United States v. Chavez
2013 U.S. App. LEXIS 22879
| 10th Cir. | 2013Background
- Chavez, a Mexican national, was indicted on firearms and illegal reentry charges and was evaluated for competency to stand trial.
- A BOP psychologist diagnosed paranoid schizophrenia and concluded Chavez was presently incompetent but could likely be restored to competency with antipsychotic medication; Chavez refused voluntary treatment.
- The district court held a Sell evidentiary hearing and granted the government’s motion to involuntarily medicate Chavez to restore competency, issuing a sealed order without specifying drugs or dosages.
- At the hearing the government’s witness, a psychologist (not a psychiatrist), testified about "typical" medications and general success/side-effect rates but presented no individualized treatment plan or specific dosage ranges; he said a psychiatrist would decide exact medications.
- Chavez objected that the lack of a specific, individualized treatment plan prevented the court from properly assessing Sell factors; the court nonetheless approved involuntary medication and required only a six-week status report.
- The Tenth Circuit held the district court erred because the Sell findings (prongs two and four) require a specific treatment plan identifying possible medications and maximum dosages before authorizing forced medication.
Issues
| Issue | Chavez's Argument | Government's Argument | Held |
|---|---|---|---|
| Whether the district court satisfied Sell’s requirement that involuntary medication will "significantly further" the government’s interest in prosecution (prong 2) | Lack of individualized treatment plan prevents meaningful assessment of efficacy and side effects | General testimony about typical drugs and success rates suffices | Reversed: court erred; need specific proposed medications/dosage ranges to satisfy prong 2 |
| Whether the district court satisfied Sell’s requirement that medication be "medically appropriate"/in patient’s best medical interest (prong 4) | Without specific drugs/doses a court cannot determine medical appropriateness | Flexibility to allow physicians to choose drugs post-authorization is acceptable | Reversed: court erred; must identify drugs and maximum dosages to find medical appropriateness |
| Whether a status report requirement or evaluator familiarity can substitute for an individualized treatment plan | Status report and evaluator familiarity are insufficient safeguards | Post-authorization monitoring and clinician judgment provide protection | Rejected: status report/familiarity cannot replace preauthorization specificity |
| Scope of permissible judicial limits on treating physicians when restoring competency | Court must impose limits (specific drugs/doses) to protect liberty interest | Courts should allow physicians flexibility to adapt treatment | Court requires specification of drugs and maximum dosages but permits reasonable ranges and alternatives; orders may be revised if circumstances change |
Key Cases Cited
- Sell v. United States, 539 U.S. 166 (2003) (establishes four-part test for involuntary medication to restore competency)
- United States v. Bradley, 417 F.3d 1107 (10th Cir. 2005) (discusses Sell and appellate review standards)
- United States v. Valenzuela-Puentes, 479 F.3d 1220 (10th Cir. 2007) (applies Sell and clarifies review of factual findings)
- United States v. Hernandez-Vasquez, 513 F.3d 908 (9th Cir. 2008) (requires Sell orders to identify medications, maximum dosages, and duration/reporting)
- United States v. Evans, 404 F.3d 227 (4th Cir. 2005) (vacated Sell order lacking proposed medication and dose range)
- United States v. Green, 532 F.3d 538 (6th Cir. 2008) (upheld Sell order where physicians presented an individualized plan with specific drugs, doses, and alternatives)
- Washington v. Harper, 494 U.S. 210 (1990) (authorizes involuntary medication for dangerous inmates; distinct from Sell restoration context)
- Riggins v. Nevada, 504 U.S. 127 (1992) (recognizes serious risks of antipsychotic medication and need for careful judicial scrutiny)
- United States v. Jarvison, 409 F.3d 1221 (10th Cir. 2005) (standard for clear-error review of factual findings)