Opinion ID: 4524141
Heading Depth: 2
Heading Rank: 3

Heading: Appellate Jurisdiction and Mootness

Text: No question has been raised about this court’s jurisdiction to entertain the present appeals. Although the denials of the motions to enjoin involuntary medication did not finally conclude the criminal proceedings, they were immediately appealable under the collateral order doctrine. As the Supreme Court held in Sell, the rulings satisfy the three requirements of that doctrine: they (1) conclusively determine the question in dispute, (2) resolve an important issue that is completely separate from the merits of the actions (which concern each defendant’s guilt or innocence), and (3) are effectively unappealable from a final judgment in that action. 38 We conclude that we have jurisdiction over these interlocutory appeals. It is a separate question whether these appeals are moot. “A case is moot when the legal issues presented are no longer ‘live’ or when the parties lack a legally cognizable interest in the outcome.” 39 The question of mootness arises, though DBH has not raised it, because D.C. Code § 7-1231.08(c)(6) provides that administrative decisions approving involuntary medication are valid for no more than thirty days. This means the orders authorizing the involuntary medication of Mr. Byrd and Mr. 38 See Sell, 539 U.S. at 175-77; see also, e.g., Loughner, 672 F.3d at 743. 39 Cropp v. Williams, 841 A.2d 328, 330 (D.C. 2004). 22 Taylor have long since expired. To avoid dismissal of their appeals on mootness grounds, appellants must continue to have a “personal stake” in the outcomes despite the expirations. 40 We conclude that neither appeal is moot, though for a different reason in each case. Mr. Byrd has the necessary continuing personal stake because his claim falls within the “exception” (as it has been called) to the mootness doctrine for controversies that are “capable of repetition, yet evading review.” This exception applies where “(1) the challenged action was in its duration too short to be fully litigated prior to its cessation or expiration, and (2) there was a reasonable expectation that the same complaining party would be subjected to the same action again.” 41 Mr. Byrd satisfies the first prong because a challenge to involuntary medication is not amenable to full litigation and resolution within the brief period before the order expires. He satisfies the second prong because, given the serious 40 See, e.g., Genesis HealthCare Corp. v. Symczyk, 569 U.S. 66, 71-72 (2013) (“[A] plaintiff must demonstrate that he possesses a legally cognizable interest, or ‘personal stake,’ in the outcome of the action. . . . If an intervening circumstance deprives the plaintiff of a ‘personal stake in the outcome of the lawsuit,’ at any point during litigation, the action can no longer proceed and must be dismissed as moot.” (Citations omitted.)). 41 In re Barlow, 634 A.2d 1246, 1249 (D.C. 1993) (quoting Weinstein v. Bradford, 423 U.S. 147, 149 (1975)). 23 nature of his mental illness and his anticipated on-going dangerousness if he is not medicated, it is reasonable to expect he will be subjected to future thirty-day administrative involuntary medication orders during his ongoing pretrial detention. 42 It makes no difference in this case that the Superior Court recently approved Mr. Byrd’s involuntary medication for the purpose of rendering him competent. Like the Tenth Circuit, “we recognize that mental illnesses wax and wane over time and that the government may often have strong reasons for seeking forced medication under Harper to alleviate a defendant’s dangerousness even after the entry of a Sell order.” 43 42 See Harper, 494 U.S. at 218-19 (holding that cessation of a schizophrenic prisoner’s involuntary antipsychotic medication did not moot his challenge, given the likelihood that officials would seek to resume the medication); see also, e.g., Honig v. Doe, 484 U.S. 305, 318-23 (1988) (holding that a handicapped student’s suit challenging his suspension from school for disability-related misconduct was not moot where there was a reasonable likelihood, in view of his disability, that he would be subjected to the same school action again). 43 United States v. Osborn, 921 F.3d 975, 982 (10th Cir. 2019); see also id. at 980-81 (appeal of Sell order allowing forcible medication to render a defendant competent to stand trial held not moot despite an intervening Harper decision to administer the same medication to address the defendant’s dangerousness, because officials “may very well” attempt to medicate the defendant under Sell again after she no longer poses a danger to herself or others). 24 The “capable of repetition, yet evading review” doctrine does not apply to Mr. Taylor because, unlike Mr. Byrd, he is no longer a pretrial detainee at Saint Elizabeths or subject to involuntary medication under D.C. Code § 7-1231.08. 