Opinion ID: 1297518
Heading Depth: 1
Heading Rank: 3

Heading: Forced Medication

Text: The last issue which must be resolved is whether the State can administer, by force, medication to treat Singleton's incompetence in preparation for execution. The leading case on this controversial issue is Washington v. Harper, 494 U.S. 210, 110 S.Ct. 1028, 108 L.Ed.2d 178 (1990). In Harper, the Court held that the Due Process clause permits forced treatment with antipsychotic drugs only where the inmate is dangerous to himself, or to others, and the treatment is in his medical interest. Id. Writing for the Court, Justice Kennedy, using a substantive due process analysis, balanced the State's legitimate penological interest of combating the danger posed by a violent mentally ill inmate, against the inmate's liberty interest of being free from the unwanted administration of antipsychotic drugs. Id. Another U.S. Supreme Court decision on forced medication was announced in May 1992, in Riggins v. Nevada, 504 U.S. ___, 112 S.Ct. 1810, 118 L.Ed.2d 479 (1992). In Riggins, there was a forced medication of a defendant during trial. The Court held this as violative of due process without a showing that there were no less intrusive alternatives, that the medication was medically appropriate, and that it was essential for the safety of the defendant and the safety of others. Id. This decision announced a more stringent standard for a defendant at the trial stage than for an inmate in the post conviction stage; however, the majority denied that it was to the level of strict scrutiny. Id. The Court also recognized the potential medical harm which stems from the use of antipsychotic drugs. Id. Both the Riggins and Harper decisions have established the federal due process analysis required in a forced medication case. They do not, however, answer the state constitutional question. The most recent determination by a state court on the subject is found in Louisiana v. Perry, 610 So.2d 746 (La.1992). In Perry, the Louisiana Supreme Court found a state constitutional basis for the prohibition of forced medication on a convicted inmate. Citing the Louisiana Constitutional provisions which provide for a right to privacy, the Court specifically stated that the forced medication violated, the right to decide what is to be done medically with one's brain and body; the right to control one's mind and thoughts; and the freedom from unwarranted physical interference with one's person. Id. at 755. The Louisiana Constitution's provision which the court relied on guarantees that, every individual shall be secure in his `person' against `unreasonable searches, seizures, or invasions of privacy.' Id. South Carolina has a strikingly similar constitutional provision in S.C. Const. art. I, § 10, which provides: [t]he right of the people to be secure in their persons, houses, papers, and effects against unreasonable searches and seizures and unreasonable invasions of privacy shall not be violated.... Id. This provision in the S.C. Constitution is no less compelling than the provision in the Louisiana Constitution. Moreover, when the provision is weighed with the due process inquiry mandated by Harper, it becomes apparent that the analysis followed by Louisiana is correct. We hold that the South Carolina Constitutional right of privacy would be violated if the State were to sanction forced medication solely to facilitate execution. An inmate in South Carolina has a very limited privacy interest when weighed against the State's penological interest; however, the inmate must be free from unwarranted medical intrusions. Federal due process and our own South Carolina Constitution require that an inmate can only receive forced medication where the inmate is dangerous to himself or to others, and then only when it is in the inmate's best medical interest. Another thorny issue which arises in this context flows from the medical profession's ethical standards. The Louisiana Court in Perry cited Hippocrates and the physician's oath as: I Swear by Apollo the physician, by Aesculapius, Hygeia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment the following Oath: ... I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone. To please no one will I prescribe a deadly drug, nor give advice which may cause his death.... I will preserve the purity of my life and my art.... In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill doing.... Id. at 752. The American Medical Society and the American Psychiatric Associations have adopted positions in their respective ethical codes opposing participation by medical professionals in the legally-authorized execution of a prisoner. Their reasoning is the causal relationship between administering a drug which allows the inmate to be executed, and the execution itself. They opine that the administration of the drug is responsible for the inmate's ultimate death. AMA Opinion 2.06 (prohibits a physician from participating in a legally authorized execution); see generally Wallace, Incompetency for Execution, 8 J.Legal Med. 265 (1987); American Psychiatric Association, The Principles of Medical Ethics: With Annotations Especially Applicable to Psychiatry § 1(4) (1985); Capital Punishment, Proc. House Delegate AMA 85 (1980). The positions of the medical community are, if nothing else, an indication of the unusual nature of forced medication solely to facilitate execution. [3] In Singleton's case, the problem is exacerbated because of the extent of Singleton's organic brain damage. The record on PCR shows, through expert medical testimony, that Singleton likely will not become competent through the administration of antipsychotic drugs. It is also clear that, because of the organic brain damage, Singleton will probably have a hypersensitive reaction to the medication, which in turn increases the harmful side effects. On these facts, the medical ethical position reinforces the mandates of our constitutional law, which dictate that we prohibit the State's use of antipsychotic drugs solely to facilitate an execution. We, therefore, hold today that the twoprong test for incompetency is the law of South Carolina. We further hold that the appropriate remedy for an incompetent inmate on death row is to seek a stay, following the procedures outlined in this opinion. Finally, on the issue of forced medication, we find that justice can never be served by forcing medication on an incompetent inmate for the sole purpose of getting him well enough to execute. For these reasons, the PCR court's decision is AFFIRMED in part, REVERSED in part, and REMANDED to the PCR court for proceedings consistent with this opinion. HARWELL, C.J., CHANDLER and FINNEY, JJ., and BRUCE LITTLEJOHN, Acting Associate Justice, concur.