Opinion ID: 624293
Heading Depth: 4
Heading Rank: 2

Heading: Post-Sell Cases

Text: The parties dispute whether the Supreme Court's precedent answers the question in this case: what substantive due process standard must the government satisfy to medicate involuntarily a pretrial detainee on the ground that he is dangerous? The government argues that, because Loughner was being medicated for dangerousness, he may be medicated following a Harper hearing, and that Sell approved the use of  Harper -type grounds for medicating pretrial detainees. See Sell, 539 U.S. at 182, 183, 123 S.Ct. 2174. Loughner responds that Harper addressed involuntary medication for convicted inmates, not pretrial detainees, and that Riggins requires that the government demonstrate that a pretrial detainee's treatment with antipsychotic medication [i]s medically appropriate and, considering less intrusive alternatives, essential for the sake of [the pretrial detainee]'s own safety or the safety of others. Riggins, 504 U.S. at 135, 112 S.Ct. 1810. The Court's cases have not addressed the issue directly. The Court in Sell seemed to assume, however, that a Harper hearing would be sufficient to medicate involuntarily a pre-trial detainee on dangerousness grounds. More importantly, we have made the same assumption in our prior discussions of Harper, Riggins, and Sell. Finally, post- Sell, every court of appeals to have considered the application of Harper in the pretrial detainee context has made the same assumption. The core of Loughner's argument comes from two statements in Riggins. First, the Court was careful to acknowledge that Harper involved a convicted prisoner: Under Harper, forcing antipsychotic drugs on a convicted prisoner is impermissible absent a finding of overriding justification and a determination of medical appropriateness. The Fourteenth Amendment affords at least as much protection to persons the State detains for trial. Riggins, 504 U.S. at 135, 112 S.Ct. 1810 (emphasis added). That parsing of Harper was followed with this observation: Although we have not had occasion to develop substantive standards for judging forced administration of such drugs in the trial or pretrial settings, Nevada certainly would have satisfied due process if the prosecution had demonstrated. . . that treatment with antipsychotic medication was medically appropriate and, considering less intrusive alternatives, essential for the sake of Riggins' own safety or the safety of others. Id. (emphasis added). Nothing in the holding of Sell fills this gap, except for the Court's significant aside that if forced medication is warranted for a different purpose, such as the purposes set out in Harper related to the individual's dangerousness, then the district court need not conduct a Sell hearing to determine whether a pretrial detainee may be medicated to render him competent to stand trial. Sell, 539 U.S. at 181-82, 123 S.Ct. 2174. When the Court later referred to  Harper -type grounds, id. at 182, 123 S.Ct. 2174, and failed to renew its disclaimer that it had not decided the Harper question for pretrial detainees, [11] we and other circuits believed that the Court had, indeed, decided just such a question. We first addressed the Supreme Court's trilogy with respect to a pretrial detainee in United States v. Rivera-Guerrero, 426 F.3d 1130 (9th Cir.2005). Rivera-Guerrero was charged with illegal reentry. See id. at 1134. After he was found incompetent to stand trial, FMC-Springfield requested an order allowing it to medicate Rivera-Guerrero to restore his competence to stand trial. See id. The magistrate judge held a Sell rather than a Harper hearing and determined that Rivera-Guerrero could be medicated. See id. at 1134-35. We reversed the order on appeal on the grounds that a pretrial involuntary medication decision could not be delegated to a magistrate judge. See id. at 1136. Following the remand, FMC-Springfield began involuntarily medicating Rivera-Guerrero on an emergency basis. The district court thereafter issued an opinion adopting the recommendations of the magistrate judgea nearly identical justification as the order we previously vacated. See id. We began our discussion by noting that  Sell orders are disfavored. The Supreme Court clearly intends courts to explore other procedures, such as Harper hearings (which are to be employed in the case of dangerousness ) before considering involuntary medication orders under Sell.  