44 Upon learning that Mr. Taylor had been sentenced and been transferred to the custody of the United States Bureau of Prisons, this court sua sponte requested supplemental briefing on whether his appeal had become moot. Both he and DBH agree it is not, mainly on the ground that Mr. Taylor may suffer collateral consequences from the Superior Court’s order upholding his involuntary medication. As they argue, this court has recognized that involuntary civil commitments based on findings of mental illness and dangerousness “can have continuing collateral consequences for the affected individual that should be dispelled if the commitment was unlawful” even if the commitment order has expired and been superseded by a subsequent commitment. 45 According to the 44 See Honig, 484 U.S. at 318. 45 In re Edmonds, 96 A.3d 683, 687 n.11 (D.C. 2014); see also In re Amey, 40 A.3d 902, 909 (D.C. 2012) (holding that appeal of expired one-year involuntary civil commitment is not moot in light of “significant and continuing collateral consequences on the patient” from the adjudication of mental illness); In re Morris, 482 A.2d 369, 371-72 (D.C. 1984) (holding that patient’s discharge does not moot challenge to involuntary emergency hospitalization on grounds of mental illness and dangerousness, in part because of the continuing collateral consequences of such hospitalization). Cf. In re Smith, 880 A.2d 269, 275-76 (D.C. 2005) (holding that “once a new order determining the status of a committed mental health patient is in effect, it supersedes any prior order on the same matter and renders moot an appeal 25 parties, the court order upholding Mr. Taylor’s involuntary medication (which was based, in part, on the court’s deference to the Hospital physicians’ determinations of his mental illness and dangerousness) is analogous to a civil commitment order and may have similar collateral consequences. Mr. Taylor claims he already has begun to confront those consequences, in that the Federal Medical Center psychologist evaluating his dangerousness pursuant to 18 U.S.C. § 4246 has consulted or sought his Saint Elizabeths records and DBH reports. Especially given the government’s agreement that the Superior Court’s affirmance of his forcible psychotropic medication may have adverse collateral consequences for Mr. Taylor, we are not prepared to conclude he no longer has a personal stake in the outcome of this appeal. IV. Appellants’ Constitutional and Statutory Claims
Appellants’ main claim is that the administrative authorization of their involuntary medication did not afford them substantive or procedural due process. They argue that although Harper upheld the constitutionality of administrative from the prior order, unless there are collateral effects from the prior order resulting in prejudice to the patient.”). 26 authorization for convicted prisoners, the Due Process Clause requires the judicial trial-related findings mandated in Sell before pretrial detainees may be medicated involuntarily with antipsychotic drugs, regardless of the purpose of the medication, because the unwanted side effects of such medication may result in undermining the detainees’ rights to a fair trial. For the following reasons, this contention does not persuade us, and we conclude that when the purpose of involuntary medication is to reduce a pretrial detainee’s dangerousness or suffering, the detainee’s liberty interests are sufficiently protected by an administrative, medical determination that is subject to judicial review and that meets the standards of Harper. First, the Sell Court explicitly envisioned that pretrial detainees could be medicated involuntarily based on Harper findings alone for reasons other than rendering them competent. The Court stated, for example, that “a court, asked to approve forced administration of drugs for purposes of rendering a defendant competent to stand trial, should ordinarily determine whether the Government seeks, or has first sought, permission for forced administration of drugs for these other Harper-type grounds; and, if not, why not.” 46 46 Sell, 539 U.S. at 183; see also id. at 181-82 (stating courts should “not consider whether to allow forced medication for [the purpose of rendering a defendant competent to stand trial] if forced medication is warranted for a different purpose, such as the purposes set out in Harper related to the individual’s 27 Second, in so endorsing Harper hearings for pretrial detainees, the Sell Court did not question the applicability of Harper’s main procedural due process holding that those hearings may be administrative rather than judicial. In the very case before it, the original decision to medicate Mr. Sell to control his dangerousness was a Harper administrative determination by the Medical Center for