Caution Against Forced Drugging


A RECENT United States Supreme Court decision gives prison officials the authority to force mentally ill inmates to take antipsychotic, or mind-altering, drugs. This power should be used with great caution. The high court's rationale was that this type of medication is allowable with an uncontrollable patient as long as procedures are followed that give the prisoner an opportunity to object to the treatment before a panel of medical officials.

The 6-to-3 ruling overturned a Washington State supreme court finding. The state jurists insisted that prison personnel must have a ``compelling interest'' to administer such medication to inmates and must prove that the drugs prescribed are ``necessary and effective.''

This standard was found to be too high by the majority of the US Supreme Court justices. Associate Justice Anthony Kennedy said that if the drugging is ``reasonably related to legitimate penological interests'' it could pass constitutional muster.

Justice Kennedy acknowledged that antipsychotic drugs can have ``serious, even fatal, side effects.'' He reasoned, however, that despite the risks involved, it is better for prison medical officials, rather than a judge, to make the decision.

The mental health community is sharply divided on the issue of forced drugging. Several briefs were filed in this case on both sides. The American Psychiatric Association, for instance, takes the position that the benefits of antipsychotic drugs outweigh the risks to the prisoners, while the American Psychological Association supports high safeguards against the use of drugs that ``can disfigure and disable a prisoner long after his penal debt has been paid.''

In addition to the potential harm for the individual to whom these drugs are administered, several questions must be considered:

Is forced drugging a violation of an individual's privacy rights? The standard of ``compelling interest'' adopted by Washington State seems to better protect individuals from possible arbitrary action by the state or medical authorities than that of ``reasonableness.''

Is there a danger of giving too much power of decision-making to medical authorities, who may have a vested interest in drug-related treatment? Associate Justice John Paul Stevens thinks so. In a dissenting opinion, he said that the majority were ``endorsing a mock trial before an institutionally biased tribunal'' - referring to the medical panel required by the state to review objections to drugging.

Will the endorsed procedures open the door to possible abuse where drugs may be used as punishment, rather than treatment, for obstreperous inmates who regularly cause disruption within an institution? We are all too familiar with practices in totalitarian nations where political dissidents and other so-called ``troublemakers'' have been given mind-altering drugs. Where are the guarantees it won't happen here?

Justice Stevens, whose dissent was joined by Associate Justices William Brennan and Thurgood Marshall, pointed out that the ``liberty of citizens to resist the administration of mind-altering drugs arises from our nation's most basic values.''

It is ironic that this ruling comes at a time when a war against drug use is being waged nationwide. Young people are strongly urged to say ``no'' to chemical substances. Some suggest that there are good and bad drugs - with the former being used for medicinal purposes and the latter taken strictly for self-gratification. But drugs for whatever reason taken can have harmful, even deadly, effects. Is it a proper trade-off to risk human life for the purpose of public safety?

Prisoners' rights, even constitutional guarantees, are sometimes sacrificed by the nature of their confinement. Society balances individual protections against the dangers to the community. But to what extreme?

Forced drugging goes to a basic issue of values, as Justice Stevens suggests. The highest court in the land may be satisfied that mandated medication is justified for mentally ill prisoners as long as constitutional procedures are followed. States, however, are under no obligation to exercise this authority.

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