CT High Court: Forced Medication for Wang Approved

The state Supreme Court ruled yesterday that Dr. Lishan Wang, who was charged more than six years ago with the Branford murder of Dr. Vanjinder Toor, may be forcibly medicated in an effort to restore him to competency so that he might stand trial.

The state’s highest court handed up a unanimous decision in which it found that Superior Court Judge Thomas V. O’Keefe, Jr., the trial judge, ​“applied the proper standards and that his findings were supported by clear and convincing evidence.”

The groundbreaking Wang case, now six years old, has rattled the criminal justice system, testing the rules for how Connecticut prosecutes murders and when seemingly delusional people may serve as their own attorney. The case has also raised the question of how the state’s psychiatric hospitals are evaluating defendants who must be deemed competent to stand trial to begin with.

In 2003, in what was a landmark decision, the United State Supreme Court imposed stringent limits on the right to forcibly medicate a criminal defendant who, like Dr. Wang had been deemed incompetent to stand trial for the sole purpose of making the defendant competent to stand trial. But in that case, ​“Sell v. United States, ” the court also held there were factors in which forcible medication could be imposed. 

In its decision, the state Supreme Court held this was one of the rare cases where forced medication was warranted. The high court’s decision will officially be released Sept. 13. Oral arguments were held before the high court last May. The murder case now returns to Superior Court in New Haven, where a pre-trial hearing is scheduled for this Friday.

Dr. Wang was arrested in on April 26, 2010, and charged with the shooting death of Dr. Vanjinder Toor, who previously had been Dr. Wang’s supervisor at a New York hospital. Dr. Wang believes Dr. Toor was responsible for his firing in 2008. Dr. Wang travelled from Georgia, where he lived with wife and children, to Branford and lay in wait for Dr. Toor as he left his Branford condo that morning. He is also accused of attempting to kill Dr. Toor’s wife, a probable cause hearing in the case has found.

Judge O’Keefe ruled last November that forced medication was necessary. Speaking from the bench back then, the judge said that in his view Dr. Wang has become decidedly more ill over the years, describing his mental state as fluctuating between paranoia, narcissism, depression, and delusional behavior. He has also been diagnosed with having unspecified schizophrenia spectrum. ​“He is extremely ill. We are trying to return him to competency. This is the only alternative. It is with great reluctance that I order this but I do order this,” he said.

The judges accepted the arguments put forth by Eugene R. Calistro, Jr., the senior assistant state’s attorney who has been handling this case since murder charges were first brought against Dr. Wang in April 2010. Calistro argued in court that forced medication was required and that the Wang case met the four factors outlined in the Sell case. One of those factors says forced medication may be sought if an important government interest is at stake — in this case the trial of Dr. Wang.” 

In a 20-page opinion written by Justice Richard N. Palmer, Palmer wrote that bringing a defendant to trial was an important governmental interest that needed to be protected.

“Put another way, if the government can establish that it has an important interest in bringing the defendant to trial, that it will not be able to do so unless the defendant is medicated and that medication is medically appropriate and in the defendant’s best medical interest, we can see no reason why the government should be further required to establish not just that it is more likely than not that forced medication will restore the defendant to competency, but that it is highly likely that forced medication will have that effect. …”

Wang’s appellate attorney Mark Rademacher, had argued in court last May that the probable success rate for the medications was in the 50 to 70 percent range, as projected by a state psychiatrist who examined Dr. Wang over a period of years. That, he said, was a low bar. But the state Supreme Court unanimously disagreed. Rademacher will now have to decide whether to appeal the state Supreme Court’s decision, possibly to the U.S. Supreme Court. 

Ultimately the major arguments raised by the defense were examined by the justices and rejected.

Wang faces multiple felonies, including murder, the attempted murder of Dr. Toor’s wife, who was pregnant with the couple’s second child at the time, carrying a pistol without a permit and illegal possession of a weapon in a motor vehicle.

Over the course of six years, Dr. Wang, was first found incompetent to stand trial, restored to competency and then found incompetent again, a process that has raised questions about how defendants are restored to competency to begin with. When he was restored to competency, then pre-trial hearing judge Roland D. Fasano approved his motion to let him represent himself. Wang did so until last year when Judge O’Keefe ordered a new competency hearing for him. 

This issue of forced medication was the second time the Connecticut Supreme Court has ruled in this case before it ever went to trial. In the first case the issue centered on court costs for witnesses for indigent defendants who chose not to have the public defender’s office represent them. The high court in the first case ruled for Dr. Wang, saying the public defender’s office had to cover the costs. 

Dr. Wang is currently housed at the Whiting Forensic institute of the Connecticut Valley Hospital where he has been a patient since he was declared incompetent for the second time in April 2015. While a patient, he has refused to take medications that were expected to restore his competency to stand trial. Back in April 2015, Judge O’Keefe also determined that Dr. Wang was no longer competent to represent himself. Thomas Ullmann, the chief public defender in New Haven, is now representing Dr. Wang, a situation Dr. Wang is not happy about.

When he made a motion to take over the defense of the case, Ullmann argued that Dr. Wang was not competent to represent himself, an argument Judge O’Keefe agreed with after a new competency hearing.

Ullmann was also the moving party in seeking to overturn Judge O’Keefe’s order to forcibly medicate Dr. Wang, arguing that Judge O’Keefe improperly ordered that he be medicated against his will. Ullmann maintains that forced medication violates Dr. Wang’s rights and may hinder his ability to assist in his defense at trial. He has said in prior court hearings that the success rate of these drugs, between 50 and 70 percent, is not impressive.

But the high court was not at all convinced by these numbers, saying that a substantial likelihood that the defendant will be restored to competency exists ​“when the state establishes that it is more likely than not that forced medication will be effective.”

Ultimately the major arguments raised by the defense were examined by the justices and rejected.

Side Effects?

The justices also examined the defense’s claim that forced medication might produce side effects that would interfere significantly with Dr. Wang’s ability to assist counsel at trial. 

The justices noted in their opinion that the staff at Whiting ​“would carefully monitor the defendant and any side effects from his medications that could interfere with his ability to present a defense at trial and would report their observations to the court.”

There were hundreds of motions and letters Dr. Wang filed while representing himself, letters and briefs that showed his mental state and were shown to the court so that the justices might read them.

Chief Justice Chase Rogers was absent from the hearing in May, but she later reviewed the tapes of the court hearings and read the briefs and voted with the majority.
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