IN THE UNITED STATES COURT OF APPEALS
FOR THE EIGHTH CIRCUIT
Appeal No. 01-1862
UNITED STATES OF AMERICA,
Appellee,
vs.
CHARLES THOMAS SELL,
Defendant/Appellant.
ON APPEAL FROM THE UNITED STATES DISTRICT
COURT FOR THE EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
Case No.4:97CR290-DJS
Case No. 4:98CR177-DJS
The Honorable Judge Donald J. Stohr
BRIEF OF AMICUS CURIAE AMERICAN CIVIL LIBERTIES UNION
OF EASTERN MISSOURI IN SUPPORT OF
APPELLANT’S PETITION FOR REHEARING OR REHEARING EN BANC
AMERICAN CIVIL LIBERTIES UNION OF
EASTERN MISSOURI
Denise Lieberman (Reg. No. 47013)
Peter Joy (Reg. No. 50553)
4557 Laclede Avenue
St. Louis, Missouri 63108
(314) 361-2111
(314) 361-3135 facsimile
denise@aclu-em.org
CONTENTS
TABLE OF CONTENTS
ii
TABLE OF AUTHORITIES
iii
INTEREST OF AMICUS
1
ARGUMENT
1
I.
THE PANEL’S OPINION IMPROPERLY FAILED
TO APPLY STRICT SCRUTINY REVIEW
2
A. The Panel Failed To Properly Analyze The
Government’s Interest Before Determining The
Level Of Scrutiny To Be Applied.
4
1. The Panel fails to distinguish a state’s
interest in medicating dangerous defendants
from its interest in bringing non-dangerous
defendants to trial.
B. The Panel Fails To Give Proper Weight To Defendants’
Liberty Interests That Give Rise To Strict Scrutiny.
7
8
1. The Panel misapplies Washington v. Harper
and Riggins v. Nevada, which apply to dangerous
or imprisoned people.
8
2. The Panel fails to acknowledge defendants’ First
Amendment liberty interests to be free from involuntary
medication.
9
3. The Panel decision fails to consider fully the impact
of forced medication on a defendant’s right to a fair trial.
10
C. The Panel Erroneously Relied On Riggins v. Nevada.
12
CONCLUSION
13
CERTIFICATE OF COMPLIANCE
14
CERTIFICATE OF SERVICE
15
ii
TABLE OF AUTHORITIES
Cases
Bee v.Greaves, 744 F.2d 1387(10th Cir. 1984)
Cruzan v. MO. Dept. of Health, 497 U.S. 261 (1990)
Illinois v. Allen, 397 U.S. 337 (1970)
3,7,9,10
3
5,6
Moore v. East Cleveland, 431 U.S. 494 (1977)
Riggins v. Nevada, 504 U.S. 127 (1992)
2
4, 7,8,9,10,12,13
Roe v. Wade, 410 U.S. 113 (1973)
2
Snyder v. Massachusetts, 291 U.S. 97 (1934)
2
U.S. v. Brandon, 158 F.3d 947(6th Cir. 1998)
U.S. v. Sanchez-Hurtado, 90 F.Supp.2d 1049 (S.D. Cal. 1999)
4,5,6,7,9,10,13
12
U.S. v. Santonio, 2001 WL 670932 (D. Utah, May 3, 2001)
8
U.S. v. Weston, 255 F.3d 873 (D.C. Cir. 2001)
6
Washington v. Glucksberg, 521 U.S. 702 (1997)
Washington v. Harper, 494 U.S. 210 (1990)
Woodland v. Angus, 820 F.Supp. 1497 (D. Utah 1993)
3,4,5
3,4,6,7, 9,13
2,7
Other
Rule 35(a) Federal Rules of Appellate Procedure
iii
1
INTEREST OF AMICUS
The American Civil Liberties Union (“ACLU”) is a nonpartisan, nonprofit
organization founded in 1920 with 275,000 members nationwide, whose purpose is to
defend the Bill of Rights. The ACLU of Eastern Missouri is an affiliate of the ACLU with
its principal place of business in St. Louis, Missouri and has 2,500 members. As part of
its mission, the ACLU has participated, either as counsel or as amicus, in numerous
cases supporting individuals’ First, Fifth, Sixth and Fourteenth Amendment interests,
including the rights of individuals to refuse involuntary medication by the government.
