Sell v. United States, is a landmark decision in which the United States Supreme Court held that only under limited circumstances in which specified criteria had been met, could lower courts order the forcible administration of antipsychotic medication to an incompetent criminal defendant for the sole purpose of rendering him competent to stand trial. The court held that in this specific case, since the lower court had failed to determine that all the appropriate criteria for court-ordered forcible treatment had been met, the order was reversed.
Previously, in Washington v. Harper, 494 U.S. 210 (1990), the court made clear that the forced medication of inmates with mental disorders could be ordered only when the inmate was a danger to himself or others and when the medication is in the inmate's own best interests. In addition, courts must first consider “alternative, less intrusive means” before resorting to forcible administration of psychotropic medication.
Using the framework found in Riggins v. Nevada, 504 U.S. 127 (1992) the Court emphasized that an individual has a constitutionally protected "interest in avoiding involuntary administration of antipsychotic drugs" and this interest is one that only an "essential" or "overriding" state interest might overcome.
In 1997 a federal judge found Sell competent to stand trial and released him on bail. However, Sell's mental status deteriorated while he was on bail, and his bail was revoked in 1998. Also in 1998, on the basis of a videotape provided by an undercover agent, Sell was charged with one count of conspiring to commit the attempted murder of the FBI officer arresting him. The agent later interviewed Sell in jail, and by questioning got him to say something about hiring a hit man. In early 1999 Sell requested a competency hearing before standing trial for the fraud and attempted murder charges.
Sell was given a competency evaluation by the United States Medical Center for Federal Prisoners (Medical Center), and in 1999 was found incompetent to stand trial. Sell was ordered to be hospitalized to determine whether he would be able become competent so as to allow his trial to proceed. While in the hospital, Sell refused to take the antipsychotic medication prescribed by the Medical Center staff. The Medical Center sought to involuntarily medicate Sell. On June 9, 1999, an administrative hearing was held before a medical hearing officer who concluded that antipsychotic medication was the treatment of choice based on the fact that Dr. Sell's "delusional thinking could make him dangerous." Sell filed a court challenge to stop the hospital's decision to give him the drug involuntarily.
The question of whether the drug could be administered involuntarily was the subject of several other hearings. In August 2000 the magistrate found that Sell was a danger to himself and others, authorized Sell to be forcibly medicated on the grounds that only medication would reduce his dangerousness, that any serious side effects could be treated, that the benefits to Sell were greater than the risks, and that the medication were substantially likely to restore Sell's competence.
In 2001, Sell appealed on certiorari to the Federal District Court which, while reversing the federal magistrate's finding of dangerousness, upheld the order of forced medication on the grounds that it was necessary to restore Sell's competency to stand trial. The Eighth Circuit Court of Appeals affirmed the lower court's decision in a divided vote. Sell's attorney pointed out that Sell had already been incarcerated for a longer period of time than if he were convicted for the offenses as charged.
Sell, on Writ of Certiorari, appealed to the United States Supreme Court. The American Psychological Association filed an amicus curiae brief taking a neutral position, supporting neither the government's nor Sell's position.
In a divided opinion (6-3), the Court held that the Constitution allows the Federal Government to administer antipsychotic drugs, even against the defendant's will, in limited circumstances. It affirmed that involuntary administration for the purposes of restoring a defendants competency to stand trial can be an appropriate means of acting in the state's interest to bring to trial defendants who are charged with serious crimes, overriding the defendant's right to refuse forced medication. However, the court outlined specific criteria which must be satisfied to justify involuntary medication. This framework was outlined in Riggins v. Nevada.
The Supreme Court held that the Eighth Circuit Court of Appeals erred in approving the lower court's order allowing forced medication to restore Sell's competence to stand trial when the original decisions of the hospital and magistrate were based on Sell's dangerousness. Since the experts testifying at the hearings focused mainly on dangerousness and not on trial competence, there was not enough evidence in the record about the possible effect of the medication on Sell's ability to obtain a fair trial.
In examining the lower courts' findings, the court found no evidence that Sell was dangerous, so the court assumed that he was not. Determining that the findings of the District Court and Court of Appeals did not satisfy these criteria, the Court vacated the appellate court's judgment.
However, others disagreed, arguing that the strict limits imposed by the Supreme Court on involuntary medication meant that the involuntary medication of a non dangerous defendant would be rare, especially since government's "important" interest in bringing the defendant to trial must be unattainable by alternative, less invasive means.
At the very least however, the criteria set forth by the court will ensure that the lower courts considering the issue of forced medication must determine why it is medically appropriate to force drug an individual who is not dangerous and furthermore is competent to make up his own mind about treatment.