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Saturday, August 6, 2011

Amicus Curiae Brief on Forced Medication of Loughner

ARLINGTON, Va. (Aug 4, 2011) - The American Psychiatric Association (APA) and the American Academy of Psychiatry and the Law (AAPL) have submitted an amicus curiae brief on the issue of forcibly administering antipsychotic medication in the case of the United States v. Jared Lee Loughner.

The brief was submitted August 3 to the U.S. Court of Appeals for the Ninth Circuit.

Loughner has pleaded not guilty in the Tucson, Arizona shootings that killed 6 people and injured 13 others, including Rep. Gabrielle Giffords.

He has been diagnosed with schizophrenia, was found incompetent to stand trial and is being held in a federal prison hospital in Springfield, Mo.

The APA/AAPL brief argues that under existing standards the government may administer involuntary medication to a pre-trial detainee who is a danger to himself or others if appropriate administrative procedures are followed.

It was also argued that such decisions should be made by those having custody of the defendant and should not require a judicial hearing.

"We have two interests in this case," said Paul S. Appelbaum, M.D., chair of APA's Committee on Judicial Action.

"When the courts address issues concerning psychiatric disorders, we want them to have accurate data on the nature and consequences of those illnesses and on appropriate treatments.

In addition, we believe psychiatrists working in correctional facilities need the flexibility to deal with dangerous persons without the delay involved in lengthy court proceedings. Those are the issues that we focus on in the brief."

The defense in the Tucson shootings case has opposed the defendant's being treated with antipsychotic medication, and the 9 th Circuit Court of Appeals halted further treatment with antipsychotics until a hearing before that court at the end of August.

Since then, the psychiatrists treating Loughner concluded he was rapidly deteriorating and represented a danger to himself, and antipsychotic medication was restarted on an emergency basis.

The brief submitted by APA and AAPL did not side with either party, but seeks to clarify issues regarding managing violent, including self-injurious, inmates and about the use of antipsychotic medications.

The brief addresses the scientific evidence of the benefits and risks associated with antipsychotic medications, likely side effects, the medical reasons for involuntary administration in certain circumstances, and the inappropriateness of using other medications (i.e., sedatives) in the place of antipsychotics.

In Loughner's appeal the court will address whether, in a case involving a pre-trial detainee, the Washington v. Harper standard may be applied in a prison administrative process or whether the greater protection of a judicial proceeding is required.

Washington v. Harper holds that the government may treat a prison inmate who has a serious mental illness with antipsychotic drugs against his will if he is dangerous to himself or others and if the treatment is in his medical interest.

In that case - which involved a convicted prisoner - the court also held that an administrative hearing was adequate to satisfy procedural due process.

Loughner's lawyers have raised additional substantive and procedural arguments.

The APA's position in the brief, approved by the APA Board of Trustees, is consistent with the organization's ongoing support of adequate mental health care for individuals in the criminal justice system.

Please see our prior blog post that details a history of this case.

Thanks to Ken Pope for this information.