted judgment principle to an incompetent patient who had been civilly committed and who objected on religious grounds to the administration of psychotropic medication to her. There was no allegation, however, that Ms. Boyd had committed serious crimes and that it was necessary to bring her to trial. The governmental interest which we find controlling here was not presented in the Boyd case. We are persuaded by the reasoning of Charters, Law, and other decisions authorizing psychotropic treatment without the accused's consent in cases such as this. Accordingly, we reject Khiem's common law claim.