Federal Prisoners, where Mr. Sell was detained pretrial. In concluding that the government could go back and “pursue its request for [Sell’s] forced medication on . . . grounds related to the danger Sell poses to himself or others,” 47 the Court presumably could anticipate that the Medical Center would follow the same process again absent any guidance to the contrary. If the Court thought nonjudicial Harper determinations to be unconstitutional for pretrial detainees like Sell, it doubtless would have said so. It did not. In short, “[w]hen read in connection with the analysis in Harper, Sell provides that a [] court may authorize involuntary medication on dangerousness grounds, using the substantive standards outlined in Harper, not that the [] court must make this determination.” 48 dangerousness, or purposes related to the individual’s own interests where refusal to take drugs puts his health gravely at risk” (emphasis in Sell)). 47 Id. at 186. 48 Loughner, 672 F.3d at 755. 28 Third, the rationale of Sell’s holding is generally applicable only to involuntary medication for the sole purpose of competency restoration, and not to involuntary medication for other purposes. It makes sense not to forcibly medicate defendants for the purpose of bringing them to trial if the medication itself would render a fair trial impossible (or if the harm inflicted by the medication would outweigh the governmental interest in a trial). But if involuntary administration of antipsychotic medication is necessary to protect defendants or others from serious danger, it may be appropriate regardless of potential adverse effects of the medication on the defendants’ fair trial rights or the government’s interest in holding a trial. 49 Put another way, we recognize that whether a fair trial can be held is a downstream decision that may be secondary to the immediate demands of keeping the defendant or others safe. Fourth, the reasons supporting Harper’s substantive and procedural due process holdings – reasons that are based on the penological interests at stake and the medical nature of the involuntary medication determination rather than on trial 49 Cf. Sell, 539 U.S. at 185 (“Whether a particular drug will tend to sedate a defendant, interfere with communication with counsel, prevent rapid reaction to trial developments, or diminish the ability to express emotions are matters important in determining the permissibility of medication to restore competence, but not necessarily relevant when dangerousness is primarily at issue.” (internal citation omitted)). 29 concerns – apply with equal force to convicted prisoners and pretrial detainees alike. The needs of prison administration on which Harper relied are no less important when the prisoners are pretrial detainees; as the Court said in Bell v. Wolfish, “maintaining institutional security and preserving internal order and discipline are essential goals that may require limitation or retraction of the retained constitutional rights of both convicted prisoners and pretrial detainees.” 50 Harper similarly stated that its due process test of a reasonable relationship to legitimate penological interests “applies to all circumstances in which the needs of prison administration implicate constitutional rights,” and it cited Bell – a pretrial detainee case – in support of that proposition.51 An inmate’s pretrial or convicted status likewise has no bearing on whether antipsychotic medication is necessary to mitigate the inmate’s dangerous or harmful behavior. In either case, the decision is primarily a medical (and penological) one 50 Bell v. Wolfish, 441 U.S. 520, 546 (1979). Pretrial detainees who have not been convicted of any crime may not be subjected to punitive restrictions, but that is not the issue here. 51 Harper, 494 U.S. at 224 (emphasis added); see also Loughner, 672 F.3d at 751 (holding that Harper applies to pretrial detainees as well as to convicted prisoners; “although we recognize that in certain contexts there are important differences – differences of constitutional magnitude – between pretrial detainees and convicted detainees, those differences largely disappear when the context is the administration of a prison or detention facility” (internal citations omitted)). 30 that is reasonably committed initially to a nonjudicial administrative process relying on medical expertise (especially with judicial review available to assure against arbitrariness or other material defects). Indeed, echoing Harper, the Sell Court agreed that “the inquiry into whether medication is permissible, say, to render an individual nondangerous is usually more ‘objective and manageable’ than the inquiry into whether medication is permissible to render a defendant competent,” and that “medical experts may find it easier to provide an informed opinion about whether, given the risk of side effects, particular drugs are medically appropriate and necessary to control a patient’s potentially dangerous behavior (or to avoid serious harm to the patient himself) than to try to balance harms and benefits related to the more quintessentially legal questions of trial fairness and competence.” 