Involuntary treatment and competence to proceed in the criminal process: capital and noncapital cases

Recent cases raise a series of questions regarding the involuntary administration of treatment intended to restore or maintain competence to proceed in the criminal process. As is often the case, these matters take on a special urgency in the context of capital punishment. The analysis presented in this paper suggests that the relevant interests that courts should consider in deciding whether to order the involuntary administration of treatment to restore or maintain competence converge to a greater degree than one might initially expect. When the applicable conception of medical interests is appropriately defined and the state's interest in protecting the integrity of the process is given appropriate weight, the legally protected state and individual interests converge to a substantial degree. Protecting both sets of interests may require a variety of procedures designed to avoid misguided interventions with the potential to undermine both sets of interests. Finally, this analysis provides an approach that allows the courts to grant appropriate weight to the professional ethics of those who perform evaluations and deliver treatment in these contexts.