Charles Thomas Sell Case Study

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In May of 1997, Charles Thomas Sell, a dentist working in St. Louis, Missouri, was accused of multiple forms of medical fraud. He and his employees altered dental records and x-rays of their patients and submitted them to insurance companies, seeking payment for procedures they never performed to fix problems that never existed. Sell was deemed competent to stand trial and was charged with 56 counts of mail fraud, six counts of medicaid fraud, and one count of money laundering.
Sell, as Justice Breyer noted in his majority opinion, had a “long and unfortunate history of mental illness” (Sell, 2003, p. 170). In the 1980s, for example, he called 911, telling the police he witnessed a leopard boarding a bus and proceeded to make suicide threats. In addition to his suicidal ideation and hallucination, Sell had a history of persecutory delusions. The gold he used for fillings in his dental practice, he believed, was contaminated by communists and he often feared that FBI agents were out to kill him. Elements of grandiosity could be seen in Sell’s delusions as well, saying in April 1997 that “‘God told me every [Federal Bureau of Investigation] person I kill, a soul will be saved’” (Breneman, 2004). Despite his history of more grossly psychotic features, both a government and independent court-ordered psychiatrist diagnosed Sell with a delusional disorder.
After his indictment, Sell was released on bail. By January 1998, however, the government soon sought to invoke his bail, claiming he had attempted to intimidate a witness in the trial. At the hearing, Sell exhibited a clearly deteriorated mental condition, acting in a violent and unorganized manner, spitting at the judge and shouting racial epithets. The court ordered him detai...

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...92‘s Riggins v. Nevada, and 1990‘s Washington v. Harper. In Harper, the court determined that prison inmates could be forcibly medicated if they were a danger to themselves or others, and if the medication was medically appropriate. Riggins, in turn, decided that a defendant already on trial could be forcibly medicated to ensure his competency and allow for the proceedings to continue smoothly, in essence bulldozing one’s 14th amendment rights to “accomplish essential state policy” (Riggins, 1992, as cited in Breneman, 2004, p. 971). Riggins also proclaimed that forcible medication must be the least invasive means of treatment, and provide minimal side effects. Sell was clearly the child of these two rulings, fusing the competing interests of governmental prosecution with the liberty and safety of the defendant.
Nevertheless, the Sell criteria has numerous flaws.

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