(CN) - The government did not violate the civil rights of accused mass-murderer Jared Lee Loughner when it forced him to take medication to treat schizophrenia, the 9th Circuit ruled Monday.
"We conclude that Loughner was provided with the substance and procedure demanded by the due process clause before the government involuntarily medicated him," Judge Jay Bybee wrote for the federal appeals court in San Francisco. "It is clear that Loughner has a severe mental illness, that he represents a danger to himself or others, and that the prescribed medication is appropriate and in his medical interest."
Loughner, who is charged with killing six people and injuring 13 in a shooting spree last year at a political meeting in Tucson, is being held in a Bureau of Prisons medical facility in Springfield, Mo.
Then-Congresswoman Gabrielle Giffords was among those injured, while U.S. District Judge John Roll died from his injuries. Loughner pleaded not guilty and has three times been declared incompetent to stand trial. He was diagnosed with schizophrenia shortly after arriving in Missouri.
After his first competency hearing last summer, doctors at FMC-Springfield determined that Loughner was a danger to himself and others. After Loughner declined to voluntarily take medication, prison officials held a hearing in his cell and ultimately decided to force him to take a drug regime.
During the hearing, Loughner barricaded himself behind his bed, refused to participate and declared that he was not an American citizen, according to the ruling.
Loughner's lawyers have repeatedly challenged the forced medication in the ensuing months, despite testimony from doctors that the regime has improved Loughner's state of mind.
The court recently ordered Loughner to remain at the treatment facility until June.
On Monday, a split panel of the 9th Circuit rejected three separate appeals filed by Loughner's attorneys.
The suspect's forced medication and continued stay in the Springfield facility are legal, according to the two-judge majority.
Loughner's attorneys argued that doctors had failed to demonstrate that forcibly medicating Loughner was "medically appropriate."
One of Loughner's doctors justified forcibly medicating the accused gunmen in a report cited in Monday's 117-page ruling.
"Dr. Tomelleri explained that Loughner had become enraged while being interviewed and yelled obscenities; had thrown objects, including plastic chairs and toilet paper; had spat on his attorney, lunged at her, and had to be restrained by staff; and his behavior had been characterized by indications that he was experiencing auditory hallucinations, including inappropriate laughter, poor eye contact, yelling 'No!' repeatedly, and covering his ears," Bybee wrote.
The majority noted that Loughner's "condition deteriorated significantly" when the court briefly stopped the forced medication last summer pending the appeal.
"Loughner 'expressed feelings of depression and hopelessness, complained of a radio talking to him inserting thoughts into his mind, ... engaged in yelling, crying, [and] rocking back and forth for prolonged periods of time, made statements such as that he wanted to die, [and] requested to be given an injection to be killed,'" Bybee wrote (brackets in original). "His sleep schedule became erratic, including a 50-hour period without sleep. His food intake was poor and he lost weight, and he would pace or spin in circles for hours without interruption."
With resumption of the medication on an emergency basis, "Loughner's agitation has decreased, his sleep has improved, and his communication with staff is progressing, but he is still restless and paces and cries frequently," the court states.
Writing in dissent, Judge Marsha Berzon argued that the panel had given Loughner's doctors too much say in his treatment through flawed administrative proceedings.
"Viewed realistically, what the majority holds is that the district court correctly abdicated to Loughner's prison physicians the responsibility to determine whether he is to be restored to trial competency through involuntary medication," Berzon wrote. "As I cannot agree that Loughner may be so committed without a judicial determination as to the propriety of involuntary medication and because, even on the majority's approach, I see several deficiencies in the administrative proceedings conducted by the medical center's physicians - I respectfully dissent," she added.
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