ARGUMENT
Rehearing En Banc is appropriate because this case involves a question of
exceptional importance on an issue on which the Panel’s decision conflicts with the
decisions of other U.S. Courts of Appeals. FRAP 35(a).
The Panel’s holding that an intermediate level of scrutiny is required for the
government to administer involuntarily antipsychotic medication for the sole purpose of
rendering a non-dangerous pretrial detainee competent to stand trial conflicts with the
decisions of other Courts of Appeals that strict scrutiny is required to satisfy a nondangerous pretrial detainee’s due process rights. The Panel’s opinion fails to determine if
the government’s interest is compelling before applying its balancing test, and fails to
acknowledge the fundamental liberty status that the Supreme Court has granted to nondangerous people to be free from involuntary medication by the government. The extent of
an individual’s liberty interest to be free from involuntary medication by the government for
the sole purpose of restoring competency to stand trial is one of exceptional importance
1
and is an issue of first impression before this Circuit. The applicable standard is in dispute
among the circuits and unresolved by the Supreme Court. Even under its intermediate
scrutiny test, the Panel fails to apply the requisite level of proof or consider fundamental
liberty interests articulated by the Supreme Court and other circuits necessary for even this
lower standard of review. Rehearing by the Court En Banc is therefore necessary to
address, as a matter first impression for this Circuit, a question of exceptional importance
on which there is conflict among the other circuits.
I.
THE PANEL’S OPINION IMPROPERLY FAILED TO APPLY STRICT
SCRUTINY REVIEW.
Involuntary medication of pretrial detainees invokes fundamental First, Fifth,
Sixth and Fourteenth Amendment rights. Because this practice infringes upon
fundamental freedoms, the Panel incorrectly applied intermediate scrutiny review rather
than strict scrutiny. Government action that burdens a fundamental right will survive a
substantive due process challenge only if it can survive strict scrutiny, i.e., if it is
narrowly tailored to a compelling governmental interest. See Roe v. Wade, 410 U.S.
113, 154 (1973) (applying strict scrutiny to infringement on fundamental right to privacy
in the abortion context). Rights are considered fundamental if they are “deeply rooted in
this Nation’s history and tradition.” Moore v. East Cleveland, 431 U.S. 494, 503 (1977)
(plurality opinion); Snyder v. Massachusetts, 291 U.S. 97, 105 (1934) (“so rooted in the
traditions and conscience of our people as to be ranked fundamental”). An individual’s
right to refuse medical treatment is clearly among those considered fundamental. “No
right is more sacred, or is more carefully guarded, by the common law, than the right of
every individual to the possession and control of his own person . . .” Woodland v.
2
Angus, 820 F.Supp. 1497, 1504 (D. Utah 1993), quoting Cruzan v. MO. Dept. of Health,
497 U.S. 261, 269 (1990). In Washington v. Glucksberg, 521 U.S. 702 (1997), Justice
Rehnquist wrote in his majority opinion that the interest to decline even life-saving
medical treatment is derived from “the common-law rule that forced medication was a
battery, and the long legal tradition protecting the decision to refuse unwanted medical
treatment,” and that such right “was entirely consistent with this Nation’s history and
constitutional traditions.” Id. at 725.
The state action at issue in this case substantially infringes upon several
constitutionally protected rights. The Due Process Clause of the Fourteenth
Amendment protects an individual’s liberty interest in being free from involuntary
administration of antipsychotic drugs by the government. See Id.; Washington v.
Harper, 494 U.S. 210, 221 (1990) (applying this interest to prisoners). This right
implicates the most sacred and fundamental notions of privacy and liberty. The
intrusion sought by the government in this case not only constitutes a physical invasion
into Dr. Sell’s body, but also constitutes the very altering of his identity and his mind.
Bee v.Greaves, 744 F.2d 1387, 1394 (10th Cir. 1984). Indeed, it is undisputed that the
government’s sole interest in medicating Dr. Sell is to alter the functioning of the
defendant’s mind to allow the state to prosecute him. Thus, Dr. Sell’s First Amendment
interest in freedom of expression is clearly implicated. In addition, the Sixth Amendment
right of a criminal defendant to a fair trial is at issue. “By administering medication, the
State may be creating prejudicial negative demeanor in the defendant – making him
look nervous and restless, for example, or so calm or sedated as to appear bored, cold,
3
unfeeling, and unresponsive.” Riggins v. Nevada, 504 U.S. 127, 243 (1992) (Kennedy,
J., concurring).
