Riggins v. Nevada

The petitioner, David Riggins, challenged his criminal convictions on the basis that his liberty and right to due process of the law, as protected by the Sixth and Fourteenth Amendments of the U.S. Constitution, were violated when the State of Nevada forcibly administered him with an antipsychotic drug during his trial.

In November 1987, Riggins was arrested for the killing of a man in Nevada. After he was taken into custody, Riggins complained that he was hearing voices and having difficulties sleeping. He was then prescribed a daily dose of 100 milligrams of an antipsychotic drug, Mellaril (thioridazine). His prescription was gradually increased to 800 milligrams per day. Riggins was also prescribed Dilantin, an antiepileptic drug. While taking the medication, Riggins was found competent to stand trial.

Riggins moved to terminate the administration of Mellaril and Dilantin until the end of his trial. He argued that these drugs would alter his mental state during the trial and deny him due process. The State argued that the medication was necessary to ensure Riggins’ competence to stand trial. The District Court denied Riggins’ motion but did not explain its reasons for doing so. Riggins continued to receive 800 milligrams of Mellaril per day until the completion of his trial.

Riggins was convicted and sentenced to death. He appealed to the Nevada Supreme Court, claiming that the forced administration of the antipsychotic compromised “his ability to assist in his own defense, and prejudicially affected his attitude, appearance, and demeanor at trial.” The Nevada Supreme Court affirmed Riggins’s convictions and death sentence. Riggins appealed to the United States Supreme Court.

The Supreme Court majority held that the District Court erred in dismissing Riggins’ request to discontinue the antipsychotic medication without recognizing his liberty interest and weighing it against the relevant state interests. The Court reversed the judgment of the Nevada Supreme Court and remanded the case.

The Court noted that the interference with a person’s liberty resulting from the involuntary administration of an antipsychotic during trial required some determination of need or about reasonable alternatives. The Court did not develop a test to determine when the interference with the person’s liberty was acceptable, but found insufficient the district court’s lack of “any determination of the need for this course [of treatment] or any findings about reasonable alternatives” (emphasis in original). The Court did develop a high-water mark where interference would be reasonable when the state established that the drug was medically appropriate, and absent less intrusive alternatives, essential for Riggin’s own safety or those of others. The Court noted that the interference may have been reasonable if the treatment was the least intrusive means to obtain an adjudication on the defendant’s guilt.

The Court noted that the side effects of Mellaril administration at such a high dose could affect Riggins’ appearance, testimony, interaction with legal counsel, and comprehension of the proceedings. This impairment was not remedied by allowing Riggins to testify to Mellaril’s effect on him. However, the Court refrained from deciding on whether Riggins’ due process rights were actually prejudiced by the forced administration of the antipsychotic medication.

The concurrence emphasized that the due process clause prohibits prosecuting officials from administering involuntary antipsychotic medication even for the purpose of rendering the accused competent for trial, absent an extraordinary State interest.

The dissent asserted that Riggins received a fair trial and that Riggins was required to demonstrate specifically how he was prejudiced by the medication.

“Nevada certainly would have satisfied due process if the prosecution had demonstrated, and the District Court had found, that treatment with antipsychotic medication was medically appropriate and, considering less intrusive alternatives, essential for the sake of Riggins’ own safety or the safety of others…Similarly, the State might have been able to justify medically appropriate, involuntary treatment with the drug by establishing that it could not obtain an adjudication of Riggins’ guilt or innocence by less intrusive means.” (Page 135)

“We also are persuaded that allowing Riggins to present expert testimony about the effect of Mellaril on his demeanor did nothing to cure the possibility that the substance of his own testimony, his interaction with counsel, or his comprehension at trial were compromised by forced administration of Mellaril. Even if…the Nevada Supreme Court was right that expert testimony allowed jurors to assess Riggins’ demeanor fairly, an unacceptable risk of prejudice remained…. Because the record contains no finding that might support a conclusion that administration of antipsychotic medicine was necessary to accomplish an essential state policy…we have no basis for saying that the substantial probability of trial prejudice in this case was justified.” (Page 137-8)

“… [A]bsent an extraordinary showing by the State, the Due Process Clause prohibits prosecuting officials from administering involuntary doses of antipsychotic medicines for purposes of rendering the accused competent for trial, and to express doubt that the showing can be made in most cases, given our present understanding of the properties of these drugs.” (Page 139, concurrence)