Law & psychiatry: Treatment of incompetent, dangerous criminal defendants: parsing the law.

The case of Jared Lee Loughner, who killed or wounded 19 people in a shooting rampage in Tucson, demonstrates the confusion inherent in current rules for the treatment of defendants with mental illness. Found incompetent to stand trial and committed for treatment, Jared Loughner refused medication. However, when he became dangerous and suicidal, the facility treated him. Loughner's attorneys objected, arguing that the U.S. Supreme Court decision in Sell v. United States entitled him to a judicial hearing. The lack of clarity over the rules that should govern such cases stems from the court's failure to make explicit the rationale for its landmark decision.