UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
FILED
UNITED STATES OF AMERICA )
) APR 0 a 2009
)
NANCY MAYER WHITTINGTON, CLERK
v. ) U.S. DISTRICT COURT
)
) Criminal Case No. 06-368 (RJL)
JAMES A. AUSTIN, )
)
Defendant. )
)
)
.,..,J
MEMORANDUM OPINION
(April"3 , 2009)
The Government asks this Court to order the involuntary medication of
defendant James A. Austin ("defendant" or "Austin"), who suffers from mental
illness, to render him competent to stand trial. The issue before the Court is
whether the Government's interest in prosecution sufficiently outweighs the
defendant's right to reject medical treatment to warrant the issuance of such an
order. Because the Government has failed to show that the administration of
antipsychotic drugs is substantially likely to return the defendant to competency,
this case does not fall within the "limited circumstances" established by the
Supreme Court in Sell v. United States, 539 U.S. 166, 169 (2003), that justify
involuntary medication. Accordingly, the Government's request is DENIED.
BACKGROUND
Austin, who is 56 years old, has struggled with mental illness for much of
his life. Gov't Ex. I, Psychological Report at 7, July 31, 2007. He has been
diagnosed with a variety of similar disorders, including schizophrenia, schizo-
affective disorder, and delusional disorder. Id. at 17. For the past twenty-three
years, he has been either incarcerated or committed to mental hospitals for
inpatient treatment. Id. at 6. Psychologists have "routinely" found him
incompetent to stand trial since 2002. Id. at 7.
In December 2006, Austin allegedly threatened to assault and murder D.C.
Superior Court Judge John Ramsey Johnson. Indictment, Dec. 19,2006. Austin
made the threats by phone while undergoing treatment at St. Elizabeth's Hospital
in Washington, D.C. 1 Def. Ex. 11, Discharge Summ. at 2, Jan. 30, 2007. At the
time of the threats, doctors at St. Elizabeth's were involuntarily medicating
defendant, which did not alter his psychosis symptoms. Id. at 4.
Following defendant's arrest, Magistrate Judge Alan Kay committed
defendant to the custody of the Federal Bureau of Prisons for a competency
evaluation. Order, Dec. 22, 2006. Dr. William Ryan, a staff psychologist at the
Metropolitan Correctional Center in New York, administered the evaluation and
recommended this Court find defendant incompetent to stand trial. The Court
concurred with Dr. Ryan's opinion and referred defendant to the United States
I Austin was committed to St. Elizabeth's for a mental health evaluation after being charged with
harassment, destruction of property, second degree theft, and arson. Def. Ex. 11, at 2.
2
Medical Center for Federal Prisoners ("USMCFP") in Springfield, Missouri for a
mental health evaluation and competency restoration. Gov't Ex. 1, at 1. Doctors
at USMCFP attempted to restore defendant to competency through non-
pharmacological means. Id. at 26. They were not successful and the defendant
has refused to voluntarily take antipsychotic medication. Id. at 13.
Currently, defendant remains incompetent to stand trial. Id. at 26. Dr.
Robert G. Sarrazin, chief psychologist ofUSMCFP, recommended that the Court
conduct a hearing under Sell to determine if defendant could be involuntary
medicated. Id. Magistrate Judge Deborah Robinson held those hearings on
October 26,2007, October 30,2007, January 29,2008, January 30, 2008, and
February 11,2008. Before she could issue her findings of fact and
recommendation, however, defendant made threats against her in open court, and
she was recused from the case. Order, May 13,2008. This Court held further Sell
proceedings on June 23, 2008. Based on the evidence presented to Magistrate
Judge Robinson and to this Court, I find, for the following reasons, that the
Government has not shown, by clear and convincing evidence, that Austin should
be involuntarily medicated under Sell.
