United States v. Diaz: the Gap Between Medication and Restoration - Bryson Mccollum
| Publication year | 2012 |
Casenote
United States v. Diaz: The Gap Between Medication and Restoration
I. Introduction
In United States v. Diaz,1 the United States Court of Appeals for the Eleventh Circuit, in a case of first impression, determined whether the state met its burden in applying the United States Supreme Court's test articulated in Sell v. United States,2 to involuntarily medicate an incompetent, schizophrenic defendant.3 Based on the Sell test that was established in 2003,4 the court of appeals had to determine which evidentiary findings were sufficient to meet the clear and convincing evidence standard allowing the State of Georgia to forcibly medicate the appellant, Michael Diaz.5 The court of appeals found no clear error in the United States District Court for the Northern District of Georgia's decision to involuntarily medicate Diaz based on evidence of Diaz's uncooperative behavior and testimony concerning the effectiveness of
1. 630 F.3d 1314 (11th Cir. 2011).
2. 539 U.S. 166 (2003).
3. Diaz, 630 F.3d at 1317.
4. Sell, 539 U.S. at 169.
5. Diaz, 630 F.3d at 1317.
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alternatives.6 While involuntary medication may be Diaz's only chance at restoring trial competency, the Eleventh Circuit ultimately made its decision based on impersonal statistics lacking any practical guidelines.7
II. Factual Background
On January 27, 2004, and again on April 8, 2004, a SouthTrust Bank in Atlanta, Georgia, was robbed at gunpoint.8 Michael A. Diaz was arrested by the Atlanta Police Department while attempting to flee the scene of the second robbery.9 Diaz was subsequently charged with one count of possession of a firearm by a convicted felon,10 two counts of armed bank robbery, and two counts of using a firearm during a crime of violence.11
While his trial was pending in the Northern District of Georgia, Diaz was examined by two doctors who disagreed about his competency.12 Based on the testimony of both doctors at an October 2005 competency hearing, the district court deemed Diaz competent to stand trial.13 Diaz's motion to proceed pro se was granted so long as his court appointed attorney, Timothy Saviello, remained as standby counsel.14 Furthermore, Diaz seemingly requested to waive his Sixth Amend-ment15 right to a jury trial,16 which was also granted.17
6. Id. at 1335-36.
7. See id.
8. United States v. Diaz, 630 F.3d 1314, 1317 (11th Cir. 2011).
9. United States v. Diaz, 540 F.3d 1316, 1317 (11th Cir. 2008).
10. At the time of arrest, Diaz was "on supervised release for a prior conviction ... in the Eastern District of Louisiana." Id. at 1317 n.2.
11. Id. at 1317.
12. Diaz, 630 F.3d at 1317. The Federal Detention Center in Miami, Florida, found Diaz to be competent after extensive interviews and psychological tests and even believed his psychological problems could be fabricated. Diaz, 540 F.3d at 1318. Diaz told the psychiatrist for the defense, Dr. Michael Hilton, that beginning at age thirteen his personality had been "vanquished" and since had "re-earthed" as six different identities. Diaz, 630 F.3d at 1317 (internal quotation marks omitted). Hilton believed Diaz was suffering from "undifferentiated schizophrenia" and "was not competent to stand trial." Id. (internal quotation marks omittted).
13. Diaz, 630 F.3d at 1318. Diaz informed the court that he did not believe in the court's authority over him and at one point requested that his trial be heard in the
"International World Court." Diaz, 540 F.3d at 1320.
14. Diaz, 540 F.3d at 1319. "Standby counsel" may be appointed by a trial court in order to assist the pro se defendant in his defense. McKaskle v. Wiggins, 465 U.S. 168, 170 (1984) (internal quotation marks omitted).