52 When those “more quintessentially legal questions” are not relevant, there is no constitutional reason the initial Harper hearing must be held before a court merely because it concerns a pretrial detainee rather than a convicted prisoner. Fifth, other courts uniformly have agreed that the substantive and procedural due process holdings of Harper, not the particular trial-related requirements of Sell, 52 Sell, 539 U.S. at 182 (internal citation omitted). 31 apply to the involuntary medication of pretrial defendants for the purpose of mitigating their dangerousness to themselves or others. 53 Appellants argue that a pretrial detainee deserves greater due process protections than Harper provides because the potential adverse impact of antipsychotic medication on a defendant’s trial rights will be the same whether the government seeks to medicate for dangerousness or for competency restoration. We do not disagree. It is true that unwanted side effects of antipsychotic medication “can compromise the right of a medicated criminal defendant to receive a fair 53 See, e.g., Loughner, 672 F.3d at 752 (“[W]e 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.”); id. at 755-56 (“[T]he decision to medicate involuntarily a pretrial detainee based on dangerousness grounds is a penological and medical decision that should be made by the medical staff. . . . [T]he Due Process Clause does not require a judicial determination or a judicial hearing before a facility authorizes involuntary medication.”); United States v. Grape, 549 F.3d 591, 599 (3d Cir. 2008) (“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. Baldovinos, 434 F.3d 233, 240 (4th Cir. 2006) (“[T]he determination of which principles to apply—those of Harper or those of Sell— depends on the purpose for which the Government seeks to medicate the defendant.”). 32 trial.” 54 And it is clear the Due Process Clause may be violated by trying an involuntarily medicated defendant if side effects of the medication adversely affect the defense. 55 But that does not mean the defendant’s constitutional rights to a fair trial must or normally should be considered at the time of a Harper hearing. As we have seen, when the sole purpose of involuntary medication is to render a defendant capable of being tried, it makes sense to determine then and there whether that purpose would be nullified because the proposed medication would likely render a fair trial impossible. But when a defendant, while detained for competency restoration, is to 54 Riggins v. Nevada, 504 U.S. 127, 142 (1992) (Kennedy, J., concurring). Justice Kennedy observed that the side effects of antipsychotic “drugs can prejudice the accused in two principal ways: (1) by altering his demeanor in a manner that will prejudice his reactions and presentation in the courtroom, and (2) by rendering him unable or unwilling to assist counsel.” Id. Without minimizing such concerns, we note that they may “have been lessened to some extent by significant pharmacological advances” in recent years. Loughner, 672 F.3d at 745 n.10 (explaining that “second-generation” antipsychotic drugs have a lower risk of serious adverse side effects). 55 Thus, in Riggins, the Court reversed a defendant’s conviction because the trial court had refused to suspend his psychotropic medication during his trial without “any determination” that the medication was justified (under Harper or otherwise), and its side effects “may well have impaired” the defendant’s constitutionally protected trial rights and his defense by affecting “not just [his] outward appearance, but also the content of his testimony on direct or cross examination, his ability to follow the proceedings, or the substance of his communication with counsel.” 504 U.S. at 136-37 (emphasis in Riggins). 33 be forcibly medicated for compelling safety reasons irrespective of whether the treatment will restore the defendant to competency, there likely will be no immediate need for a court to predict whether side effects of the beneficial medication will interfere with the defendant’s future ability to assist counsel in conducting a defense or otherwise impair the defendant’s right to a fair trial. Those intertwined medical and legal questions ordinarily can and should be deferred and dealt with, by a court, in the event the defendant is restored to competency, trial is in the offing, and the defendant is still being medicated at that time. Inquiry at that later time will be far more informed – the court will not have to predict how the medication will affect the defendant because its actual side effects will have become known (and possibly mitigated). And the defendant still will enjoy “a full and fair opportunity to raise his concerns before he goes to trial.” 