DISCUSSION
In Sell, the Supreme Court held that, in limited circumstances, the Fifth
Amendment permits the administration of antipsychotic medication against a
defendant's will to render the defendant competent to stand trial. 539 U.S. at 169.
However, the Government can administer those drugs only if: 1) important
3
governmental interests are at stake; 2) involuntary medication will significantly
further those interests; 3) involuntary medication is necessary to further those
interests; and 4) administering the drugs is medically appropriate. Id. at 180-81.2
After evaluating these factors, the Court finds that the Government has not
shown each of these criteria by clear and convincing evidence. 3 While the
government has demonstrated important governmental interests at stake (i. e.,
prosecuting threatening conduct directed towards judicial officers), that interest is
firmly outweighed by the unlikelihood that involuntary medication will
"significantly further those interests." Id. at 181. Specifically, the Government
has not shown that there is a substantial likelihood the defendant will be restored
to competency. Therefore, under Sell, involuntary medication is inappropriate.
How so?
I. Importance of the Government's Interest
To render a defendant competent to stand trial through involuntary
medication, the Government must have an "important" interest at stake. Id. at
180. To evaluate the nature of the Government's interest, the court must consider:
2 Notably, the Supreme Court emphasized that a district court should "consider whether forced
administration of drugs can be justified on ... alternate grounds before turning to the trial competence
question." Sell v. United States, 539 U.S. 166, 182 (2003); see also United States v. Morrison, 415 F.3d
1180,1186 (lOth Cir. 2005). Dr. Sarrazin concluded that defendant "could not be involuntarily medicated
under the Harper criteria." Gov't Ex. 1, at 14. The parties do not challenge this finding. It is therefore
appropriate to consider whether the involuntary medication proposed here satisfies the Sell criteria.
3 While the D.C. Circuit has not addressed the standard of proof applicable to a Sell proceeding, other
circuits have adopted a clear and convincing evidence standard for each of the Sell criteria. See United
States v. Valenzuela-Puentes, 479 F.3d 1220, 1224 (lOth Cir. 2007) ("Given 'the vital constitutional liberty
at stake' ... the district court must find all necessary facts by 'clear and convincing evidence. "') (quoting
United States v. Bradley, 417 F.3d 1107, 1114 (lOth Cir. 2005»; United States v. Gomes, 387 F.3d 157,
160 (2d Cir. 2004) ("[T]he relevant findings must be supported by clear and convincing evidence."). This
Court finds their reasoning to be sound and uses the same standard here.
4
1) whether the defendant is charged with a serious crime; and 2) if any special
circumstances, such as the length of time defendant has already been confined,
undermine the importance of the Government's interest in prosecution. Id.
Although the severity of the offense in this case is - to say the least -
obvious, the possible sentence for a crime is also an important factor in gauging its
relative seriousness as an offense. See United States v. Hernandez-Vasquez, 513
F.3d 908, 918-19 (9th Cir. 2008); United States v. Valenzuela-Puentes, 479 F.3d
1220, 1226 (lOth Cir. 2007). Here, both the maximum sentence (ten years) and
the proposed sentence under the federal guidelines (at a maximum, forty-one
months)4 indicate defendant's crime is a serious one. Moreover, the Fourth Circuit
has held that "threatening to murder a federal judge ... is 'serious' under any
reasonable standard." United States v. Evans, 404 F.3d 227,238 (4th Cir. 2005)
(internal citations omitted). Surely, the Government has demonstrated an
important interest in trying an individual charged with this offense.
Yet that interest is, to some extent, undermined by the length of time
defendant has already been confined. Sell, 539 u.S. at 180. Defendant was
arrested on December 20,2006. As of the date of this Opinion, he has been
committed for twenty-seven months. If defendant were restored to competency -
a process which can take up to four months, ifsuccessful, Tr. 1129108 at 68:10-12
- tried, convicted, and sentenced, he would already have served a substantial
4 The Government and defendant disagree as to the specific calculations under the federal sentencing
guidelines. For the purposes ofthis opinion, the Court refers to the lengthier guidelines range provided by
the Government - 33 to 41 months. Tr. 7/29/08 at 5:11-16.
