Michelle Meyers

Legal Issues of the 21st Century

Legal Research Paper

Antipsychotic drugs are chemical agents used to manage and treat serious mental illness.  In general, the drugs influence chemical transmissions to the brain, affecting both activatory and inhibitory functions.  Because the drugs’ purpose is to reduce the level of psychotic thinking, it is virtually undisputed that they are mind-altering. [i]


My paper will focus on whether or not people should be forced to stand trial under involuntary medication to make them fit to stand trial or should they have the “right-to-refuse” medication.

What Types of Drugs are Used?


Psychotropic drugs include any medications that affect mentation.[ii]  Sedatives, tranquilizers, hypnotics, and antipsychotics are all subclasses of the psychotropes.[iii] Antipsychotics, sometimes referred to as a major tranquilizers, reverse the symptoms of major mental illnesses and their aim is to restore normal mentation.[iv]  The main focus of involuntary medication cases resolves around psychotropic drugs.

Standard To Stand Trial


 In every first year criminal law course it is taught that a defendant must be “fit” to stand trial.  To be fit, a defendant must have “sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding—and…a rational as well as factual understanding of the proceedings against him.”  Because the standard is one of ration, the defendant does not need to comprehensively understand all actions against him.

Legal History


Goedecke v. State is one of the earliest involuntary medication cases.  The Colorado Supreme Court in its analysis of allowing the defendant the “right-to-refuse” treatment focused on the negative side effects of the drug.  The court applying state law held that a civilly committed inpatient possesses the right to refuse antispychotic medication.[v] The court noted that medication given to the defendant altered his thought processes and thus may have had an effect of his ability to stand trial.

The court focuses only on the adverse effects, but does not address the defendant’s ability to have “normal” mental capacity.  Therefore, I question the court’s reasoning, if a defendant must meet a mere rational standard to stand trial, is it really irrational for the court to medicate him?  I believe the answer is no under this courts reasoning.

In Riggins v. State of Nevada, the defendant sought review of his conviction and sentence of death for first-degree murder and robbery after he had involuntary taken medication to make him fit to stand trial. The defendant had brutally stabbed and killed his friend. After being found fit to stand trial, defendant pleaded guilty by reason of insanity.[vi] The trial court placed the defendant on Mellaril, an antipsychotic drug.  The court of appeals affirmed his conviction over his objection to involuntary medication.  The Supreme Court of Nevada in per curiam opinion vacated Riggin’s conviction.  The court remanded for a trial without involuntary administration of antipsychotic medications of any type, unless the district court should find,…, that the administration is medically appropriate and essential, considering less intrusive alternatives, to ensure the safety of the appellant…”[vii]

The Supreme Court’s opinion makes this area of law even more of a penumbra. The court did not make a bright line rule as one would expect against involuntary medication but instead gave the trial court discretion in order to decide when it is appropriate to administer drugs.  The Supreme Court’s decision gave the trial court the same discretion the court already had.  Therefore, this opinion does not further the law on involuntary medication.

Constitutional Issues

     The United States Supreme Court in Roe v. Wade arguably created a constitutional right to privacy.[viii] The constitutional right of privacy has been recognized as establishing an individual’s autonomy over her own body.[ix] There is a strong argument to be made that if the right to privacy extends to right to keep or abort a fetus, it could also be extended to government’s interference with a defendant’s thoughts and behavior. This is not to say that the government does not have a compelling interest in ensuring the defendant’s safety as well as the safety of those around him by placing him in facility for the mental disabled.  My argument questions can the government’s interests extend to defendant’s being fit to stand criminal trial?

  A question, which needs to be answered, is whether people have an inherent right to have the capacity to think. Realistically, the capacity to think and decide is a fundamental element of freedom. [x] The protected right of communication presupposes a capacity to produce ideas.  Whatever powers the Constitution has granted our government, involuntary mind control is not one of them, absent extraordinary circumstances.[xi]  The ability to decide whether or not to take medicine to stand trial is up to the defendant. 

Additionally, the punishment the defendant receives will not be the appropriate one. The defendant will not be rehabilitated if it is found he is guilty and sent to a penitentiary without medical supervision.  The defendant needs not be in jail, but instead a mental institution to help him deal with his medical issues.  Masking the defendant’s mental capabilities with mind-altering drugs, does not solve the problem. Therefore, I do not think the government has a compelling state interest to violate the defendant’s privacy.


As the cases demonstrate there seems to be no bright line rule.  However, what is clear is that the trial court has the discretion to decide whether a person should be given “mind-altering” drugs to stand trial.  Further, I do not think the courts are acting within the Constitution when they involuntarily force a defendant to be medicated.  I think that privacy extends to a person’s thoughts.









[i] Rogers v. Okin, 478 F.Supp. 1342 (D.Mass.1979)

[ii] Subcommittee of the Committee on Public Information, American Psychiatric Association, A Psychiatric Glossary 129 (4th ed. 1975).

[iii] Gutheil, Thomas, M.D., Appelbaum, Paul, M.D. Mind Control, Synthetic Sanity, Artifical Competence, and Genuine Confusion: Legally Relevant Effects of Antipsychotic Medication

[iv] Id.

[v] Goedecke v. State, 198 Colo. 407, 603 P.2d 123, 124,125 (1979). 

[vi] Riggins v. State of Nevada, 107 Nev. 178, 808 P.2d 535, 535 (1991).

[vii] Riggins v. State of Nevada, 109 Nev. 966, 968; 860 P.2d 705, (1993).

[viii] Roe v. Wade, 410 U.S. 959; 93 S. Ct. 1409; 35 L. Ed. 2d 694 (1973).

[ix] Id.

[x] Gutheil, Thomas, M.D., Appelbaum, Paul, M.D. Mind Control, Synthetic Sanity, Artifical Competence, and Genuine Confusion: Legally Relevant Effects of Antipsychotic Medication