Psychotropic Medication and Competence to Stand Trial

At any given time, as many as 15,000 persons are hospitalized for study or treatment regarding their competence to stand trial. Although most of the defendants found incompetent to stand trial "could rapidly be returned to competence and so maintained were the facilities and treatments of modern psychiatry made available to them", the impact of recent advances in psychiatry—particularly drug therapy—has not been fully absorbed by the legal system. Defendants restored to competence by psychotropic drugs frequently require ongoing medication. Some courts, mistakenly assuming that psychotropic drugs produce a "chemical sanity" that is unacceptable for participation in a trial, have adopted a practice—the "automatic bar rule"—of automatically prohibiting the return for trial of defendants under the influence of such drugs. A lack of statutory, regulatory, or judicial guidance leaves the question largely to the discretion of individual trial judges. This article critically examines the automatic bar rule in light of the effects of various psychotropic drugs and of the consequences of the rule both to defendants and to the state.