nothin New Haven Independent | High Court Weighs Forced Medication for Wang

High Court Weighs Forced Medication for Wang

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Hartford – The murder case of Dr. Lishan Wang, who has yet to go to trial on charges that he killed a Yale University physician six years ago, was back at the Connecticut Supreme Court yesterday. The court is expected to decide in the next several months whether to affirm or reject a trial judge’s order to forcibly medicate Dr. Wang in order to try to make him competent to stand trial.

This is the second time that the state’s highest court has heard arguments in the Wang case, a case that nearly two years ago set new law regarding pro-se representation. (The state’s public defender’s office now pays for experts even if it doesn’t represent an indigent defendant.) The high court now decides whether to uphold an order by Superior Court Judge Thomas V. O’Keefe, Jr., the trial judge, to medicate Dr. Wang against his will.

The groundbreaking 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. 

Trial Judge Orders Forced Medication

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 judge 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 a case entitled Sell v. United States.” The Sell case was decided by the United State Supreme Court in 2003, and includes one factor that says forced medication may be sought if an important government interest is at stake — in this case the trial of Dr. Wang. 

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.

Dr. Wang was not present at yesterday’s oral arguments in the Supreme Court. Typically prisoners in custody are not.
 
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. Ullmann attended the hearing yesterday.

Ullmann is the moving party in seeking to overturn Judge O’Keefe’s order, arguing that the trial court 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 that argument seemed to be carrying little weight among the justices yesterday.

The Justice Ask A Series of Questions

With Permission

Seated, L to R: Justice Richard N. Palmer, Chief Justice Chase T. Rogers, Justice Peter T. Zarella. Standing, L to R: Justice Carmen E. Espinosa, Justice Andrew J. McDonald, Justice Dennis G. Eveleigh, Justice Richard A. Robinson, Senior Justice Christine S. Vertefeuille

Justice Dennis G. Eveleigh had listened to the appellate lawyer for the public defender’s office for some five minutes when he threw out his first question. It centered on Dr. Mark Cotterell, the chief psychiatrist at Whiting and a doctor who has known Dr. Wang well. He testified in Superior Court that he and a team of health professionals had evaluated Dr. Wang over a period of several months.”

Based on observations and interviews of the defendant, the team diagnosed Dr. Wang with unspecified Schizophrenia Spectrum and Other Psychotic Disorder,” he told the trial judge in September 2015. 

Judge Eveleigh noted of Cotterell that It is not that this doctor came in for an hour or so. He has been treating him for five years.”

Not quite five years,” replied Mark Rademacher, Assistant Public Defender in the appeals bureau, who argued the case for the public defender’s office.

Well, for a while,” the judge replied. Doesn’t’ the trial judge have the right to act?” Eveleigh asked.

Rademacher replied that the trial judge was basing his decision to medicate Dr. Wang on an individual” and not on a study” that shows these medications don’t work all the time and could have side effects. 

The judge told Rademacher that this is not like an hour-long exam” of a patient. Afterwards, Rademacher said in an interview outside the courtroom that it appeared to him some members of the high court found Cotterell’s testimony, along with the team of doctors, sufficient to make a determination.

Dr. Cotterell testified that any of the currently available antipsychotic medications …
might be effective” in restoring the defendant’s competency, and proposed Olanzapine and Ziprasidone, two medications that have a substantial likelihood of treating the [defendant’s] symptoms” and restoring him to competence.”

In addition to Dr. Cotterell, Gail Sicilia, a psychiatric nurse practitioner appointed by Judge O’Keefe to be Wang’s health care guardian, testified in Superior Court in New Haven that she believed forced medication would restore his competency and help him mentally.
Justice Richard A. Robinson asked Rademacher about the impact of the medication; other justices had questions as well. Rademacher answered questions for about half an hour, noting whenever he could that a major issue is whether the forced medication was substantially likely to succeed.”

State’s Attorney Addresses Court

Then Nancy L. Walker, Deputy Assistant State’s Attorney in the appeals bureau, addressed the court, giving the state’s position. She outlined the state’s reasoning for forcibly medicating Dr. Wang. She said the reasons conform to the United State Supreme Court decision in Sell, adding that medication is essential in order for Dr. Wang to be tried for a serious crime.”

The court should affirm the trial court decision,” she said, adding that Dr. Wang suffers from a number of different psychiatric disorders.
Justice Robinson, continuing his line of questioning, asked Walker what the impact of the medication might be on the defendant at trial. Walker conceded that there were unknowns, but regardless, steps needed to be taken to try to restore Dr. Wang to competency. It is possible that the medication won’t work at all and there is a possibility it will work.” 

Walker spoke for about 20 minutes with few justices asking questions. Before she finished she asked if there were any more questions. There had been only two. The justices indicated there were none. 

Rademacher stood up to give his rebuttal and told the court there was too much at stake here…. to force medication.” The state is not permitted to respond to the rebuttal argument.

There were hundreds of motions and letters Dr. Wang filed while representing himself, letters and briefs that showed his mental state. One of those letters made it to the high court so that they may read his thoughts for themselves.

The hearing in the ornate courtroom took about an hour. Chief Justice Chase Rogers was absent, but will later review the tapes of the court hearings and will vote.

In the court hallway, after the hearing was over, Rademacher said one of his concerns was that if a defendant is medicated, he may not be engaged at trial. The jury holds that against a defendant. Sometimes the drugs cause you to shake and move about. That’s not the way a jury expects an innocent person to behave in court,” he said.
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