The 6-3 ruling, a defeat for prosecutors, means that the government will have to revise a common practice now of putting defendants on anti-psychotric drugs for their trials. Justices said that the Constitution allows the government to administer drugs only "in limited circumstances."
The case required the court to balance the government's interest in punishing nonviolent crime with a person's constitutional right to control his or her body.
Justice Stephen Breyer (search), writing for the majority, said that courts in considering individual cases must decide if involuntary medications "will significant further" interests in punishments.
The federal government puts hundreds of defendants on medication each year to make them competent to stand trial. Most take the drugs willingly. In a recent 12-month period, 59 people were medicated against their wishes and about three-fourths were restored to competency, the government has said.
In a series of decisions more than a decade ago, the Supreme Court ruled that inmates considered dangerous could be forced to take medication and that defendants in criminal trials could be required to take drugs if it was medically appropriate.
The latest ruling dealt with the rights of people facing less serious charges who do not want to take anti-psychotic drugs.
Breyer said that a lower court should reconsider whether the government could medicate Dr. Charles Sell, 53, of St. Louis, who has spent more than four years in a prison hospital as his lawyers fought over his drugging. Breyer said that the court must consider "alternative, less intrusive treatments."
In a dissent, Justice Antonin Scalia (search), joined by Justices Sandra Day O'Connor and Clarence Thomas, said that the ruling was narrow, but that it would allow some criminal defendants "to engage in opportunistic behavior" to thwart prosecutions.
Sell has been diagnosed with a delusional disorder. Court records show that Sell has seen imaginary leopards, believes the FBI is trying to kill him and wants to go into combat.
Sell's lawyers and prosecutors agree that Sell is mentally ill and too unstable to stand trial. He is accused of submitting bogus claims to Medicaid and private insurance companies for dental services. Sell was later charged with conspiring and attempting to kill a witness — a former worker in his office — and the FBI agent who arrested him.
The case is Sell v. U.S., 02-5664.