Accordingly, an individual’s right to be free from involuntary medication of
psychotropic drugs invokes fundamental private interests that only a compelling state
interest can override. The Panel failed to examine fully either whether the State had
met this burden or the extent of the individual interests involved when setting its test.
A.
The Panel Failed To Properly Analyze The Government’s Interest
Before Determining The Level Of Scrutiny To Be Applied.
While the Panel acknowledged that involuntary medication invoked “substantial”
rights, it did not apply strict scrutiny, instead applying an intermediate “heightened
scrutiny” test. The three-part test articulated by the Panel, Op. at 11, incorporates the
balancing of individual rights against the government’s interests. However, the
balancing of Dr. Sell’s right against the government’s interests must occur prior to the
Court determining the standard of review. U.S. v. Brandon, 158 F.3d 947, 959 (6th Cir.
1998) (“In substantive due process analysis, a balance of rights is struck by deciding
the appropriate standard of review in the first place.”) Id., citing Harper, 494 U.S. at
223-24 (1990). A proper analysis of this case requires the Court to begin with the
threshold question of whether the challenged state action implicates a fundamental
right. Glucksberg, 521 U.S. at 720 – 21. This requires a “careful description” of the
asserted fundamental liberty interest. Id. at 721. This inquiry is a necessary
prerequisite to determining the applicable standard of review. The Panel’s passing
reference to Dr. Sell’s “significant liberty interest,” Op. At 12, fails to assess adequately
the fundamental interest at stake. Indeed, there is no discussion at all of the character
4
or legal tradition of the right to refuse medication. Without making this threshold inquiry,
it is improper for the Panel to determine the magnitude of the state interest required in
its test.
If the Court finds that a fundamental right is implicated, it must then assess
whether the state has advanced a “compelling interest.” Glucksberg, 521 U.S. at 721.
This requires the Court to consider at the outset whether the government’s interests are
sufficient to override a fundamental right. Brandon, 158 F.3d at 959. Where
fundamental rights are invoked, if the government’s interest is not compelling, the
remainder of the balancing test cannot take place. Id. In Brandon, the Sixth Circuit
made this initial inquiry and concluded that the defendant’s charges (sending
threatening letters through the mail) were insufficiently grave for the government to
satisfy the prerequisite showing that it had a compelling interest in bringing the
defendant to trial. Id. The Panel’s opinion fails to analyze whether the government’s
interest in bringing Dr. Sell to trial is substantial enough to override a fundamental
liberty. Indeed, the Panel does not consider the government interest at the outset in
determining what standard should apply. Rather, the Panel addresses the government’s
interest in the application of its heightened scrutiny test by simply labeling the
government interest in prosecuting defendants as “essential,” Op. at 12, citing Illinois v.
Allen, 397 U.S. 337 (1970). The dissent aptly notes this omission and engages in
requisite analysis, persuasively suggesting that the government had not met its burden
of proving a compelling interest before engaging in the balancing test. Op. at 19, 23 (J.
Bye, dissenting).
5
The Panel decision relies in part on U.S. v. Weston, 255 F.3d 873, 880 (D.C. Cir.
2001), in not applying strict scrutiny. But, unlike the Panel’s decision, the Weston court
did weigh the government interest at length before articulating its standard of review,
finding that the grave nature of Weston’s alleged crimes (murder) rendered the
government’s interest “essential.” 225 F.3d at 881. The Weston court acknowledged
that in spite of the language from Illinois v. Allen, which was cited by the Panel, and
many other Supreme Court cases describing the government’s general interest in
adjudicating crimes as “essential” and even “compelling,” the government’s interest is
not absolute. “We need not decide under what circumstances trying and punishing
offenders is not ‘essential.’ The government's interest in finding, convicting, and
punishing criminals reaches its zenith when the crime is the murder of federal police
officers in a place crowded with bystanders where a branch of government conducts its
business.” Id. Thus, Weston deals with the narrow issue of the government’s interest in
adjudicating violent crimes that carry substantial punishments. Id.
The Panel seems to acknowledge a requirement of analyzing the government’s
interest. The majority opinion states, “Not all charges … are sufficient to justify forcible
medication of a defendant; rather the charges must be serious.” Citing Brandon, 158
F.3d at 961. (Op. At 12). The Panel’s analysis of the charges against Dr. Sell consists
of a single sentence that conclusively states that the charges are serious. The Panel
fails to explain why the charges are serious. By failing to go through this process, the
Panel’s majority interpretation results in a test that is out of line with the established
analysis for governmental infringements of fundamental liberties. See Harper, 494 U.S.
