U.S. v. Charters

• Citation: 863 F.2d 302
• Decision Date: 09 December 1988
• Docket Number: No. 86-5568,86-5568
• Parties: UNITED STATES of America, Plaintiff-Appellee, v. Michael Francis CHARTERS, Jr., Defendant-Appellant. AMERICAN PSYCHOLOGICAL ASSOCIATION, Amicus Curiae, v. AMERICAN PSYCHIATRIC ASSOCIATION, Amicus Curiae.
• Court: United States Courts of Appeals. United States Court of Appeals (4th Circuit)

Page 302

863 F.2d 302

57 USLW 2384

UNITED STATES of America, Plaintiff-Appellee, v. Michael Francis CHARTERS, Jr., Defendant-Appellant.

AMERICAN PSYCHOLOGICAL ASSOCIATION, Amicus Curiae, v. AMERICAN PSYCHIATRIC ASSOCIATION, Amicus Curiae.

No. 86-5568.

United States Court of Appeals Fourth Circuit.

Argued June 9, 1988.

Decided Dec. 9, 1988.

Thomas Rawles Jones, Jr. (William B. Moffitt, Lisa Bondareff Kemler, Moffitt & Jones, Alexandria, Va., on brief), for defendant-appellant.

Donald B. Verrilli, Jr. (Donald N. Bersoff, Ennis, Friedman & Bersoff, Washington, D.C., on brief), for amicus curiae American Psychological Ass'n in support of defendant-appellant.

Joel I. Klein (Robert D. Luskin, Onek, Klein & Farr, Washington, D.C., on brief), for amicus curiae American Psychiatric Ass'n in support of plaintiff-appellee.

Victor Darrel Louis Stone, U.S. Dept. of Justice, Washington, D.C. (Henry E. Hudson, U.S. Atty., Constance H. Frogale, Asst. U.S. Atty., Alexandria, Va., Melissa Glassman, Third-Year Law Student, on brief), for plaintiff-appellee.

Before WINTER, Chief Judge, RUSSELL, WIDENER, HALL, PHILLIPS, MURNAGHAN, SPROUSE, ERVIN, CHAPMAN, WILKINSON, and WILKINS, Circuit Judges, sitting en banc.

PHILLIPS, Circuit Judge:

Michael Francis Charters, an involuntarily-committed psychiatric patient at the Federal Correctional Institution at Butner, North Carolina (Butner), appeals a district court order permitting the administration of antipsychotic medication over his objection. Charters contends that medicating him without his consent or a judicial determination that he is incompetent to make his own medical decisions unconstitutionally impinges upon his liberty interests. We believe the district court correctly determined that Charters' interests were adequately protected by the exercise of the professional judgment of Butner's medical personnel at the time the decision to medicate was made. Because there may have been a change of circumstances in the interval, however, we remand for such reevaluation of the situation as the medical personnel think appropriate.

I

Charters was indicted in November 1983 for threatening the President of the United States in violation of 18 U.S.C. Sec. 871. Shortly thereafter, the government's motion for psychiatric evaluation was granted and Charters was committed to the Springfield, Missouri Medical Center for psychiatric evaluation. The Center's medical personnel diagnosed Charters as incompetent to stand trial. In early 1984, the district court referred Charters to Butner for further evaluation pursuant to then 18 U.S.C. Sec. 4244. In February 1984, the court found Charters incompetent to stand trial and dangerous, and ordered him confined to Butner pursuant to then 18 U.S.C. Sec. 4246 for continued evaluation and treatment. The court directed the personnel at Butner to report on Charters' mental condition within 60 days. Following receipt of the report, the court held another hearing and on June 5, 1984, issued an order continuing Charters' confinement based on his persistent incompetence to stand trial and dangerousness to himself and others. Over the next one and one-half years, the district court reviewed Charters' confinement four more times, each time ordering continued confinement based on findings of incompetence and dangerousness.

On January 17, 1986, the court made a determination consistent with its previous findings but denied the government's request to permit the medical personnel at Butner to treat Charters with antipsychotic medication over his objections. In April 1986, Charters' treating psychiatrist, the Director of Forensic Services and Clinical Research at Butner, Dr. Sally Johnson, wrote the district court, detailing Charters' condition and recommending the administration of antipsychotic medication.

In May 1986, the district court conducted a hearing to determine if Charters should be medicated. Dr. Johnson testified that Charters suffers from degenerative schizophrenia, which is incurable but can be controlled symptomatically with medication. She also testified that in his untreated condition Charters will almost certainly require indefinite confinement in an institutional setting. She noted however that, as demonstrated by previous treatment with antipsychotic medication, Charters' mental state could improve through proper medication, decreasing his dangerousness to a level that could permit his return to the community.

