title: The Ninth Circuit's Loughner decision neglected medically appropriate treatment.
abstract: In a previous issue of The Journal, I anticipated the decision of the Ninth Circuit in United States v. Loughner. The Ninth Circuit's opinion upheld the involuntary medication of Mr. Loughner under a Harper order, with awareness that he could thereby gain trial competence, and it allowed Mr. Loughner's extended commitment to Federal Medical Center (FMC)-Springfield for the purpose of rendering him trial competent. As also anticipated in that article, the Ninth Circuit did not comment on the medical appropriateness of the setting for involuntary medication of pretrial defendants or its own court order permitting the involuntary medication of Mr. Loughner in a nonmedical correctional facility. In this article, the Ninth Circuit's opinion is analyzed with respect to its potential effect on the medical appropriateness of the setting, medical versus nonmedical, for involuntary medication with antipsychotic agents of pretrial defendants. Although the likelihood of Supreme Court review of the Loughner case has been made nil by his guilty plea, this case raises an unresolved constitutional point as well as the question of whether involuntary medical treatment should be administered in a setting that is appropriate for such treatment.
authors.affiliation: Division of Forensic Psychiatry, Department of Neurology and Psychiatry, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, Missouri 63104, USA. felthous@slu.edu
authors.forename: Alan R
authors.initials: AR
authors.lastname: Felthous
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage*; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D006708:Homicide / Q000331:legislation & jurisprudence*; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D007298:Insanity Defense; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D011329:Prisoners / Q000331:legislation & jurisprudence*; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*
chemical_list: D014150:Antipsychotic Agents