The purpose of this Note is to analyze what right, if any exists for a mentally ill criminal defendant to refuse the administration of antipsychotic drugs to gain competence to stand trial. Focusing mainly on the trial context of the right to refuse is not to suggest that there is not overlap between the right of a criminal defendant to refuse and the right of a civilly committed patient to refuse. Indeed, it is often unclear why an individual is brought to the emergency room of a general hospital and eventually committed, rather than being arrested and booked and later found incompetent to stand trial. The constitutional analysis of the right of a mentally ill defendant to refuse antipsychotic drugs is informed by the existence of a similar right in the civil commitment area, although the state interests in these two areas differ; while the state interest in forcibly medicating a defendant for the purpose of standing trial is that of trying those accused in good faith of violating its laws, the interests in coercing antipsychotic drug treatment in the civil commitment area are patient contro, treatment, and fiscal concerns. This Note first analyzes the relationship between competency and ability and then presents the arguments supporting the view that a defendant should have no meaningful right to refuse medication. After presenting the legal analysis supporting the right to refuse antipsychotic drugs in the trial setting, the Note proceeds to consider several possible alternatives to forced drugging as a means toward achieving the state's goal of a fair trial and concludes that these alternatives, while arguably less effective than medication, are preferable to forced drugging since they more adequately address the legitimate concerns of both the state and the mentally ill criminal defendant.
Brian Domb, A New Twist in the War on Drugs: The Constitutional Right of a Mentally Ill Criminal Defendant to Refuse Antipsychotic Medication That Would Make Him Competent to Stand Trial, Symposium: Ohioans without Health Insurance: How Big a Problem - Are there Solutions, 4 J.L. & Health 273 (1989-1990)