In this presentation we will use the IRAC (acronym for Issue, Rule, Analysis and Conclusion) format. The issue is the legal admissibility of involuntary or forced medication or treatment for prison inmates. We will analyze the issue in the light of judicial verdicts and observations and try to develop a synthesis or ‘consensus opinion’. Finally we will give a summary and conclusion.

Analysis

Let us frame some questions to set the ball rolling.

Is the prison inmate who has been diagnosed with ‘bipolar’ condition refusing to take the medication to get some advantage? Is he going to press for release on grounds of sanity? Is he going to claim a reduction in his prison sentence? Is he trying to get special concessions/treatment meant for severally handicapped mental patients? Does the prisoner have any symptoms for the spread of his disorder to other inmates?

Apparently the answers to these questions appear to be in the negative. The diagnosis has been made and there is no reason to doubt the validity of this diagnosis.

What then is the remedy to address this issue? On the face of it the prisoner’s attitude does not betray any malafide motives. We will have to seek some legal advice and prior to that do a little research. There are far too many cases for us cite in support of a particular contention or point of view on the issue.

We will therefore select the most relevant and widely cited cases. One such case is that of Washington v. Harper. While on parole Harper attacked two nurses in a hospital. Harper had earlier served time, for robbery, in the mental health unit of the prison where he had consented to taking psychotic medication. Harper’s parole was revoked. Harper was sent to the Special offender Center where the treating physician administered medication over Harper’s objections.

The Court in Harper observed "The forcible injection of medication into a non consenting person's body represents a substantial interference with that person's liberty." The court took full account of the side effects like dystonia and neuroleptic malignant syndrome which can cause death. However the court also held that state's interest was legitimate and that the medication given, against his will, if he was dangerous to himself or others and if the treatment was in his best medical interest.

This was a rational means of furthering the state's legitimate objectives. The Court also found that there were no other alternatives that fully accommodated the inmate's rights with only minimal cost to the prison.

Prior to forced medication, procedures require administrative hearings in the presence of a psychiatrist, a psychologist and the center's associate superintendent. This may serve the interests of the inmate better than a judicial official.

The logic in the Harper case was found applicable in Riggins v. Nevada also. Riggins was arrested for murder. He told the jail physician that he was hearing voices and having problem sleeping. He voluntarily took Mellaril with 100 mg potency. This dose was increased to 800mg daily. His counsel moved the court to suspend the medication till after the trail on grounds that the drug will influence negatively his demeanor and conduct at the trial.

The District Court denied Riggin’s motion but gave no rationale for it. At the trial riggings pleaded insanity but the jury sentenced him to death. Nevada Supreme Court affirmed the conviction. The United States Supreme Court observed that pursuant to Harper, a prison is prohibited from forcing antipsychotic drugs on a convicted prisoner without a finding of overriding justification and a determination of medical appropriateness.

The decision of Nevada Supreme Court was thus reversed .The case was remanded for further proceedings not inconsistent with the Supreme Court's opinion

Inmates and pretrial detainees, then, retain substantive due process rights requiring any regulation infringing upon those rights to be reasonably related to a legitimate penological interest.
Even for those convicted the Fifth and Fourteenth Amendments guarantee due process of law and protection of liberty interests.

No infringement is allowed unless it is "narrowly tailored to serve a compelling state interest." For inmates an infringement may be allowed if it is reasonably related to a legitimate state interest.
For prisoners awaiting trial the Supreme Court took particular notice of the following three factors in the case of Riggins v. Nevada:

1. Grave side effects of antipsychotic drugs.
2. Antipsychotic medications could have negative implications on the defendant (Riggins) while conducting his defense at the trial.
3. Such drugs may have negative influence on the demeanor of the defendant at trial.
However, as per the majority opinion, these considerations do not have an overriding effect if the state can prove that there exist no ‘lesser intrusive’ alternative.

Generally prisoner’s rights to refuse prescribed medication within the prison are reduced compared to a free individual member of the society. Still such rights must be balanced with the state’s right for forcible medication. The state may need such medication to (i) check the disease from spreading to other inmates (ii) to ensure the physical safety of the prisoner and the prison staff and (iii) to ‘restore’ competency to a mentally incompetent defendant so that he may face the trial for which he/she stands charged.

The prisoner in question suffers from a bi-polar condition. Such a disorder can cause extreme mood swings from being very bad-tempered and irritable to depression and desperation. These episodes of mania and depression are best treated with a combination of medication and psychosocial treatment.

Chapter 7 (Medical) of the Florida Model Jail standard provides for inmates with suicidal tendencies or those with tendency to have seizures will be assigned to quarters that have close observation.

We have done some research on our topic. The judicial observations have been discussed. The same will apply in the present case too. The Administrator of the Ocala, Florida prison health care center will need to be mindful of these considerations. The prisoner’s rights guaranteed under the Fourth and Fourteenth Amendments, and the administration hearings are all important factors.

Biblioraphy:

“http://www.state.co.us/gov_dir/leg_dir/lcsstaff/1999/comsched/99cjs0810medicationllsmemo.htm” Retrieved on October03, 2004.
“Inmate Rights & Privileges 2 ".

“NAMI | Weston Case Raises Legal Questions Over Forced Medication - NAMI Legal Letter, Volume I No. 1” Retrieved on October03,2004 from the website
www.nami.org/legal/990828b.html

“robinyap.com: Remember "IRAC"?”.