Opinion ID: 758687
Heading Depth: 2
Heading Rank: 4

Heading: historical development

Text: 14 In Bell v. Wolfish, 441 U.S. 520, 99 S.Ct. 1861, 60 L.Ed.2d 447 (1979), the Supreme Court established that the presumption of innocence afforded pretrial detainees does not immunize them from reasonable restraints related to their confinement. Id. at 534, 99 S.Ct. 1861. Addressing the conditions affecting non-fundamental rights, the Court explained that the restraints are constitutional unless they amount to punishment. Id. at 536-37, 99 S.Ct. 1861. 15 Less than one month after Bell was decided, the Supreme Court issued its decision in Parham v. J.R., 442 U.S. 584, 99 S.Ct. 2493, 61 L.Ed.2d 101 (1979), holding that Georgia's mental-health laws regarding involuntary civil commitment proceedings provided sufficient procedural safeguards for minors. See id. at 607, 99 S.Ct. 2493. The Court weighed the child's substantial liberty interest in avoiding unnecessary confinement against the state's parens patriae interest in protecting the welfare of the child. See id. at 604-05, 99 S.Ct. 2493; see also BLACK'S LAW DICTIONARY 1114 (6th ed. 1991) ( 'Parens patriae,' literally 'parent of the country,' refers traditionally to role of state as sovereign and guardian of persons under legal disability, such as juveniles or the insane.). The Court rejected the need for a judicial hearing on what it held was essentially a medical decision. See Parham, 442 U.S. at 609, 99 S.Ct. 2493. The Court explained that minors are best protected when decisions regarding their best interests are reserved to medical professionals, rather than to a judge. See id. at 607, 99 S.Ct. 2493. 16 The Court reasserted its deference to medical judgment in Youngberg v. Romeo, 457 U.S. 307, 102 S.Ct. 2452, 73 L.Ed.2d 28 (1982), holding that a mental health facility could exercise its parens patriae power to physically restrain an incompetent inmate, so long as the decision was made within the exercise of professional medical judgment. See id. at 321, 102 S.Ct. 2452. 17 The Tenth Circuit, in Bee v. Greaves, 744 F.2d 1387 (10th Cir.1984), held that the forced medication of a pretrial detainee would affect the detainee's ability to produce ideas and, therefore, affected the detainee's freedom of speech. See id. at 1393-94. Accordingly, the court adopted a strict-scrutiny test to decide whether a detainee may be forcibly medicated to render him competent to stand trial. See id. at 1395. While the court noted that Bee was eventually found competent, it questioned whether bringing him to trial could ever be a sufficiently compelling reason to medicate him against his will. See id. 18 In United States v. Charters, 863 F.2d 302 (4th Cir.1988) (en banc ), the Fourth Circuit extended the medical judgment standard in deciding whether to forcibly medicate a dangerous pretrial detainee. The court relied on Parham and Youngberg, holding that a judicial hearing was not necessary or valuable for making the base-line determination, but such a hearing should be conducted to review the hospital's decision for the purpose of ensuring that it was not arbitrary. See id. at 313, 102 S.Ct. 2452. 19 In Washington v. Harper, 494 U.S. 210, 110 S.Ct. 1028, 108 L.Ed.2d 178 (1990), the Supreme Court applied this deference to medical judgment in a case involving the forced medication of a dangerous convicted felon. The government's interest at stake in Harper was the safety conditions within the prison. See id. at 225, 110 S.Ct. 1028. Relying on Parham, the Court concluded that such medical decisions were not aided by judicial intervention. Id. at 232, 110 S.Ct. 1028. The Court also applied a rational-basis standard of review, holding that the regulation was reasonably related to legitimate penological interests. See id. at 224, 110 S.Ct. 1028 (citing Turner v. Safley, 482 U.S. 78, 89, 107 S.Ct. 2254, 96 L.Ed.2d 64 (1987)). 20 In Riggins v. Nevada, 504 U.S. 127, 112 S.Ct. 1810, 118 L.Ed.2d 479 (1992), the Supreme Court declined to prescribe substantive standards to define when a pretrial detainee awaiting trial on murder and robbery charges may be forcibly medicated. See id. at 136, 112 S.Ct. 1810. The Court described Harper as requiring that a decision to forcibly medicate a prisoner be based on a finding of an overriding justification for and the medical appropriateness of the treatment, see id. at 135, 112 S.Ct. 1810, and reversed the district court's order, which allowed forced medication without considering the need for such treatment or the availability of reasonable alternatives. See id. at 136, 112 S.Ct. 1810. The Supreme Court went on to say, however, that such a decision would be constitutional if based on a finding that no less restrictive alternatives were available, and that such medication was necessary for either safety reasons or to obtain a proper adjudication of guilt or innocence. See id. at 135, 112 S.Ct. 1810. 21 The only case decided since Harper and Riggins that discusses whether a pretrial detainee is entitled to a judicial hearing before being medicated for the purpose of restoring competency to stand trial is Khiem v. United States, 612 A.2d 160 (D.C.1992). Quoting Parham, the Khiem court extended the medical-judgment rule to non-dangerous pretrial detainees, holding that due process is not violated by the use of informal traditional medical investigative techniques. Id. at 173. The court did not offer any reason for this conclusion other than its understanding that Parham and Harper do not require adversarial proceedings.