6
at 223-24. This flaw influenced how the Panel analyzed both the individual liberty
interests and the competing government interests in the balance, resulting in an
ultimately flawed test.
1.
The Panel fails to distinguish a state’s interest in medicating
dangerous defendants from its interest in bringing nondangerous defendants to trial.
The Panel’s opinion fails to make the important distinction between the
government’s interest in controlling dangerous people and its interest in bringing a nondangerous defendant to trial. The Panel’s heightened scrutiny test relied on Harper,
supra, and Riggins, supra, both of which involved dangerous people. Riggins expressly
provided that the government may involuntarily medicate pretrial detainees where it is
“essential for the sake of the [detainee’s] own safety or the safety of others.” 504 U.S.
at 135. Harper similarly determined that even with prisoners, who have diminished
rights, the government’s interest in forced medication cannot stand unless the individual
poses a danger to himself or others. 494 U.S. at 221-22. Unlike the dangerous people
in Harper and Riggins, Dr. Sell is a non-dangerous pretrial detainee who the
government seeks to drug involuntarily.
The Panel’s reliance on Harper and Riggins is misplaced. See Angus, 820
F.Supp. at 1509 ("the reduced standard of review applied by the Court in Harper is not
appropriate in resolving th[e] case" where the government seeks to medicate a nondangerous individual in order to render him competent to stand trial). The Sixth Circuit
in Brandon similarly found Harper inapplicable because it addressed individuals who
had been deemed dangerous. “To forcibly medicate Brandon, therefore, the
7
government must satisfy strict scrutiny review and demonstrate that its proposed
approach is narrowly tailored to a compelling interest. “Brandon,158 F.3d at 957, citing
Greaves, 744 F.2d at 1395; Angus, 820 F.Supp. at 1509. The court in U.S. v. Santonio,
2001 WL 670932 (D. Utah, May 3, 2001), similarly required strict scrutiny where the
sole purpose of involuntary medication was to render a non-dangerous defendant
competent for trial. Id at *4. Even Justice Kennedy, who wrote the majority opinion in
Harper, later stated in his concurring opinion in Riggins his doubt that it could ever be
appropriate to administer forcibly antipsychotic drugs solely to render a non-dangerous
pretrial detainee competent to stand trial. Riggins, 504 U.S. at 138, 141 (Kennedy, J.,
concurring).
Because the state’s interest in medicating non-dangerous pretrial detainees is
distinct from its interest in medicating dangerous persons, the Panel’s failure to address
this distinction resulted in faulty analysis of the level of the state interest involved.
Accordingly, rehearing En Banc is merited.
B.
The Panel Fails To Give Proper Weight To Defendants’ Liberty
Interests That Give Rise To Strict Scrutiny.
In addition to failing to properly assess the government interest, the Panel failed
to give appropriate weight to the individual First, Fifth and Sixth Amendment liberty
interests at stake in the involuntary medication of non-dangerous pretrial detainees.
1.
The Panel misapplies Washington v. Harper and Riggins v.
Nevada, which apply to dangerous or imprisoned people.
The Supreme Court has recognized that forced medication implicates a
defendant’s Fifth Amendment liberty interest in being free from bodily intrusion: “[t]he
8
forcible injection of medication into a nonconsenting person’s body represents a
substantial interference with that person’s liberty,” Harper, 494 U.S. at 221-22; see
section I, supra. Dr. Sell’s liberty interest is heightened by the fact that the medications
at issue have irreversible side effects. See Harper, 494 U.S. at 1028 (Stevens, J.,
concurring); Brandon, 158 F.3d at 954. The test used by the Panel’s application of
Harper, as set forth in Riggins (Op. at 10), fails to consider the diminished liberty
interests of prisoners.
Riggins noted that pretrial detainees have at least the same rights as prisoners,
504 U.S. at 135, though it identified situations in which the government may be able to
show an “overriding justification” sufficient to warrant involuntary medication to a trial or
pretrial setting. Id. The Riggins test focuses on the government’s interest but doesn’t
address the higher competing liberty interest enjoyed by non-prisoners. The Sixth
Circuit acknowledged this distinction, noting that the individual’s liberty interest in the
non-prison setting, particularly where not dangerous, rises to fundamental status in
which strict scrutiny is required. Brandon, 158 F.3d at 957.
