Washington v. Harper

1990-04-16

Headline: Prison mental-health rules allowed to require involuntary antipsychotic treatment, with administrative medical hearings upheld, making it easier for prisons to medicate mentally ill, dangerous inmates without a prior judicial hearing.

Holding: The Court held that the State may, without a prior judicial hearing, involuntarily treat a mentally ill, dangerous prisoner with antipsychotic drugs when treatment is in the prisoner’s medical interest and administrative procedures are followed.

Real World Impact:

Allows prisons to medicate mentally ill, dangerous inmates without a prior judicial hearing.
Affirms administrative medical committee hearings and periodic review as constitutionally adequate.
Limits inmates’ ability to get immediate court approval before forced medication.

Topics: prison mental health, involuntary medication, due process, antipsychotic drugs

Summary

Background

A man serving a prison sentence in Washington, Walter Harper, refused antipsychotic drugs after previously taking them while in the prison mental-health unit. The State relied on its Special Offender Center Policy 600.30, which lets psychiatrists seek involuntary medication for inmates judged mentally disordered and either gravely disabled or likely to harm themselves, others, or property. The policy provides an internal hearing before a committee, notice, a lay adviser, appeal to the superintendent, and periodic review; a state trial court found the policy adequate, but the Washington Supreme Court required a full judicial hearing instead.

Reasoning

The central question was whether the Constitution demands a judicial hearing before the State can medicate a mentally ill prisoner over his objections. The Court said it does not. It held that the State may involuntarily medicate a prisoner only when the inmate has a serious mental illness, poses a danger to self or others, and the treatment is in the inmate’s medical interest. Because prisons have strong safety and medical obligations, the Court applied a reasonableness standard tied to legitimate prison interests and concluded the policy’s medical decisionmaking, notice, opportunity to be heard, lay adviser, appeal, and periodic review satisfy due process.

Real world impact

The ruling makes it easier for prison medical staff and administrators to use antipsychotic drugs under internal procedures rather than seek prior court approval. It affects mentally ill inmates in state prisons, prison clinicians, and administrators. The Supreme Court reversed the state high court and sent the case back for further proceedings consistent with this opinion.

Dissents or concurrances

Justice Blackmun concurred but urged formal commitment when appropriate. Justice Stevens (joined by Justices Brennan and Marshall) dissented in part, arguing the policy sacrifices inmate liberty, risks abuse, and that impartial judicial or independent review with stronger safeguards should be required.