Treatment over Objection to Restore Defendant to Competency to Stand Trial

U.S. v. Onuoha, 820 F.3d 1049 (9th Cir. 2016)

Ninth Circuit vacates and remands district court order authorizing treatment, finding government failed to show proposed treatment is in the defendant’s best medical interests.

Background: From 2004 to 2012, Onuoha served in the National Guard. From 2006 to September 2013, when he resigned, Onuoha worked as a Transportation Security Administration (TSA) screener at LAX Airport. A few hours after resigning, Onuoha returned to TSA headquarters at LAX and left a note for a former supervisor who had been involved in a suspension of Onuoha earlier that summer. The government alleged that Onuoha then made calls to a TSA checkpoint and to the LAX police department alluding to sending a message to America and the world and telling them to evacuate LAX. TSA headquarters was evacuated. Law enforcement officials went to Onuoha’s apartment and discovered that all of his belongings had been removed and all that remained was a large note reading “09/11/2013 THERE WILL BE FIRE! FEAR! FEAR! FEAR!” Later that day, Onuoha called LAX police and told them that he was at a church in Riverside, CA. He told police that he did not intend to make a bomb threat or injure anyone and that he only wanted to deliver a message. Onuoha waited at the church until he was apprehended.

Onuoha’s defense counsel submitted a report that Onuoha suffered from paranoid schizophrenia and planned to raise a diminished-capacity defense. The government requested a competency evaluation, and Onuoha was found not competent to stand trial. The government then filed a motion for an order to involuntarily medicate Onuoha with the goal of restoring him to competency, which the district court granted.

Holding: On appeal, the Ninth Circuit vacated and remanded, holding that the district court erred in finding that the proposed treatment was in Onuoha’s best medical interest under the Sell test. The court of appeals held that the district court was correct in finding that there is an important government interest at stake in prosecuting Onuoha, but the district court clearly erred in finding that the proposed course of treatment was in Onuoha’s best medical interests.

Notable Points:

The seriousness of the offense outweighed the “special circumstance” of time detained: The first Sell factor requires the government to prove that important governmental interests are at stake in prosecuting Onuoha. In Sell, the court recognized that there may be some special circumstances that diminish the government’s interest in prosecution, including the amount of time the defendant had already been confined. In this case, the court considered that Onuoha had already spent time in custody since September 2013, amounting to confinement beyond the minimum possible sentence. Nevertheless, the court found it important that a conviction and resulting sentence for the serious crime at issue is significant in terms of general deterrence, not just incapacitation of a specific individual. Here, the court concluded that the government’s valid interest in prosecuting Onuoha outweighed any special circumstances of Onuoha’s detention.

The government did not meet its burden for proving the fourth Sell factor by clear and convincing evidence: The fourth Sell factor requires the government to prove that administration of the drugs is medically appropriate and therefore in Onuoha’s best medical interest in light of his medical condition. The Ninth Circuit held that after hearing the testimony of a medical expert experienced in administering involuntary medication, the district court could not credit the expert’s testimony without exploring contradictory evidence in the record. In this case, contradictory evidence included that the recommended treatment increased the risk of side effects, the dosage proposed was higher than is generally recommended, and the use of the proposed drug does not conform to the community standard of care. Because involuntary medication orders are disfavored in light of the significant liberty interests at stake, and because the record demonstrated that the proposed treatment included dosages higher than generally recommended, the medication was not in Onuoha’s best medical interest.

Found in DMHL Volume 35, Issue 2