Document Type

Book Chapter

Publication Date



This is a draft of a chapter that has been accepted for publication by Oxford University Press in the forthcoming book Fitness to Plead: International and Comparative Perspectives edited by Ronnie Mackay and Warren Brookbanks due for publication in May 2018. It addresses whether the state may forcibly medicate an unwilling defendant or prisoner to restore competence in the criminal process, including competence to stand trial, competence to plead guilty and to waive trial rights, competence to represent oneself, and competence to be sentenced. It begins with a description of the doctrinal and mental health background information and the right of prisoners generally to refuse psychotropic medication. The succeeding section discusses the general balance of interests that obtains in deciding this issue and then canvases the particular competencies in question with analysis and recommendations for future directions. The general thesis is that the interest of both the state and the individual in finality is so weighty that forcible medication is justified in most cases if it is necessary to permit the criminal process to proceed. A brief conclusion follows.


Competence, psychotropic medication, finality, state interests, individual interests, civil commitment, criminal law, competency

Publication Title

Fitness to Plead: International and Comparative Perspectives

Publication Citation

in Fitness to Plead: International and Comparative Perspectives (Ronnie Mackay & Warren Brookbanks eds., Oxford University Press, forthcoming 2018).