Opinion ID: 2708848
Heading Depth: 2
Heading Rank: 4

Heading: Best Medical Interest of the Defendant

Text: We turn now to the fourth Sell requirement: that “administration of the drugs is medically appropriate, i.e., in the patient’s best medical interest in light of his medical condition.” 539 U.S. at 181. Our review of this aspect of Sell is hindered by the parties’ failure to include in the record the report of Dr. Lucking on which the court, apparently, heavily relied. We No. 13-3281 13 must conclude that the Government did not meet its burden with respect to this element. The only pertinent information in the record is Mr. Debenedetto’s statement to the district court, in which he details his previous violent and serious reaction to antipsychotic drugs.13 In sum, the record does not support the conclusion that the Government met its burden of establishing each of Sell’s requirements by clear and convincing evidence. We therefore must vacate the district court’s commitment order. On remand, the district court must consider and make explicit findings concerning: 1. The importance of the Government’s interest as evidenced by the seriousness of Mr. Debenedetto’s crime and any other special circumstances that might lessen either the seriousness of his crime or the importance of the Government’s stated interest; 2. The likelihood that the identified proposed course of treatment will render Mr. Debenedetto, given his 13 To the extent that the district court believed that it was unnecessary to make the required Sell findings because Mr. Debenedetto voluntarily agreed to the medication, we do not believe that such a conclusion is supported by the record. Mr. Debenedetto’s statements to the court reveal a legitimate fear of serious side effects based on past experience. He made it very clear that he did not want to experience those side effects again. His statements also reveal a belief that antipsychotic drugs may not be necessary to improve his competency. These comments evince a clear interest in exploring less invasive means and strongly point to the conclusion that he did not unqualifiedly consent to the administration of antipsychotic drugs. Because Mr. Debenedetto did not consent to the administration of those drugs, we believe the requirements of Sell must be satisfied. 14 No. 13-3281 specific diagnosis, competent to stand trial and the likelihood that it will not have side effects that will interfere significantly with his defense; 3. The necessity of the proposed treatment to render Mr. Debenedetto competent for trial and the likelihood that less intrusive alternatives could not achieve substantially the same results; and 4. The appropriateness of the proposed course of treatment for Mr. Debenedetto, i.e., that it is in his best medical interest. As with the findings for the second factor, these findings should reflect a recognition of Mr. Debenedetto’s diagnosis and his personal medical history. As our colleagues in the Sixth Circuit have observed: “Each involuntary medication case presents a court with the challenging task of balancing the defendant’s fundamental constitutional right to liberty against the government’s important interest in prosecution.” Grigsby, 712 F.3d at 976. This type of detailed, fact-intensive inquiry is therefore “necessary to determine where to strike that balance.” Id.