Id. at 1137 (emphasis added). Although we reversed for a procedural error in the Sell proceedings, we noted that because of Rivera-Guerrero's involuntary medication on dangerousness grounds and confinement for more than the permissible period of time, on remand, conducting a Sell inquiry no longer constitutes the appropriate procedure. Id. at 1143. We instructed the district court to order FMC-Springfield to report on Rivera-Guerrero's medical status. If the FMC reports that Rivera-Guerrero has been rendered competent to stand trial as a result of its administration of the medication, and the district court accepts that assertion, then the district court may proceed with the criminal trial. . . . Id. at 1144. In United States v. Hernandez-Vasquez, 513 F.3d 908 (9th Cir.2008), we addressed a slightly different circumstance. The government had charged Hernandez-Vasquez, like Rivera-Guerrero, with illegal reentry. See id. at 911. After the district court found Hernandez-Vasquez incompetent, he was transferred to FMC-Springfield where the government requested that he be medicated to render him competent to stand trial; in the alternative, the government asked that Hernandez-Vasquez be evaluated for dangerousness. See id. at 912. The district court conducted a Sell hearing and granted the government's motion to medicate Hernandez-Vasquez to render him competent for trial. See id. On appeal, we noted that a Sell inquiry is independent of the procedure that allows involuntary medication of dangerous inmates under Harper.  Id. at 913. We addressed the question of whether the district court had an obligation to apply Harper and make a dangerousness inquiry before proceeding under Sell,  and held that [i]f a district court does not conduct a dangerousness inquiry under Harper, it should state for the record why it is not doing so. Id. at 914. We concluded that the district court should take care to separate the Sell inquiry from the Harper dangerousness inquiry and not allow the inquiries to collapse into each other. Id. at 919. We suppose that a close reading of these cases might yield a conclusion that our statements regarding Harper are dicta. But given the extensive nature of our discussions, our lack of reservation about applying Harper to pretrial detainees, and our instructions on remand to conduct the Harper dangerousness inquiry, id., there is little doubt that we believe that the standards set forth in Harper apply to inmates being held by the government, whether they are awaiting trial or are serving a sentence of incarceration. See Ruiz-Gaxiola, 623 F.3d at 689 (referring to the magistrate judge ordering the government to conduct an administrative hearing pursuant to Harper  prior to considering an involuntary medication order under Sell for a pretrial detainee [d]ue in part to our admonition that ` Sell orders are disfavored'). Even if we were inclined to reweigh the factors considered by the Supreme Court in Harper in the context of a convicted prisoner, we would arrive at the conclusion that Harper applies to pretrial detainees as well. Two points are sufficient. First, we recognize that the most important factor for determining the appropriate level of scrutiny is the purpose of the involuntary medication, not the inmate's criminal status. See United States v. Baldovinos, 434 F.3d 233, 240 (4th Cir. 2006) ([T]he Court indicated that the determination of which principles applythose of Harper or those of Sell depends on the purpose for which the Government seeks to medicate the defendant.); United States v. Brandon, 158 F.3d 947, 957 (6th Cir. 1998) ( Harper 's rationale is based upon the premise that if the government's action focuses primarily on matters of prison administration, then the action is proper if reasonably related to a legitimate penological interest, even if it implicates fundamental rights.). If the government seeks to medicate involuntarily a pretrial detainee on trial competency grounds, that is a matter of trial administration and the heightened standard announced in Sell applies. See Sell, 539 U.S. at 183, 123 S.Ct. 2174. When dangerousness is a basis for the involuntary medication, however, as is the case with Loughner, the concerns are the orderly administration of the prison and the inmate's medical interests. See Harper, 494 U.S. at 222-25, 110 S.Ct. 1028; Baldovinos, 434 F.3d at 240; Brandon, 158 F.3d at 957. Second, although we recognize that in certain contexts there are important differencesdifferences of constitutional magnitudebetween pretrial detainees and convicted detainees, see Bell v. Wolfish, 441 U.S. 520, 537, 99 S.Ct. 1861, 60 L.Ed.2d 447 (1979) (This Court has recognized a distinction between punitive measures that may not constitutionally be imposed prior to a determination of guilt and regulatory restraints that may.); Friedman v. Boucher, 580 F.3d 847, 853-58 (9th