The district court considered Dr. Johnson's testimony and concluded that the government's legitimate interests outweigh Charters' protected interests. The court identified the government's interests as: (1) protecting society and other inmates from a dangerous individual; (2) maintaining a pretrial detainee in a competent condition to stand trial; and (3) fulfilling its duty to treat the medical needs of the citizens in its custody. The court also determined that Charters possesses interests in liberty and privacy under the due process clause of the fifth amendment and in freedom of thought under the first amendment. These interests, the court concluded, were adequately protected by the exercise of the professional judgment of Butner's medical personnel. Based on this conclusion, the court ordered the administration of the proposed antipsychotic medication over Charters' objections but stayed its order pending an expedited appeal to this court. Charters appealed, and a panel of this court reversed the district court, holding that Charters could not be subjected forcibly to the prescribed medication without a more elaborate procedural protection prescribed by the panel. United States v. Charters, 829 F.2d 479 (4th Cir.1987). We then ordered rehearing en banc.

II

All citizens possess a constitutionally protected liberty interest in remaining in free society. Parham v. J.R., 442 U.S. 584, 600, 99 S.Ct. 2493, 2503, 61 L.Ed.2d 101 (1979); Morrissey v. Brewer, 408 U.S. 471, 480, 92 S.Ct. 2593, 2599, 33 L.Ed.2d 484 (1972). But this basic interest is extinguished for any period of legal confinement that follows commitment procedures that are compatible with due process. See Greenholtz v. Nebraska Penal Inmates, 442 U.S. 1, 7, 99 S.Ct. 2100, 60 L.Ed.2d 668 (1979). This does not mean, however, that persons legally confined are stripped entirely of all protectible interests. They retain significant interests, Youngberg v. Romeo, 457 U.S. 307, 315, 102 S.Ct. 2452, 2457, 73 L.Ed.2d 28 (1982); Vitek v. Jones, 445 U.S. 480, 491-94, 100 S.Ct. 1254, 1262-64, 63 L.Ed.2d 552 (1980), but they are not absolute. Romeo, 457 U.S. at 319-20, 102 S.Ct. at 2459-60. These retained interests must yield to the legitimate government interests that are incidental to the basis for legal institutionalization, see Rennie v. Klein, 720 F.2d 266, 273 (3d Cir.1983) (Seitz, J., concurring), and are only afforded protection against arbitrary and capricious government action. Cf. Slochower v. Board of Higher Education, 350 U.S. 551, 559, 76 S.Ct. 637, 641, 100 L.Ed. 692 (1956) (education employment context).

A

The Supreme Court has recognized several constitutionally-protected interests that are retained by involuntarily committed individuals--interests in conditions of reasonable care and safety, in reasonably nonrestrictive confinement conditions, and in such training as may be required by these interests, Romeo, 457 U.S. at 324, 102 S.Ct. at 2462--but the Court has not yet directly held that involuntarily-committed mental patients retain a protectible interest in refusing antipsychotic medication. It has, however, assumed "for the purposes of ... discussion" that such patients "do retain liberty interests protected directly by the Constitution ... and that these interests are implicated by the involuntary administration of antipsychotic drugs." Mills v. Rogers, 457 U.S. 291, 299 n. 16, 102 S.Ct. 2442, 2448 n. 16, 73 L.Ed.2d 16 (1982) (citation omitted) (remanding for reconsideration in light of intervening State Supreme Court decision).

In this circuit, we have held, based in part upon the Supreme Court's recognition in Romeo of a protectible liberty interest in freedom from bodily restraint, that "the forcible administration of antipsychotic drugs presents a sufficiently analogous intrusion upon bodily security to give rise to such a protectible liberty interest." Johnson v. Silvers, 742 F.2d 823, 825 (4th Cir.1984). See also Bee v. Greaves, 744 F.2d 1387, 1394 (10th Cir.1984) (recognizing a similar interest); Project Release v. Prevost 722 F.2d 960, 977-79 (2d Cir.1983) (same). We hold here, therefore, that Charters possesses this constitutionally-protected retained interest.

B

Charters does not contest the fact of his confinement. The procedures by which he was committed fully comport with due process. Greenwood v. United States, 350 U.S. 366, 375, 76 S.Ct. 410, 415, 100 L.Ed. 412 (1956) (finding commitment pursuant to 18 U.S.C. Secs. 4244-48 constitutional). Charters was initially committed to Butner for psychiatric evaluation on the government's motion pursuant to then 18 U.S.C. Sec. 4244. ¹ This provision established the procedure for determining mental incompetency during the period "after arrest and prior to the imposition of sentence or prior to the expiration of any period of probation." Butner psychiatric personnel evaluated Charters and subsequently issued a report which concluded that Charters was mentally incompetent. Pursuant to Sec. 4244, the district court then conducted a hearing to determine independently whether Charters was competent to stand trial. At the hearing, the court considered the evidence and testimony presented and concluded that Charters was both incompetent to stand trial and a present public danger to the officers and interests of the United States. The court then committed Charters to the custody of the Attorney General pursuant to then 18 U.S.C. Sec. 4246 which allowed continued commitment until Charters was rendered...