5
portion of a sentence within the federal guidelines range. Under these
circumstances, the importance of the Government's interest, while not eradicated,
is certainly diminished.
II. Probability of Restoration to Competency
Although the Government may have a strong interest in prosecuting Austin,
it fails to proffer clear and convincing evidence that "involuntary medication will
significantly further" that interest. Sell, 539 U.S. at 181. Involuntary medication
significantly furthers the government interest if: 1) the administration of drugs is
"substantially likely to render defendant competent to stand trial," and 2) the drugs
are substantially unlikely to have side effects that would interfere significantly
with the defendant's ability to "assist counsel in conducting a trial defense." Id. at
181 (emphasis added). Expert testimony regarding the likelihood of success must
reflect an individualized assessment of the patient's medical history and mental
illness. See Evans, 404 F.3d at 241 (expert testimony that did not consider "all of
the particular characteristics of the individual defendant" was insufficient to
sustain government's burden). Here, unfortunately for the Government, the expert
testimony does not meet that standard.
During the Sell hearing, Dr. Robert G. Sarrazin, the Government's chief
expert witness,5 testified that he did not review all of Austin's medical records.
Dr. Sarrazin mainly relied upon a discharge summary from St. Elizabeth's
5 The Government also proffered the testimony of Dr. Chad Brinkley, a clinical psychologist at USMCFP,
but it has since conceded that Dr. Brinkley did not have sufficient expertise to address the question of
whether anti-psychotic medicine would be substantially likely to restore Austin to competency. Tr. 2111108
at 7:22-24.
6
Hospital in 2003 in recommending involuntary medication, but he admitted to
having only "likely skimmed" the records documenting Austin's progress through
competency restoration treatment at the hospital. Tr. 1130108 at 11:8-15. Indeed,
the discharge summary provides few specifics about Austin's restoration to
competency, noting only that it occurred after Austin began taking the medication.
Def. Ex. 4, Discharge Summ., June 26,2003. As a result, Dr. Sarrazin could not
testify with certainty that antipsychotic medication was responsible for Austin's
restoration to competency in 2003. Tr. 1129/08 at 58:6-23. As such, Dr.
Sarrazin's cursory review of Austin's records is insufficient to show, by clear and
convincing evidence, that Austin will likely be restored to competency.
To the contrary, Austin's medical history indicates that a restoration to
competency is unlikely. He has a lengthy history of civil and criminal
commitment resulting from his mental illness, during which he has repeatedly
been adjudicated incompetent to stand trial. Unfortunately, as time passes, Austin
becomes less and less likely to respond to medication. Tr. 1130108 at 30:22-31 :20.
Indeed, he has never been adjudicated to be competent after undergoing
involuntary medication. 6 And perhaps most tellingly, Austin committed the crime
with which he is charged while involuntarily medicated and participating in a
competency restoration program. Def. Ex. 11, at 4.
Because the Government has failed to show that involuntary medication is
6 Although Austin was deemed competent in 2003 by the doctor completing his discharge, no court of law
has ever found Austin competent to stand trial after undergoing competency restoration treatment. Def. Ex.
4, Discharge Summ., 2003.
7
substantially likely to restore Austin to competency, the Government cannot
administer antipsychotic medication to defendant against his will. 7
CONCLUSION
Thus, for all of the foregoing reasons, the Government's request to
involuntarily medicate defendant James Austin is DENIED.
~United States District Judge
7 The final prongs of the Sell analysis require this Court to consider whether involuntary medication is
necessary to further the government interests, and whether the treatment is "medically appropriate." Sell,
539 U.S at 181. However, because the government has failed to proffer sufficient evidence that medication
is likely to restore Austin to competency, consideration of these factors is unnecessary.
8