Forced medication: When does it violate rights?

A St. Louis dentist accused of insurance and Medicaid fraud is fighting an effort by the US government to forcibly inject him with antipsychotic drugs, to render him competent to stand trial.

For nearly four years, Charles Thomas Sell has fought a losing court battle to avoid the unwanted medication. He says it is a form of government-authorized mind control in violation of his First Amendment right to freedom of thought.

Monday, his case arrives at the US Supreme Court, where the justices must decide whether the government's interest in prosecuting Dr. Sell outweighs Sell's interest in being free from forced medication.

The case holds major implications for individual liberty, should the justices grant the government broad powers to overrule personal decisions rejecting medical treatment. It could, for example, enable local boards of education to force problem schoolchildren to take Ritalin as a condition of attending public school, or empower health officials to mandate blanket anthrax vaccinations regardless of personal objections.

In even broader terms, the case could affect the right of certain religious groups to practice a reliance on prayer rather than on conventional medicine and medical technology endorsed by the government and its chosen experts.

"I have a God-given right not to have [my brain] altered by the government's antipsychotic, psychotropic medication," Sell says in court filings. The dentist, who has a history of mental illness, compares the effects of such drugs to enduring a lobotomy.

Sell's case comes to the high court from the Eighth US Circuit Court of Appeals in St. Louis, which ruled in a similar case last month that Charles Singleton, an Arkansas death-row inmate who is mentally ill, could be involuntarily medicated to render him competent to be executed.

What distinguishes the Sell case, his lawyers say, is that the dentist has not been convicted of a crime. Rather, he has merely been accused of violating the law. In addition, the crimes for which he has been charged are less serious than murder, they say.

Government lawyers insist that Sell will be better off in a medicated state. "Antipsychotic medication is likely to enhance, rather than suppress, a psychotic or delusional patient's ability to think and communicate," says US Solicitor General Theodore Olson in his brief to the court.

"This court has made clear that an individual has a significant liberty interest in avoiding the involuntary administration of antipsychotic medication. Such an interest, however, is not absolute," Mr. Olson continues. "In circumstances where the government's interest is sufficiently weighty, [the individual's interest may be] subordinated to the greater needs of society."

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