2.
The Panel fails to acknowledge defendants’ First Amendment
liberty interests to be free from involuntary medication.
The Panel fails to acknowledge the First Amendment interests of nonviolent
pretrial detainees in being free from involuntary medication. The Sixth and Tenth
Circuits have found that the forced medication of a pretrial detainee affects his ability to
produce ideas in violation of his freedom of speech under the First Amendment.
Brandon, 158 F.3d at 953; Greaves, 744 F.2d at 1393-4. A defendant facing involuntary
medication enjoys “a First Amendment interest in avoiding forced medication, which
9
may interfere with his ability to communicate ideas,” Brandon, 158 F.3d at 953, citing
Greaves, 744 F.2d at 1393 (“Antipsychotic drugs have the capacity to severely and
even permanently affect an individual's ability to think and communicate.”) The interest
in retaining one’s identity and communicative process is substantial enough to invoke
strict scrutiny, and thus warrants rehearing of the Panel’s decision. The Panel entirely
fails to consider this interest when determining the nature of the scrutiny to be applied,
looking only to the due process interest in being free from physical bodily intrusion.
Moreover, even under the lower standard articulated by the majority, the Panel fails to
weigh this interest in the its balancing test. Accordingly, En Banc review is warranted.
3.
The Panel decision fails to fully consider the impact of forced
medication on a defendant’s right to a fair trial.
Forced medication by the government also implicates a defendant’s right to a fair
trial as protected by the Due Process Clause and the Sixth Amendment. In his
concurring opinion in Riggins, Justice Kennedy warned that the mind-altering affect of
antipsychotic drugs may infringe upon a defendant’s right to effective assistance of
counsel by making him unable to assist in his own defense. 504 U.S. at 139 – 41.
The Panel’s opinion improperly fails to include an analysis of a defendant’s right
to a fair trial as part of its test. Though the Panel concludes that a Sixth Amendment
inquiry is not ripe prior to the administration of the medication, the Fourteenth
Amendment fair trial analysis acknowledges “that before forcibly medicating an
accused, there must be evidence that he will be able to participate in a fair trial.” Op. At
18. In spite of this reference, the Panel’s opinion fails to instruct how this analysis is
incorporated into its test and what burden of proof must be met.
10
The government’s burden is higher when seeking to medicate pretrial detainees
because it must show that its interest not only outweighs the defendant’s right to be free
from unwanted bodily intrusion but also that it outweighs the possibility that his right to a
fair trial may be implicated. Thus, in balancing a state’s interest in medicating a nondangerous defendant for the sole purpose of rendering him competent to stand trial, the
court must consider not only his right to be free from forced medication, or his right to
express his identity, but also his right to receive a fair trail and pursue a defense. The
Panel’s opinion does not engage in this necessary analysis.
Under the test articulated by the Panel, the Court balances only the state’s
interest in bringing a defendant to trial with Dr. Sell’s interest in refusing unwanted
medication. The Panel fails to consider at all Dr. Sell’s right to a fair trial. Thus, even
under the lesser standard proposed by the Panel, the first prong of its test – that the
government’s interest outweighs the defendant’s liberty interest - is in need of
reconsideration to include the defendant’s interest in having a fair trial in the balancing
test.
Certainly a non-dangerous individual’s rights to express his identity and to be
free from forced medication alone are sufficient to invoke a liberty interest requiring
strict scrutiny review. It follows that when such an individual is being detained for trial,
his added rights to due process and a fair trial also invoke a liberty interest warranting
strict scrutiny review. Arguably, even when involuntary medication may be justified
where a defendant is dangerous, the state’s interests in bringing the defendant to trial
cannot override a detainee’s right to a fair trial. Clearly, the state’s interests are even
less when the defendant has been deemed not dangerous.
11
Riggins is distinguishable on this issue because it involved a pretrial detainee
who had agreed to medication, eventually attained competence, and then during trial
tried to assert a right to discontinue the medication. U.S. v. Sanchez-Hurtado notes that
Riggins primarily considered the administration of antipsychotic medication during trial,
rather than before trial, which Sanchez found distinguishable from a pretrial detainee
who has not already agreed to be medicated. 90 F.Supp.2d 1049, 1053 (S.D. Cal.
1999).
