Opinion ID: 166217
Heading Depth: 1
Heading Rank: 2

Heading: Standard of Proof & Standard of Review

Text: 26 The Supreme Court in Sell articulated neither a standard of proof for the Sell factors nor a standard of appellate review. In deciding these standards, we bear in mind that involuntary administration of antipsychotic medications implicates a constitutional right. [A]n individual has a constitutionally protected liberty interest [under the Due Process Clause] in avoiding involuntary administration of antipsychotic drugs—an interest that only an essential or overriding state interest might overcome. Sell, 539 U.S. at 178-79, 123 S.Ct. 2174 (internal quotation marks and citation omitted). The standards we set must weigh this vital constitutional interest in the balance. 27 To date, only one circuit has decided the standard of proof and the standard for appellate review of the Sell factors. The Second Circuit first parsed the Sell factors into factual and legal questions. It decided [w]hether the Government's asserted interest is important is a legal question. United States v. Gomes, 387 F.3d 157, 160 (2d Cir.2004), cert. denied, ___ U.S. ___, 125 S.Ct. 1094, 160 L.Ed.2d 1081 (2005). We agree, with one qualification. We would expand the parameters of the legal question to include whether involuntary administration of antipsychotic drugs is necessary significantly to further important governmental trial-related interests. Sell, 539 U.S. at 179, 123 S.Ct. 2174. In other words, [h]as the Government, in light of the efficacy, the side effects, the possible alternatives, and the medical appropriateness of a particular course of antipsychotic drug treatment, shown a need for that treatment sufficiently important to overcome the individual's protected interest in refusing it? Id. at 183, 123 S.Ct. 2174. 12 The Second Circuit determined the remaining Sell factors depend upon factual findings and ought to be proved by the government by clear and convincing evidence. Gomes, 387 F.3d at 160. Recognizing the vital constitutional liberty interest at stake, we agree. We review conclusions of law de novo and findings of fact for clear error. Stillwater Nat'l Bank & Trust Co. v. CIT Group/Equipment Finan. Inc., 383 F.3d 1148, 1150 (10th Cir.2004).