Third Circuit Holds That Criminal Defendants Can Be Required To Take Antipsychotic Drugs Until The Sentencing Process Has Been Completed

Posted On Wednesday, July 16, 2014

The United States Supreme Court has held that under certain circumstances, the government can force a mentally-ill criminal defendant to take medication in order to render that person competent to stand trial.  In arriving at this conclusion, the Supreme Court recognized that individuals have the constitutional right to refuse to take antipsychotic drugs.  However, according to the Supreme Court, the state also has an important interest in bringing those charged with serious crimes to trial and this interest can sometimes overcome one’s right to control what happens to his or her own body.  In United States v. Cruz, No. 13-4378 (3d Cir. July 10, 2014), the United States Court of Appeals for the Third Circuit applied the same reasoning to the sentencing phase of a criminal proceeding.

             Abraham Cruz was convicted of two counts of threatening a federal law enforcement officer.  After the conviction but prior to the imposition of sentence, Cruz was diagnosed with schizophrenia and determined to be mentally incompetent. Mental health professionals prescribed antipsychotic medication that would make Cruz competent.  Cruz refused to take the drugs.  At the request of the government, the trial court issued an order authorizing prison officials to administer medication to Cruz against his will.  On appeal, the Third Circuit concluded that the government has an important interest in restoring a criminal defendant to competency for sentencing because it has a legitimate interest in punishing those who have committed crimes.  Moreover, in order for the process to function appropriately, the defendant must be able to actively participate in the sentencing process and the government has an interest in ensuring that this takes place.  As a result, the Third Circuit concluded that the government can ask a court to order that a criminal defendant who has been convicted of a serious crime be given antipsychotic drugs until a sentence has been imposed. 

             Under Cruz, forced medication does not end with a conviction.  Rather, it can continue until the sentencing process has been completed.  Moreover, while the Third Circuit made it clear that a finding of incompetency does not automatically mean that one can be required to take antipsychotics, this may be the practical effect of this decision.  In this regard, the government must show by clear and convincing evidence that:  a) medication is substantially likely to restore the person to competency; b) the medicine does not have side effects which will impair the defendant’s ability to assist his or her attorney; c) less intrusive treatments are unlikely to achieve the same result as the recommended medication and d) the drugs in question are medically appropriate.  The government can use the psychologists or psychiatrists who are already responsible for providing mental health treatment to prisoners to provide testimony to establish these factors.  In order to effectively challenge the opinions expressed by these witnesses, a criminal defendant will have to hire experts to testify on his or her behalf.  It remains to be seen whether the government will be required to provide indigent defendants with mental health professionals.  However, even if the state is required to provide those who cannot afford a lawyer with a psychologist or a psychiatrist, there are many others involved in the criminal justice system who, although not indigent, do not have the financial resources to obtain these types of services.