State v. SeekinsState v. Seekins
Opinion
Under
The record reveals the following facts and procedural history. On June 30, 2006, the defendant pleaded guilty to production or preparation of a controlled substance without a license in violation of
A pretrial hearing was held on September 3, 2008, at which time the state moved for a competency hearing pursuant to
On September 23, 2008, the trial court conducted a hearing to ascertain the results of the competency evaluation. Bruce Knox, a licensed clinical social worker and member of the clinical team that had evalu ated the defendant, testified that it was the unanimous opinion of that team that the defendant was incompetent to stand trial. According to the team’s evaluation report, which was admitted into evidence without objection, the defendant suffered from bipolar disorder, was “pervasively delusional,” and was incapable of understanding the proceedings against him. Knox testified, however, that, with appropriate treatment, a “substantial probability” existed that the defendant could be restored to competency within sixty days through inpatient psychiatric hospitalization that included the administration of psychotropic medication. Knox further testified that the defendant previously had been restored to competency very quickly using standard medication for bipolar disorder and, further, that the medication likely would prove effective again in treating the defendant’s symptoms. Knox confirmed the assistant state’s attorney’s report to the court, however, that the defendant had refused to take any medication during his most recent admission to Whiting.
On cross-examination, defense counsel asked Knox whether there were any health risks associated with psychotropic medication. Knox responded that “there’s always some potential risk with any medication, but the treatment team at Whiting is familiar with the defendant. They’ve known him for many months, and I’m sure they would monitor any medication very closely, given [the defendant’s] . . . concerns about [the] matter.” The trial court then asked Knox whether, when the defendant previously had been restored to competency, he had suffered any adverse side effects from the medication. Knox responded that, as far as he knew, the defendant had suffered no such side effects.
After Knox completed his testimony, the trial court found the defendant incompetent to stand trial. The court further found, however, that the defendant could be restored to competency within sixty days through
inpatient treatment at Whiting if that treatment included the administration of psychotropic medication. The court then inquired of defense counsel as to whether the defendant would be willing to take such medication. Defense counsel responded that the defendant would be willing to take medication as long as it was not detrimental to his health. The trial court observed that the defendant previously had been restored to competency through the use of standard bipolar medication and inquired of defense counsel whether the defendant had experienced any adverse side effects from that medication. The defendant himself interjected that he had not experienced any side effects during the restoration period but that, later, he had experienced several side effects that he believed were adverse to his health. Specifically, the defendant
A second competency hearing was held on November 18, 2008, at which Susan McKinley, a licensed clinical social worker, testified. McKinley informed the court that she and a clinical team from Whiting recently had evaluated the defendant for competency to stand trial and had found him to be incompetent. McKinley testi- fled that, although the defendant understood the charges against him and the general workings of the judicial system, he was unable to assist in his defense because “his persecutory and delusional [thinking] interfere [d] with his ability to think logically and rationally about the proceedings . . . [to] [c]onsider advice from counsel . . . [and to] [m]ake reasonable decisions about his case.” McKinley explained that, since his commitment to Whiting on September 23, 2008, the defendant had refused to take any “synthetic” medications, insisting on “organic remedies” only, which were not available at Whiting. According to McKinley, the members of the evaluation team agreed unanimously that the defendant could be restored to competency within sixty days if he were to be medicated involuntarily. When the trial court asked McKinley if any less intrusive means were available to restore the defendant’s competency, she responded that all less intrusive means already had been attempted but had failed. McKinley added, however, that she and the evaluation team believed that medicating the defendant involuntarily would not only restore him to competency but likely would benefit him by improving his mental health generally, as well.
