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Wrightsman's Psychology and the Legal System 9th Edition

Wrightsman's Psychology and the Legal System (9th Edition)

Book Edition9th Edition
Author(s)Greene, Heilbrun
The Scope of Forensic Psychology
The Insanity Defense
Chapter 10, Competence, CRITICAL THOUGHT QUESTION, Exercise 03
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The Case of Charles Sell: Involuntary Medication to Restore Competence?


Charles Sell, once a practicing dentist, had an extensive history of severe mental illness and was hospitalized several times. He was accused of fraud after he allegedly submitted fictitious insurance claims for payment. His competence to stand trial was evaluated, and he was found competent and released on bail. Subsequently, a grand jury indicted Sell on 13 additional counts of fraud and, later, attempted murder. During his bail revocation hearing, Sell's mental illness was markedly worse, and his behavior was "totally out of control," including "spitting in the judge's face" (2003, p 2 His competence was again evaluated, at which time he was adjudicated incompetent to stand trial He was hospitalized for treatment to help restore his competence Hospital staff recommended antipsychotic medication, which Sell declined to take The hospital administered these medications to him involuntarily Sell challenged this in court, arguing that involuntary medication violates the Fifth Amendment right to "liberty to reject medical treatment" p 10 The lower court found that Sell was a danger to himself and others, that medication was the only way to render him less dangerous, that the benefits to Sell outweighed the risks, and that the drugs were substantially likely to return Sell to competence The court further held that medication was the only viable hope of rendering Sell competent to stand trial and was necessary to serve the Government's interest in obtaining an adjudication on the issue of his guilt Sell appealed and this case was granted certiorari by the United States Supreme Court.


At the heart of this case is the question of whether it is a violation of a defendant's rights to be forcibly medicated in order to make that defendant competent to proceed to trial, with the associated possibility of conviction and incarceration in prison. But if the

defendant cannot be restored to competence without medication, he or she may remain hospitalized, and thus also deprived of his or her liberty, for a lengthy period of time. In this decision, the Court weighed these considerations and outlined the conditions under which the government may forcibly administer psychotropic medication to render a mentally ill defendant competent to stand trial. The treatment must be (1) medically appropriate, (2) substantially unlikely to have side effects that may undermine the trial's fairness, and (3) necessary to significantly further important government trial-related interests.


Critical Thought Question


Assume that a defendant is hospitalized as incompetent to stand trial with a severe mental illness, and assume further that he is actively psychotic and declines to take prescribed medication while in the hospital. Finally, assume that he does not present a threat of harm toward others or himself. Under those circumstances, what are the advantages and disadvantages of forcing him to take psychotropic medication?

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