Allmond v. Department of Health & Mental Hygiene
141 A.3d 57
| Md. | 2016Background
- Gary Allmond, committed to a state psychiatric hospital after being found incompetent to stand trial on a murder charge, repeatedly refused antipsychotic medication; an incident in Sept. 2014 led his treating psychiatrist to seek involuntary medication.
- A clinical review panel authorized involuntary medication for 90 days in Sept. 2014 and renewed that authorization in Dec. 2014; Allmond appealed to an ALJ and then to the circuit court.
- The ALJ found medical appropriateness satisfied and that Allmond would remain seriously mentally ill without medication, but concluded he was not dangerous in the facility; she relied on subparts of HG §10-708(g).
- Allmond raised a facial constitutional challenge under Article 24 (substantive due process) to HG §10-708(g)(3)(i)(2),(i)(3),(ii)(2),(ii)(3), arguing the statute permits forced medication absent a finding of dangerousness in the facility.
- The Maryland Court of Appeals affirmed the circuit court: it held the statute is not facially invalid, but emphasized that involuntary medication of pretrial detainees requires medical appropriateness plus an overriding justification (e.g., safety or rendering competent for trial); the panel’s prior authorization had since expired.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether HG §10-708(g)(3)(i)(2),(i)(3),(ii)(2),(ii)(3) is facially unconstitutional under Article 24 for permitting involuntary medication without a finding of dangerousness in the facility | Allmond: The statute allows forced medication absent in-facility dangerousness, violating substantive due process | DHMH: The statute’s criteria and procedures suffice; no further constitutional requirement beyond statutory standards | The statute is not facially invalid because there are constitutional applications (e.g., to render a detainee competent), but involuntary medication requires medical appropriateness plus an overriding justification (per Harper/Riggins/Sell) |
| Whether the court should decline Allmond’s unpreserved constitutional claim for failure to exhaust administrative remedies | Allmond: Court should hear facial challenge; issue is fit and capable of repetition yet evading review | DHMH: Failure to raise constitutional claim before the ALJ bars this review | Court exercised discretion to hear the facial due-process challenge because it is appropriate to resolve statutory construction and avoid repeated appeals; declined to hear a separate free-speech claim raised only in this Court |
| What standard applies to involuntary medication of pretrial detainees | Allmond: (implicit) apply strict protection to refusal-right; statute fails to provide necessary safeguards | DHMH: statute’s framework is sufficient; broader state interests justify medication when statutory criteria met | Court: Apply federal precedent: medical appropriateness plus an overriding justification (e.g., safety in facility or rendering competent for trial) per Harper, Riggins, Sell |
| Whether additional state interests (e.g., resource allocation, ADA compliance, general obligation to provide care) constitute an overriding justification | Allmond: not directly argued on these points | DHMH: suggested interests like providing care, shortening hospitalization, ADA/efficiency justify forced meds | Court: These interests alone are insufficient; they would collapse medical appropriateness and overriding justification into one inquiry and thus do not meet Riggins/Sell standards |
Key Cases Cited
- Washington v. Harper, 494 U.S. 210 (1990) (upholding involuntary medication for convicted prisoners when medically appropriate and reasonably related to penological interests)
- Riggins v. Nevada, 504 U.S. 127 (1992) (pretrial detainee may be involuntarily medicated only with a finding of overriding justification and medical appropriateness; safety or competence may suffice)
- Sell v. United States, 539 U.S. 166 (2003) (permitting involuntary medication to render a defendant competent only if four Sell factors are met: important government interests, meds significantly further interests, necessity, and medical appropriateness)
- Williams v. Wilzack, 319 Md. 485 (1990) (Maryland statute previously struck for inadequate procedural protections; led to statutory revision)
- Department of Health & Mental Hygiene v. Kelly, 397 Md. 399 (2007) (construed earlier HG §10-708 to require in-facility dangerousness where the statute expressly referenced it)