At the conclusion of the evidentiary portion of the hearing, the trial court found the defendant incompetent to stand trial. The trial court then noted that, because the state was seeking an order of involuntary medication, the state bore the burden of establishing by clear and convincing evidence that the charges against the defendant were sufficiently serious to justify such an intrusion on the defendant’s liberty. The assistant state’s attorney responded that the state had a substantial interest in restoring the defendant to competency in view of the serious nature of the numerous drug felonies with which he had been charged and the fact that the defendant was a repeat offender. At the
conclusion of the assistant state’s attorney’s argument, the trial court found that the charges against the defendant were serious and that the state had an overriding interest in restoring him to competency. The trial court further found that, to a reasonable degree of medical certainty, involuntary medication would render the defendant competent to stand trial and that no less intrusive means existed for doing so. In light of these findings, the trial court appointed Betsy Graziano, a licensed clinical social worker, as the defendant’s health care guardian to represent the defendant’s best interests in accordance
On December 24, 2008, after reviewing the defendant’s medical and psychiatric records and meeting with the defendant on two occasions, Graziano filed a report with the court in which she concluded that it was in the defendant’s best medical interest to receive a therapeutic dose of antipsychotic medication and mood stabilizer, involuntarily, if necessary. Graziano noted that she had consulted with John Dubozcy, the defen dant’s treating psychiatrist, among others, and that he had informed her that all possible, less intrusive means for restoring the defendant to competency had been attempted and had failed. With respect to the appropriate medication, Dubozcy recommended that the defendant be administered “a therapeutic dose of Risperdal and lithium . . . .’’If the defendant were to refuse that medication, which is administered orally, Dubozcy then would prescribe a single, five milligram dose of Haldol, which would be administered intramus-cularly. Graziano noted that the defendant’s symptoms successfully had been treated with Risperdal and lithium on prior occasions with minimal side effects. Grazi-ano further noted that, although a variety of side effects can occur with the administration of psychotropic medication, they generally are associated with long-term use and a failure to monitor a patient’s vital signs and symptoms. Graziano then explained that Dubozcy had assured her that Whiting has sufficient staff to monitor the defendant around the clock, seven days a week, for any possible side effects, and that the staff would intervene appropriately should any adverse effects be detected.
A hearing on Graziano’s report was conducted on January 5, 2009, at which she testified regarding her findings and recommendations. At the conclusion of the hearing, the trial court found, to a reasonable degree of medical certainty, that involuntary medication would “render the defendant competent to stand trial,” an adjudication of his guilt or innocence could not be accomplished using less intrusive means, the proposed treatment plan was “narrowly tailored to minimize intrusion on the defendant’s liberty and privacy interests,” and the proposed drug regimen would not cause any “unnecessary risk to the defendant’s health” in view of the fact that the defendant would be closely monitored for side effects by his clinical team. The trial court
further found that the charges against the defendant were sufficiently serious to justify the state’s intrusion on the defendant’s liberty interests. In light of its findings, the trial court
The defendant subsequently filed an interlocutory appeal from the trial court's decision. 10 Thereafter, the trial court granted the defendant’s motion to stay the order of involuntary medication pending the outcome of his appeal. We transferred the defendant’s appeal from the Appellate Court to this court. See footnote 2 of this opinion.
On appeal, the defendant challenges only the trial court’s finding under
The following legal principles guide our analysis of this claim. It is well established that “[a]n individual has a constitutionally protected liberty interest in avoiding involuntary administration of antipsychotic drugs — an interest that only an essential or overriding state interest might overcome.
Sell
[v.
United States,
“At the same time, the government has a significant interest in bringing a
“[T]he [constitution permits the [g]ovemment involuntarily to administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges in order to render that defendant competent to stand trial, but only if the treatment is medically appropriate, is substantially unlikely to have side effects that may undermine the fairness of the trial, and, taking account of less intrusive alternatives, is necessary significantly to further important governmental trial-related interests. [Id., 179].
“Articulating a standard for determining the circumstances in which the government may obtain a court order to medicate involuntarily a defendant to render him competent to stand trial, the [United States] Supreme Court has focused on the competing interests of the defendant and the government.” (Internal quotation marks omitted.)
United States
v.
Bush,
With these principles in mind, we turn to the defendant’s claim that the trial court improperly determined that the charges against him are sufficiently serious to justify involuntary medication. A trial court’s determination as to the seriousness of a crime for purposes of applying
Although this court has not yet had occasion to apply the
Sell
factors in reviewing the propriety of an order
of involuntary medication,
12
all of the federal circuit courts that have done so have looked to the potential penalty that may be imposed in determining whether a crime is serious. See, e.g.,
United States
v. Fazio,
In adopting the maximum statutory penalty approach in
United States
v.