56 The point was made persuasively by the Fourth Circuit in United States v. Morgan, 57 one of the many cases holding Harper applicable to pretrial detainees. The Fourth Circuit “realize[d] that forcibly medicating a pretrial detainee on the basis that such treatment is necessary because he is dangerous to himself or to others 56 Loughner, 672 F.3d at 768. 57 193 F.3d 252 (4th Cir. 1999). 34 in the institutional setting might have the incidental effect of rendering him competent to stand trial.” 58 But if that occurred, the court pointed out, the defendant “would not simply be thrust into the courtroom for trial without additional procedural protections.” 59 He would be entitled to a hearing and he “could be brought to trial only if the government proved [that he] was able to understand the nature and consequences of the proceedings against him and to assist properly in his defense.” 60 The court could ensure, for example, that the medication “posed no significant risk of altering or impairing [the defendant’s] demeanor in a manner that would prejudice his capacity or willingness to either react to testimony at trial or to assist his counsel.” 61 In short, “the government would be precluded from bringing [the defendant] to trial in a medicated state unless the constitutional implications of doing so were thoroughly considered in an appropriate judicial forum.” 62 58 Id. at 264. 59 Id. 60 Id. 61 Id. at 264. 62 Id. at 265 (citing Riggins, 504 U.S. at 135). 35 We conclude that Harper’s substantive and procedural due process holdings apply to pretrial detainees as well as to convicted prisoners. Appellants therefore were not deprived of the due process to which they were entitled.
Albeit for different reasons, both appellants argue that D.C. Code §§ 24531.09 and 7-1231.08 should not be read to permit their forcible medication without court authorization. Mr. Taylor contends that, by its terms, § 24-531.09 does not permit involuntary medication of a criminal defendant without a court order for any purpose. He interprets the statute as allowing a court (and not a nonjudicial body) to order involuntary medication (1) for competency restoration only if the criteria in subsection (b) are met, and (2) for any other purpose only if the medication would be consistent with § 7-1231.08. We consider this an untenable reading of § 24531.09, however. On its face, that statute allows a defendant to be administered medication involuntarily pursuant to two different procedures: a judicial proceeding subject to enumerated criteria if the sole purpose of the medication is to render the defendant competent to stand trial, and a non-judicial administrative process – the process specified in § 7-1231.08 – if the purpose is otherwise. Section 24-531.09 36 makes no mention whatsoever of court involvement in the latter process. Nor does anything in the legislative history of § 24-531.09 support Mr. Taylor’s assertion. On the contrary, as previously mentioned, the Judiciary Committee Report states unequivocally that the statute authorizes the involuntary administration of medication for purposes other than competency restoration “as long as the same procedures are followed for defendants as would be followed for any other consumer of mental health services.” 63 Those procedures are administrative, not judicial. 64 Mr. Byrd argues that his involuntary medication would not be “consistent with” § 7-1231.08 because he is not a “consumer” within the meaning of that section. This argument misapprehends the “consistency” requirement in § 24-531.09. It is true that Mr. Byrd is not a “consumer,” i.e., someone who sought or received mental health services or support at Saint Elizabeths pursuant to Chapter 5 of Title 21; he was not committed to the Hospital pursuant to D.C. Code § 21-545(b)(2) after a judicial hearing and determination that he was mentally ill and likely, because of that illness, to injure himself or others if he were not committed. But as explained above, the cross-reference to § 7-1231.08 in § 24-531.09(a) authorizes the 63 Judiciary Committee Report at 8 (emphasis added). 64 See D.C. Code § 7-1231.08(c) (detailing the requirements of the “administrative procedure established by the Department”) (emphasis added). 37 involuntary medication of defendants like Mr. Byrd under the same procedure that would be followed if they were “consumers.” That authorization would be superfluous if it were limited to defendants who, as chance would have it, just happened to be “consumers” (civilly committed or otherwise) and therefore already were subject to involuntary medication pursuant to § 7-1231.08.