15. U.S. Const. amend. VI.
16. Diaz refused to sign the required waiver, but because of his oral statements the court allowed his attorney to sign instead. Diaz, 540 F.3d at 1320. These oral statements from Diaz included that he did not "wish the jurors to be infringed upon," and when
2012] UNITED STATES V. DIAZ 1439
The district court held a bench trial in which Diaz was found guilty on all five counts and was sentenced to 584 months of imprisonment.18 Diaz appealed, and the Eleventh Circuit vacated Diaz's convictions and remanded for further proceedings after determining that Diaz did not knowingly waive his right to a jury trial.19
In May 2009, the district court held Diaz's second competency hearing. This time he was found incompetent to stand trial and was committed to the custody of the U.S. Attorney General for a maximum of four months to determine whether competency to stand trial could be attained. Four business days later, Diaz received notice of a Due Process Involuntary Medication Hearing scheduled for June 3, 2009. At the hearing, Dr. Carlos Tomelleri concluded that he could not approve involuntary medication for Diaz because he was not likely to cause harm to himself or others.20 Dr. Tomelleri did, however, believe that medication would have a "substantial probability" of rendering Diaz legally competent.21
Following the Due Process Involuntary Medication Hearing, the district court held a hearing pursuant to the decision in Sell v. United States22 on September 8, 2009, concerning involuntary medication for the sole purpose of attaining trial competency of a nondangerous defendant.23 At the hearing, Diaz was found to suffer from schizophrenia and, in light of testimony, government evidence, and assessment of the Sell factors,24 the district court directed the Springfield Medical Center
pressed as to whether he wanted a jury his answer was, "I can have a jury. I can have a jury. I mean you want me to choose ... to be prosecuted?" Id. at 1321 (alteration in original) (internal quotation marks omitted).
17. Id. at 1321.
18. Id. at 1323.
19. Diaz, 630 F.3d at 1318.
20. Id. at 1318-19.
21. Id. at 1319 (internal quotation marks omitted).
22. 539 U.S. 166 (2003).
23. Diaz, 630 F.3d at 1319. The guidelines set forth in Sell require the government to meet four criteria by clear and convincing evidence in order to involuntarily medicate a defendant for the purposes of attaining trial competency. Id. at 1329. Under Sell, only "essential or overriding" state interests may permit the government to involuntarily medicate an incompetent defendant to attain trial competency. Id. at 1331 (quoting Sell,
539 U.S. at 178-79).
24. In order to involuntarily medicate an incompetent defendant for the sole purpose of attaining trial competency, all four Sell factors must be found by the court: (1) important government interests are at stake; (2) forced medication will significantly further the government interests-that is, the medication is substantially likely to render the defendant competent and substantially unlikely to interfere with the defendant's ability to assist counsel; (3) involuntary medication is necessary to further the state interests and alternative treatments are unlikely to reach comparable results; and (4) administering the
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to "first seek[] to obtain Mr. Diaz's voluntary participation" and then, if he refused to cooperate, to forcibly medicate him.25 The district court found that there were no alternatives to medication to restore competency, Diaz's crimes were serious and of important interest to the government, and Diaz was unlikely to cooperate in any other manner.26
Between all hearings and court appearances, Diaz spent time in various government medical facilities. While at these facilities, Diaz refused to participate in group activities, clinical testing, psychological interviews, or questioning by doctors. He also refused to take any medications regardless of doctor recommendation.27
Diaz appealed the involuntary medication order, contending that the government did not meet the clear and convincing evidence standard regarding the second and third Sell factors.28 Diaz filed a motion to stay the order pending the appeal, and the motion was granted.29 The Eleventh Circuit affirmed the district court's decision to involuntarily medicate Diaz for the sole purpose of attaining trial competency.30
III. Legal Background
The right to privacy and personal liberty are heavily cherished by the citizens of the United States, as well as historically guarded by the United States Supreme Court. Within the medical arena, individuals are constitutionally granted, through the Fifth and Fourteenth amendments,31 the right to choose their personal course of medical treatment with minimal limitation or government interference.32 Citizens also have the right to be fully aware of all risks involved with their medical treatment through the doctrine of informed consent.33
drugs is medically appropriate. Sell, 539 U.S. at 180-81.
25. Diaz, 630 F.3d at 1330 (internal quotation marks omitted).
26. Id. at 1329-30.
27. Id. at 1317-20.
28. Id. at 1331
29. Id. at 1330.
30. Id. at 1335-36.
31. U.S. Const. amends. V, XIV.
32. Planned Parenthood v. Casey, 505 U.S. 833, 877 (1992) (holding that a law or provision of a law is invalid if it creates an undue burden on the individual-that is, if the law's purpose or effect is to place substantial obstacles in the path of a woman's right to choose an abortion before the fetus attains viability, then the law is unconstitutional); Cruzan v. Dir., Mo. Dep't of Health, 497 U.S. 261, 278 (1990) (noting that competent individuals have "a constitutionally protected liberty interest in refusing unwanted medical treatment").
33. Planned Parenthood, 505 U.S. at 882. Informed consent includes explaining truthful information about the nature of the procedure and all potential health risks to the patient. Id.
2012] UNITED STATES V. DIAZ 1441
A. Early Interpretation of Involuntary Medication
Complex situations, such as the due process rights afforded to patients ofstate mental institutions and the use ofpsychotropic drugs, complicate inherent rights to privacy and individual liberty in personal medical decisions.34 In 1980, the United...
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