Evans,
supra,
The Fourth Circuit concluded: “[I]n light of
Duncan
and its progeny, it is appropriate to focus on the maximum penalty authorized by statute in determining if a crime is ‘serious’ for involuntary medication purposes. Such an approach respects legislative judgments regarding the severity of the crime . . . while at the same time giving courts an objective standard to apply . . . .” (Citations omitted.) Id.; see also
United States
v.
Green,
supra,
Because Connecticut does not have sentencing guidelines, the sentencing guideline approach to assessing the seriousness of a crime is not an option available to the courts of this state. As we previously have indicated, however, the defendant faces a mandatory
minimum
sentence of seven years imprisonment if he is convicted of three of the crimes with which he has been charged, namely, § 2 la-278 (b), which provides for a mandatory minimum sentence of five years imprisonment, § 21a-279 (b), which provides for a maximum sentence of five years imprisonment for the first offense, and § 2 la-279 (d), which provides for a mandatory, nonsus-pendable sentence of two years imprisonment that is to run consecutively to any sentence imposed for violating § 21a-279 (a), (b) or (c). Moreover, one of the offenses
with which the defendant has been charged, namely, § 21a-278 (b), carries a maximum possible sentence of twenty years imprisonment. Even if we consider only the mandatory minimum sentence that the defendant faces if convicted under §§ 21a-278 and 21a-279, however, and not the maximum
combined
sentences that could be imposed if he is convicted of all charges, it is apparent that the charges pending against the
Our conclusion that the charges in this case are serious, however, does not end our inquiry. As we previously have explained, in evaluating the state’s interest in prosecuting the defendant, we also “must consider the facts of the individual case,” bearing in mind that “[s]pecia! circumstances may lessen the importance of that interest.”
Sell
v.
United States,
supra,
In the present case, the defendant contends that the state’s interest in bringing him to trial is undermined by the fact that the crimes with which he has been charged are all nonviolent, victimless offenses involving the recreational use of marijuana rather than the sale or distribution of that drug. At oral argument before this court, the defendant further contended that, in assessing the state’s interest, this court should take into account society’s growing tolerance of marijuana use, as evidenced by the movement in some states to decriminalize the recreational use of that drug and by the fact
that several states already have permitted it to be used
First, the defendant is not charged merely with possession of marijuana; he is charged with manufacturing the drug and possessing it with the intent to sell. As we previously have indicated, at the time of the defendant’s arrest, the police discovered fifty marijuana plants growing in his home and approximately two pounds of marijuana in his refrigerator, along with a digital scale and various accoutrements associated with the cultivation of marijuana. In light of the quantity of marijuana involved and the nature of the other seized evidence, we cannot conclude, as a matter of law, that the charges against the defendant are not serious, or that they are unfounded or otherwise lacking in significance. 15 Although the defendant may be able to rebut the state’s contention that the large quantity of marijuana found in his home was intended for sale or distribution and not merely for personal use, that issue is one for the jury, not this court, to evaluate and decide.
We also disagree with the defendant that the nonviolent nature of the offenses militates against the state’s interest in bringing him to trial. As the United States
Court of Appeals for the Sixth Circuit stated in rejecting a similar claim: “[W]e simply cannot conclude that only violent crimes are serious for purposes of this analysis. There are any number of criminal behaviors that do not involve crimes of violence that are serious matters. Indeed, the [court in]
Sell
. . . [concluded] that fraud was a serious crime. See
Sell
[v.
United States,
supra,
“[Furthermore], we do not subscribe to the theory that the legislative branch considers drug-trafficking crimes as victimless, regardless of the scale of the operation. If a criminal defendant possesses an illegal substance with the intent to distribute that substance to others, unquestionably there are victims. The lack of an identifiable person . . . does not equate to a completely victimless crime. . . . Society as a whole is the victim when illegal drugs are being distributed in its communities.” (Internal quotation marks omitted.)
United States
v.
Green,
supra,
In addition, we are not persuaded by the defendant’s argument that society’s increasing tolerance of marijuana use, or the fact that some states have taken steps to decriminalize the recreational use of that drug, diminishes the state’s interest in this case. Notwithstanding the movement afoot in some quarters to repeal or modify laws banning the use and possession of marijuana, the fact remains that “[m]arijuana is a schedule I controlled substance [in Connecticut]. See
Thus, if we were to adopt the defendant’s position, we necessarily “would [be] usurp [ing] the legislature’s role and . . . vitiat[ing] what is an inherently legislative determination” that marijuana is a dangerous substance.
