Restoration of competency through forcible medication

United States v. Watson, 793 F.3d 416 (4th Cir. 2015)

Sell standard requires government to make a particularized showing by clear and convincing evidence that proposed treatment is substantially likely to restore defendant to competency

Background: The government requested court authorization to medicate defendant involuntarily in order to restore him to competency to stand trial. The district court granted the request finding that the government had met the Sell requirements8 by clear and convincing evidence. Defendant appealed, claiming that the government failed to satisfy (1) the first Sell prong because the “important governmental interest at stake” in prosecuting Watson was mitigated by the fact that Watson had the “possibility” of an affirmative defense of “not guilty by reason of insanity” and (2) the second Sell prong because the government did not prove that the proposed forced medication was substantially likely to render Watson competent to stand trial.

Holdings: In a 2-1 panel decision, the Court reversed the District Court, holding that the record showed that the government not only failed to meet the second Sell prong, but could not meet it, and it dismissed the matter, without remand to the District Court for further hearing.

Notable Points: Emphasizing the importance of the liberty interest at stake, the intrusiveness of the act of forcible medication, and the burden of “clear and convincing evidence” that the government had to meet, the Court ruled that the evidence in the record failed to show that the forced medication proposed for Watson was substantially likely to restore Watson to competency. The Court, noting that Watson had a “rare” delusional disorder, concluded that the government’s expert, and the research relied upon by that expert, addressed the efficacy of the proposed forced medication for people suffering from psychosis in general and that the government failed to address the medication’s likely effect on this defendant in particular.

Found in DMHL Volume 34 Issue 3