Thursday, November 13, 2008

No Forced Medication in New Jersey Case has this article from the New Jersey Law Journal regarding a case in which a judge has ruled against forcibly medicating a defendant in order to render him competent to stand trial ("Defendant Can't Be Forced to Take Drug to Make Him Fit for Trial, Judge Rules", 11-12-2008).

This case raises interesting questions as to how the system should handle a defendant who has been indicted but whose mental illness makes it unlikely that he will be able to stand trial any time soon, if ever. Similar questions emerge in the case of death row inmates who have been deemed incompetent to be executed and are not being forcibly medicated (or for whom medication has not restored competency). These inmates remain in legal limbo, where the state is neither seeking their execution nor moving to commute the sentence.

Here's the article in full:

"Federal authorities can't force a mentally ill bank robbery suspect to take an anti-psychotic drug that could make him competent to stand trial, because the side effects might be harmful, a federal judge in Camden, N.J., has ruled.

Prosecutors argued that injections of Haldol had an excellent chance of making paranoid, hallucinating, delusional suspect Wayne Moruzin fit for prosecution on charges he held up a Westville, N.J., bank in 2005.

But Moruzin objected to taking the injections and U.S. District Judge Jerome Simandle ruled on Oct. 30 that there was insufficient evidence that the suspect would respond to the treatment and a chance that his health would be undermined by side effects. Moruzin has a history of drug abuse and hepatitis.

The government failed to establish that the proposed treatment 'is medically appropriate, is substantially unlikely to have side effects that may undermine the fairness of the trial, and, taking into account less intrusive alternatives, is necessary significantly to further important government trial-related interests,' Simandle ruled in U.S. v. Moruzin, cr-05-306.

While the ruling makes no new law, the case is unusual because the authorities have determined that Moruzin does not pose a danger to himself or others. In those cases, it's easier for the government to win the right to administer the drugs by arguing medical necessity.

The U.S. Attorney's Office does have the right to seek civil commitment in hopes Moruzin's condition will improve, but government doctors have testified that competency is not likely to occur without the anti-psychotic drugs that Moruzin refuses to take.

And because Moruzin could be sentenced to up to 30 years if convicted, a very long time would pass before a judge could release him on grounds he had served the equivalent of what a sentence would have been.

'The question becomes, what do they do with the indictment?' asks defense lawyer Mark Catanzaro, who has a firm in Moorestown, N.J. 'If he refuses to take the medicine he is not likely to return to competence. They are not obligated to dismiss the indictment right now but I don't know how long they can keep it open. I can't imagine five years from now there would still be an open indictment hanging out there.'

'It may not be a legal matter, but a practical matter,' Catanzaro says. 'Judge Simandle calls up and screams at [the prosecutors] and says, get this thing off my docket.'

Assistant U.S. Attorney Norman Gross did not return a call on Thursday.

In January 2007, U.S. District Judge Joel Pisano made the same ruling and dismissed the indictment in U.S. v. McCray, cr-04-493, a case involving a mentally ill bank robber. But he did so knowing it wasn't a get-out-of-jail free card for defendant Kevin McCray, who had already pleaded guilty to three bank jobs in Delaware and was serving a 36-year sentence in state prison.

Moruzin was arrested on Sept. 16, 2004, the day after he allegedly walked into the First Colonial National Bank, fired a shot from a chrome-colored gun and fled with $11,588.

Employees said they recognized him because he was a former customer. When police chased him down the next day they said they found some of the money, but not all of it. He admitted to eating a $50 bill, 'and requested a glass of water to help digest same,' the FBI complaint said.

A jury tampering charge was added to the indictment in 2005, after authorities intercepted a letter in which Moruzin suggested to a woman that she appear at his upcoming jury selection and inform potential jurors that he had been set up.

Simandle granted Moruzin the right to represent himself at trial, but the defendant's behavior suggested he might be suffering from a mental defect and Simandle ordered a hearing into whether Moruzin was competent to stand trial.

He wasn't. Based on medical evidence that Moruzin was paranoid and delusional, Simandle wrote in October 2006, 'he presently seems to be unable to have constructive dialogue about this case or his defense due to his hostility and paranoia, and there is little doubt that his unfounded mistrust of his attorney and his attorney's motives hampers his attorney-client relationship.'

Doctors who evaluated Moruzin for the government recommended that the judge order the involuntary administration of anti-psychotic drugs, which would be the normal treatment for anyone with the defendant's condition and had a chance of making him competent to stand trial.

The drug of choice was Haldol by injection twice a month and then once a month.

The courts have given medical personnel the right to order such treatment if the patient is a threat to himself or others, but that wasn't the case with Moruzin.

His situation was covered by Sell v. United States, 539 U.S. 166 (2003), a U.S. Supreme Court ruling that says defendants have a constitutional right to avoid involuntary administration of anti-psychotic drugs but can be forced to comply if the government satisfies a series of legal tests.

Simandle ruled that the government flunked all the tests, starting with the one that gives the prosecution the benefit of the doubt when a crime is particularly serious.

Simandle ruled that although Moruzin is exposed to a possible sentence of 30 years, the strong likelihood of the alternative -- a civil commitment -- would undermine the need for a prosecution, he ruled.

Second, he ruled that there was insufficient evidence that Haldol would restore competency to Moruzin, who has been a drug abuser for 40 years and has been mentally ill for at least 32 years.
What's more, the side effects experienced by many patients, including pseudo-Parkinson's-type physical movements, grimacing, tongue protrusion and lip smacking, could make Moruzin's courtroom demeanor prejudicial, the judge ruled.

Third, the government hadn't proved that alternative treatments, including psychotherapy, were possible.

And finally, the government hadn't proven that Haldol was the appropriate treatment for Moruzin's illness, given the dangers of side effects, he ruled."


ACDesign said...

I hope you get my comment:) I would like to commend you for your efforts to educate others about the issues with our mental health system. It is sad how those with mental disorders are treated like animals. We don't treat someone with cancer with such discrimination. I would like to follow your blog. Here are my website, blog and news article links. Hope you can check them out. I plan to keep posting on my blog. Keep up the good work!

Kristin Houle said...

Thanks so much for your kind words. I'm glad to hear that you find this blog useful -- I'm just sorry that I haven't been able to update it as frequently as I would like.

I definitely will check out your website, blog and article links.

Thanks again!