Washington v. Harper

(Inpatient Commitment, Federal)

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No. 88-599
494 U.S. 210; 110 S. Ct. 1028; 108 L. Ed. 2d 178; 1990 U.S.
October 11, 1989, Argued
February 27, 1990, Decided


DISPOSITION: 110 Wash.2d 873, 759 P.2d 358, reversed and remanded.
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DECISION: State regulation allowing involuntary treatment of state prisoner with antipsychotic drugs, without judicial hearing, held not to violate Fourteenth Amendment’s due process clause.

SUMMARY: The Department of Corrections for the state of Washington maintained a Special Offender Center to diagnose and treat convicted felons who were state prisoners and had serious mental disorders. The center had a written policy providing that (1) if a psychiatrist determined that a prisoner should be treated with antipsychotic drugs but the prisoner did not consent, the prisoner was entitled to a hearing before a committee consisting of a psychiatrist, a psychologist, and the associate superintendent of the center, none of whom could be, at the time of the hearing, involved in the prisoner’s treatment or diagnosis; (2) the prisoner could be subjected to involuntary treatment with the drugs only if the committee determined by a majority vote, in which the psychiatrist was in the majority, that the prisoner (a) suffered from a mental disorder, and (b) was gravely disabled or posed a likelihood of serious harm to himself, others, or their property; (3) the prisoner had the right to (a) be notified of the center’s intent to convene the hearing, (b) attend the hearing, (c) present evidence and witnesses, (d) cross-examine staff witnesses, (e) be assisted by a lay adviser who had not been involved in the case but understood the psychiatric issues involved, (f) appeal the committee’s decision to the Superintendent of the center, and (g) seek judicial review of the committee’s decision in a state court; and (4) after the initial hearing, involuntary treatment could continue only with periodic review by the Department of Corrections. After involuntarytreatment proceedings were conducted in accordance with the center’s policy, a prisoner was involuntarily treated with antipsychotic drugs, subject to the periodic reviews of the prisoner’s case required under the policy. While being subjected to involuntary treatment at the center, the prisoner, who was later transferred from the center to another state correctional facility at which he was not treated involuntarily with antipsychotic drugs, filed suit in state court under 42 USCS 1983 against various individuals and the state, claiming that the failure to provide a judicial hearing before the involuntary administration of antipsychotic drugs violated the due process provisions of the Federal Constitution. After the trial court held that the procedures contained in the center’s policy met the requirements of due process, the Washington Supreme Court, on appeal, reversed and remanded the case to the trial court, holding that under the Fourteenth Amendment’s due process clause, the state could administer antipsychotic drugs to a competent, nonconsenting prisoner only after a judicial hearing at which the state had proved that the administration of the drugs was both necessary and effective for furthering a compelling state interest (110 Wash 2d 873, 759 P2d 358).

The United States Supreme Court reversed and remanded. In an opinion by Kennedy, J., speaking for a unanimous court as to point 1 below, and joined as to point 2 below by Rehnquist, Ch. J., and White, Blackmun, O’Connor, and Scalia, JJ., it was held that (1) the case was not rendered moot by the fact that the state had ceased administering antipsychotic drugs to the prisoner against his will; (2) the regulation comported with the substantive due process requirements of the Fourteenth Amendment, because it was reasonably related to the legitimate governmental interests in insuring the safety of prison staffs and administrative personnel, and in taking reasonable measures for the prisoners’ own safety, given that (a) the state’s interest in decreasing the danger to others caused by a prisoner’s mental disability necessarily encompassed an interest in providing medical treatment for the prisoner’s illness, (b) the regulation was a rational means of furthering the state’s legitimate objectives, and (c) physical restraints or seclusion were not alternatives that fully accommodated the prisoner’s rights at de minimis cost to valid penological interests; and (3) the administrative hearing procedures provided by the regulation comported with the procedural due process requirements of the Fourteenth Amendment, because (a) due process does not require a judicial hearing as a prerequisite for the involuntary treatment of prison inmates, (b) the regulation contained adequate procedural safeguards to insure that the prisoner’s interests were taken into account, and (c) the procedures under the regulation were sufficient to meet the requirements of due process in all other respects.

Blackmun, J., concurring, joined the court’s opinion of and expressed the view that formally committing a mentally ill patient in any appropriate case is a step that should not be avoided or neglected when significant indications of incompetency are present, since this step would protect the inmate, the institution, its staff, the physician, and the state.

Stevens, J., joined by Brennan and Marshall, JJ., concurring in part and dissenting in part, agreed with the court that the case was not moot, but expressed the view that the procedures under the center’s policy did not adequately protect the liberty interest implicated by the forced administration of psychotropic drugs, since (1) a competent individual’s right to refuse psychotropic medication is a fundamental liberty interest requiring the highest order of protection under the Fourteenth Amendment; (2) the policy allowed forced psychotropic medication on the basis of purely institutional concerns, where so serving institutional convenience eviscerated the inmate’s substantive liberty interest in the integrity of the inmate’s body and mind; and (3) the policy failed to provide that treatment decisions be made or reviewed by an impartial person or tribunal concerned not with institutional interests, but only with the individual’s best interests.

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