Because the Panel failed to properly balance the defendant’s right to a fair trial,
not just against the government interest, but in determining the extent of the
government interest in the first place, its resulting test merits rehearing En Banc.
C.
The Panel Erroneously Relied On Riggins v. Nevada.
In deciding not to adopt strict scrutiny, the Panel relied in part on the erroneous
conclusion that the Supreme Court “declined to adopt such a standard in Riggins.” Op.
at 10. This reliance is wholly misplaced as the Riggins Court did not rule on the
appropriate standard of review at all. Indeed, Riggins expressly declined to articulate a
standard of review. Yet, this incorrect reading of Riggins forms the basis for the Panel’s
decision not to apply strict scrutiny.
Not only does Riggins expressly not support the lesser scrutiny applied by the
Panel here, but in fact, has been viewed to support strict scrutiny. The dissent in
Riggins concluded that the majority actually had adopted strict scrutiny, despite its
statement that it was not articulating any standard, because of the substantial weight it
gave to the defendant’s liberty interest compared to the government’s. Riggins, 504
12
U.S. at 156 (Thomas, J. dissenting). Similarly, in Brandon, the Sixth Circuit cites
Riggins’ reliance on Harper’s “overriding justification” standard to suggest that the Court
may have been articulating strict scrutiny review. Brandon, 158 F.3d at 959. At the very
least, Brandon concludes that Riggins intended to require the government to offer
reasons sufficient to override whatever level of scrutiny it decides to apply in the future,
a reasoning that was not conducted by the Panel in this case (see section A, supra.).
“On the one hand, the Court [in Riggins] seems to have alluded to a strict scrutiny
approach . . .On the other hand, the Court’s majority opinion makes it clear that it did
not set out any standard.” Brandon, 158 F.3d at 957.
Ultimately, the Panel cannot find support for its use of heightened and not the
required strict scrutiny from Riggins. At the least, the Panel’s reliance on Riggins to
justify its heightened scrutiny approach is not dictated by that precedent and is
therefore worthy of rehearing En Banc.
CONCLUSION
Because standard to be applied is critical to the determination of the exceptionally
important issue of when government can involuntarily administer antipsychotic medications
to incompetent, non-dangerous pretrial detainees solely to bring them to trial and because
the matter is one in which the circuits are divided, the issue warrants rehearing by the
Court. For the foregoing reasons, the Court should grant rehearing En Banc.
DATED: APRIL 4, 2002
13
Respectfully Submitted,
AMERICAN CIVIL LIBERTIES UNION
OF EASTERN MISSOURI
_______________________________________
Denise D. Lieberman, MBE 47013
Peter A. Joy, MBE 50553
4557 Laclede Avenue
St. Louis, Missouri 63108
(314) 361-2111
(314) 361-3135 facsimile
CERTIFICATE OF COMPLIANCE WITH FED. R. APP. P.32(a)(7)(B)
AND 8th CIR. R. 28A(c)
The undersigned hereby certifies that this brief contains 3,584 words. The name and
version of the word processing software used to prepare the brief is: Microsoft Word 2000.
A 3½-inch computer diskette containing the full text of the brief has been provided to the
clerk. The diskette has been scanned for viruses and is virus-free.
__________________________________
Denise D. Lieberman
14
CERTIFICATE OF SERVICE
The undersigned hereby certifies that two copies of Amicus Curiae’s Brief in Support of
Appellant’s Petition for Rehearing En Banc and one copy of the diskette containing the full
text of same were mailed first-class, postage prepaid, on the 4th day of April 2002, to:
Dorothy L. McMurtry, Esq.
Howard J. Marcus, Esq.
Assistant United States Attorney
111 South 10th St.
St. Louis, MO 63101
Lee Lawless
Federal Public Defender’s Office
1010 Market Street, Suite 200
St. Louis, MO 63101
Barry Short
Lewis & Rice
500 N. Broadway, Suite 2000
St. Louis, MO 63102
Karen Tripp
American Association of American
Physicians & Surgeons, Inc.
1100 Louisiana Street, Suite 2690
Houston, TX 77002
Grant J. Shostak
Moline, Shostak & Mehan LLC
8015 Forsyth
St. Louis, MO 63105
Richard Glen Boire
Center for Cognitive Liberty & Ethics
231 G. Street, No. 7
Court & Cedar Offices
Davis, CA 95616
__________________________________
Denise D. Lieberman
15