Cir.2009) (holding that suspicionless, warrantless searches of pretrial detainees that do not contribute to prison security are unconstitutional, and distinguishing cases upholding similar searches of convicted detainees), those differences largely disappear when the context is the administration of a prison or detention facility. As the Court stated in Bell, [t]he fact of confinement as well as the legitimate goals and policies of the penal institution limits . . . retained constitutional rights. There must be a mutual accommodation between institutional needs and objectives and the provisions of the Constitution that are of general application. This principle applies equally to pretrial detainees and convicted prisoners. 441 U.S. at 546, 99 S.Ct. 1861 (1979) (emphasis added) (citations omitted) (internal quotation marks omitted); see Bull v. City & Cnty. of San Francisco, 595 F.3d 964, 973-74 & nn. 10, 11 (9th Cir.2010) (en banc) (We have never distinguished between pre-trial detainees and prisoners in applying the Turner test, but have identified the interests of correction facility officials responsible for pretrial detainees as being `penological' in nature.); United States v. Hearst, 563 F.2d 1331, 1345 n. 11 (9th Cir. 1977) (All legitimate intrusive prison practices have basically three purposes: the preservation of internal order and discipline, the maintenance of institutional security against escape or unauthorized entry, and the rehabilitation of the prisoners. The first two interests are implicated regardless of the status of the prisoner. The third, of course, applies only to prisoners already convicted of a crime. Accordingly, a pretrial detainee may assert his status as a shield against intrusive practices aimed solely at rehabilitation but not against practices aimed at security and discipline. (citations omitted) (internal quotation marks omitted)). So long as Loughner is a pretrial detainee, and lawfully held, his rights are limited by the facility's legitimate goals and policies, and his dangerousness to himself or to others may be judged by the same standard as convicted detainees. See Harper, 494 U.S. at 224, 110 S.Ct. 1028 (We made quite clear that the standard of review we adopted in Turner applies to all circumstances in which the needs of prison administration implicate constitutional rights.). Finally, we observe that, post- Sell, [12] every court of appeals to have considered the interplay between Harper and Sell a context that necessarily implicates pretrial detainees onlyhas similarly assumed that Harper is the appropriate standard for measuring whether a pretrial detainee may be involuntarily medicated because of dangerousness. See Grape, 549 F.3d at 599 (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 the inmate's medical center.); United States v. Green, 532 F.3d 538, 545 n. 5 (6th Cir.2008) (The Sell standard applies when the forced medication is requested to restore competency to a pretrial detainee and the pretrial detainee is not a danger to himself or others. When the pretrial detainee is a potential danger to himself or others, the Harper standard is used.); United States v. White, 431 F.3d 431, 435 (5th Cir.2005); United States v. Morrison, 415 F.3d 1180, 1186 (10th Cir.2005) ([T]he central role of dangerousness in the Sell inquiry in this case calls out for proceeding under Harper first.); Evans, 404 F.3d at 235 n. 3 (The Supreme Court has outlined different tests for when the government may involuntarily medicate an individual, depending on whether the medication is for purposes of prison control or prisoner health on the one hand, see [ Harper, 494 U.S. at 227, 110 S.Ct. 1028], or, on the other hand, for the purpose of prosecuting an incompetent defendant, see Sell [, 539 U.S. at 166, 123 S.Ct. 2174].); see also Morgan, 193 F.3d at 262-63 (pre- Sell case holding that [u]nder Harper, due process permits institutional medical personnel to forcibly treat a pretrial detainee with antipsychotic medication once they conduct the type of administrative proceeding the State of Washington employed). If there was any remaining doubt in our cases about the proper standard, we now hold that when the government seeks to medicate a detaineewhether pretrial or post-convictionon the grounds that he is a danger to himself or others, the government must satisfy the standard set forth in Harper. [T]he Due Process Clause permits the State to treat a prison inmate who has a serious mental illness with antipsychotic drugs against his will, if the inmate is dangerous to himself or others and the treatment is in the inmate's medical interest. Harper, 494 U.S. at 227, 110 S.Ct. 1028.