WASHINGTON — A divided Supreme Court said Monday the government can force medication on mentally ill criminal defendants only in the rarest of circumstances, ruling that prosecutors' simple desire to see a suspect face trial is not enough.
The court split 6-3 in ruling that a mentally ill dentist — he once called police to report a leopard was boarding a bus outside his window — cannot be forced to take antipsychotic drugs that might make him sane enough for trial. The government must meet a series of conditions before it mandates treatment, the court majority said.
Involuntary administration of drugs solely for trial competence is appropriate only "in limited circumstances," Justice Stephen Breyer wrote for the majority.
The government must establish that it has an important interest in prosecuting the crime and that it effectively has no other choice but to demand involuntary medication. Even then, the treatment must be medically appropriate and unlikely to produce side effects that might hurt the defendant's ability to get a fair trial, Breyer said.
Breyer, whose wife is a psychologist, said courts must evaluate such cases on an individual basis. While the government undoubtedly has a strong interest in bringing to trial those it has charged as serious criminals, there may be special circumstances in the case of mentally ill defendants, Breyer said.
For example, the mere fact that a defendant refuses to take drugs may mean he or she would be confined for a long period in a mental institution, Breyer said. "That would diminish the risks that ordinarily attach to freeing without punishment one who has committed a serious crime."
On the other hand, Justice Antonin Scalia, writing for the dissenters, said that the ruling would allow some criminal defendants "to engage in opportunistic behavior" to thwart prosecutions.
The ruling should not have a broad immediate effect. The Bush administration said in a court filing that in a recent 12-month period 59 people were given drugs against their will. Of those, 45 were later deemed competent to stand trial, the government said. More than 200 others accepted drugs willingly.
In other action Monday the court:
Ruled that the government can prohibit campaign contributions from advocacy groups, a warm-up decision to the showdown over the broader new campaign finance law. The court said the right to free speech does not trump Congress' goal of limiting the corrosive effects of corporate money in politics.
Agreed to hear complaints of a Michigan prisoner who filed a handwritten appeal, without the help of an attorney, a case that raises technical questions about when inmate lawsuits are allowed.
Rejected an appeal from a South Carolina hospital that tested pregnant women for drugs and turned over the results to police. The court already had ruled the testing was unconstitutional.
Affirmed strict limitations on family visits to inmates, ruling that prisoners' civil rights do not outweigh security concerns in crowded prisons.