Some Inmates Are Allowed to Refuse Drugs

Mentally ill inmates cannot be forced to take anti-psychotic drugs, the California Supreme Court ruled Monday, allowing a certain class of prisoners to refuse treatment in limited circumstances.

The justices’ 6-1 decision concerns California inmates who have done their time for criminal convictions but have been found to be mentally unfit for release to the community. Those inmates, hundreds in all, are housed at state mental institutions until they are deemed fit for return to the community.

If they refuse anti-psychotics, the court ruled, the state cannot force them to take the medication unless a judge authorizes it. A judge must find that the inmate is incompetent to refuse treatment and is an immediate danger to himself or others.

Justice Carlos Moreno, writing for the majority, said the 1985 law authorizing the retention of mentally disordered inmates past their release dates allows the state to administer anti-psychotic drugs against a patient’s wishes when there is a medical emergency or when safety and lives are at risk.

Although the court acknowledged the drugs can work wonders for the mentally ill, the medicine also can produce intolerable side effects, including muscle spasms, blurred vision, dry mouth, sexual dysfunction, body rigidity and tremors, among others.

“The basic constitutional and common law right to privacy and bodily integrity is therefore especially implicated by the forced administration of medications with such potential adverse consequences,” Moreno wrote.

The law, he said, was similar to those affecting mentally ill inmates serving their original sentences.

In dissent, Justice Janice Rogers Brown wrote that the ruling goes against the legislative purpose of the 1985 law, which was designed to rehabilitate the mentally ill and safeguard the public.

Those “permitted to refuse anti-psychotic medication will not receive necessary treatment for their mental disorders and their refusal will effectively subject them to indefinite commitment with little prospect of rehabilitation, precisely the type of warehousing the Legislature sought to avoid,” Brown wrote.

The case concerned Kanuri Surgury Qawi, who was sentenced in 1991 to four years for assault and battery. On parole, he was arrested for stalking a sales clerk that he claimed was his wife.

While incarcerated the second time, authorities diagnosed him with paranoid schizophrenia, and he has repeatedly been kept from the community under the Mentally Disordered Offender Act.

In 2000, Qawi challenged his involuntary treatment and said the drugs’ side effects were unbearable.

His attorney, Renee Torres, said Monday’s decision means that just because the state can lock somebody up it deems mentally disordered, “they can’t force them to be medicated.”

Torres said her client has been on medication for eight years, “and he still hasn’t gotten out.”

The state Department of Justice did not return calls seeking comment.