State
v.
Heinemann,
Finally, we consider whether “[t]he defendant’s failure to take drugs
In reaching our conclusion, however, we are mindful that the experts who previously testified at the hearings
on the defendant’s competency agreed that the defendant would be restored to competency quickly and with minimal side effects using medication that is standard in the treatment of bipolar disorder. The defendant has not challenged that testimony on appeal. Indeed, the defendant himself represented to the trial court that he had experienced no side effects during a prior restoration. We also are mindful that the trial court, in entering its order, did so on the condition that the defendant would be closely monitored for possible adverse side effects, thereby minimizing any risk to the defendant’s health. In light of these considerations, and for the reasons previously set forth in this opinion, we agree with the state that the trial court properly determined, in view of all the special circumstances that had been
The decision of the trial court is affirmed.
In this opinion the other justices concurred.
Notes
Although
The defendant appealed to the Appellate Court from the decision of the trial court, and we transferred the appeal to this court pursuant to
For the first time on appeal, the defendant claims that the trial court’s order of involuntary medication violates his right to freedom of religion
under the first and fourteenth amendments to the United States constitution and the Religious Freedom Restoration Act of 1993, Pub. L. No. 103-141, 107 Stat. 1488, codified as amended at
At oral argument before this court, defense counsel noted that, according to the operative police report, the police seized 1.8 pounds of marijuana from the defendant’s refrigerator. At all times relevant to the competency proceedings and in its brief to this court, however, the state has maintained that the police seized 8.4 pounds of marijuana from the defendant’s refrigerator. At oral argument before this court, the state acknowledged the discrepancy between the police report and its position concerning the amount of marijuana that the police had seized from the defendant’s refrigerator. The state indicated at that time that it was not prepared to concede that only 1.8 pounds of marijuana, rather than 8.4 pounds, had been seized from the defendant’s refrigerator. Moreover, at no time prior to our release of this decision on December 7,2010, did the state advise this court of any material change in its position with respect to the amount of marijuana seized or with respect to whether it intended to reduce or drop any of the charges pending against the defendant in light of the police report. Consequently, in our decision released on December 7, 2010, we referred to the seizure of 8.4 pounds of marijuana from the defendant’s refrigerator. Subsequent to the release of this decision, however, the state filed a motion to correct, acknowledging for the first time that the police did, in fact, seize only 1.8 pounds of marijuana from the defendant’s refrigerator. We granted the state’s motion, and, consequently, the corrected decision refers to the seizure of 1.8 pounds of marijuana from the defendant’s refrigerator. The state contends, and we agree, that the correction with respect to the quantity of marijuana found in the defendant’s refrigerator does not affect our analysis in this case.
The defendant faces a maximum sentence of ten years imprisonment for a violation of § 21a-246 (a) because he previously has been convicted of that offense. See
Under § 21a-278 (b), the execution of the mandatory minimum sentence imposed thereunder shall not be suspended unless, at the time the offense was committed, the defendant was under eighteen years old or the defendant’s mental capacity was significantly impaired, but not so impaired as to constitute a defense to prosecution.
Harassment in the second degree carries a maximum sentence of three months imprisonment. See
As this court previously has determined, an order directing that a defendant be forcibly medicated under
As we explain more fully hereinafter, that standard was set forth by the United States Supreme Court in
Sell
v.
United States,
In
State
v.
Jacobs,
We do not discount the possibility that, at a hearing conducted in accordance with
The defendant also claims that the state’s interest in trying him is undermined by the fact that he does not pose a threat to himself or others. As the state maintains, however, the standard set forth in
Sell
is applicable
only when
involuntary medication is
not justified
on the ground of dangerousness. See
Sell
v.
United States,
supra,
We note that the defendant does not claim that the state has overcharged him to increase his maximum exposure for an improper purpose.
Experts testified at the defendant’s prior competency hearings that it would take approximately two months to restore the defendant to competency.