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United States v. Charters.


 The Fourth Circuit examined the legal grounds on which a medically incompetent patient confined in a federal treatment facility can be forcibly medicated with antipsychotic drugs. Distinguishing the case from Youngberg v. Romeo, in which the Supreme Court recommended deference to the professional judgment of the mental institution, the Fourth Circuit offered a more protective test focusing on the rationality of the patient's reasons for refusing the medication. If the patient's incompetence precludes a rational decision, the court should substitute its judgment based on evidence of what the patient would have decided if competent, or on what is in the patient's best interests. In reaching its conclusion, the court was concerned that mentally ill patients may still be competent to make decisions concerning their medical care, and that antipsychotic drugs can cause serious injury and infringe on an individual's freedom of thought.
