Sell v. U.S.: involuntary medication to restore trial competency--a workable standard?

Competency to Stand Trial (CST) evaluations are common in the U.S. criminal justice system. Of those defendants found Incompetent to Stand Trial (IST), psychotic disorders are the most common diagnoses, and active psychotic symptoms are strongly correlated with impairments in trial-related abilities. If a defendant is rendered IST because of psychosis, restoration will be unlikely without antipsychotic medication. Last term, in Sell v. U.S., the U.S. Supreme Court dealt with medication refusal in the context of competency restoration. The Court held that involuntary medication, under certain circumstances, is appropriate. This article includes a review of earlier relevant legal decisions and an analysis and discussion of the Sell decision.