title: Adjusting Treatment for an Inmate-Patient Receiving Medication Involuntarily.
abstract: Correctional psychiatrists can pursue authorization for forcible medication of pretrial detainees housed in a federal prison hospital through two pathways: an administrative process based upon the U.S. Supreme Court decision in Washington v. Harper and a judicial process founded on the Court's ruling in Sell v. United States. The pathway associated with Harper pertains to the involuntary treatment of a mentally ill inmate believed to be dangerous or gravely disabled, or both, to protect the inmate-patient and others from harm, whereas the avenue linked with Sell involves the forcible treatment of an incompetent pretrial defendant to restore competence to stand trial. Given the difference in objectives between these two processes, there is rarely confusion regarding which pathway the correctional psychiatrist should pursue. However, circumstances can arise that blur the distinction between the Harper and Sell processes. I present a composite case highlighting such a scenario and provide discussion and commentary to assist the correctional psychiatrist in deciding on the most appropriate course of action.
authors.affiliation: Dr. Williams is Clinical Assistant Professor, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC. The views expressed in this article do not necessarily reflect the views of the University Of North Carolina School Of Medicine or the U.S. Federal Bureau of Prisons. joseph_williams@med.unc.edu.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Williams
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003617:Dangerous Behavior; D003692:Delayed-Action Preparations; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D005555:Forensic Psychiatry / Q000331:legislation & jurisprudence; D019983:Guideline Adherence; D006220:Haloperidol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence; D010819:Physician's Role; D011329:Prisoners / Q000331:legislation & jurisprudence* / Q000523:psychology*; D012563:Schizophrenia, Paranoid / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D016312:Treatment Refusal / Q000331:legislation & jurisprudence
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; C033563:haloperidol decanoate; D006220:Haloperidol