In November 2015, a gunman drove up to a Planned Parenthood facility in Colorado Springs and opened fire before storming inside and continuing to shoot. There were three fatalities and nine injuries. While being taken into custody, Robert Lewis Dear Jr., the man charged in the attack, allegedly muttered “no more baby parts.”

Dear, a self-described “baby warrior,” was charged with 179 crimes, including murder and attempted murder. Dear, who suffers from a form of delusional disorder, has been found incompetent to stand trial nearly seven years after the massacre.

However, on Monday, U.S. District Judge Robert E. Blackburn issued an order that prosecutors say may break the impasse, ruling that the government can force Dear, 64, to take antipsychotic medication that experts say will likely make him competent to stand federal trial. Competence is defined as a defendant’s ability to comprehend the implications of the proceedings and contribute to the defense.

Dear has frequently interrupted court proceedings with outbursts since his first appearances, declaring at one hearing: “There is no trial.” Colorado’s murder case against Dear was halted due to his mental state and determinations that he was incompetent to stand trial. Dear, on the other hand, was indicted on 68 federal charges in 2019, many of which were for alleged violations of the Freedom of Access to Clinic Entrances Act, which was designed to protect people seeking and providing services at reproductive health facilities.

Dear, like in the state case, was found unfit to stand federal trial after an evaluation, and Blackburn ordered Dear into a mental facility where he could be monitored last September. According to prosecutors, medical experts later determined that Dear’s competence could not be restored without medication. According to the judge’s most recent order, Dear has so far refused to take the medication.

Prosecutors moved in December to have that medication administered to Dear against his will, so that a trial could take place.

Dear has spoken out against the action. According to the Associated Press, he stated during an August hearing, “This is my brain at stake.” They want to make me a zombie.” According to the Associated Press, his defense team has also argued that the medication could worsen his blood pressure and cholesterol.

On Monday, Blackburn ruled in favor of the prosecution, concluding that Dear’s health is unlikely to be harmed by the medication and that prosecutors have a “important interest” in seeing the case proceed. He stated that the medication should be given “involuntarily and forcibly if necessary.”

According to Slate, there have been more than 130 federal cases since 2003 in which a judge considered a defendant’s motion for involuntary medication. The motion was granted in 62% of the cases.

Under the 2003 U.S. Supreme Court precedent Sell v. United States, which established the “Sell test” for courts to consider whether a defendant deemed incompetent to stand trial should be forcibly medicated, courts have the authority to order involuntary medication. The prosecution must have a significant interest in moving the case forward; the involuntary medication must significantly further those interests; it must be necessary to further those interests; and it must be determined that the medication will not harm the defendant’s health.

According to Susan McMahon, a clinical law professor at Arizona State University who has closely studied forcible medication orders, courts have interpreted the test too broadly in most cases. According to her, this results in some defendants with mental illnesses facing nonviolent charges being forcibly medicated.

Where the law has failed, McMahon says, “is that courts have taken a very expansive view of what qualifies as serious crime,” adding that few of the cases she has studied involved physical violence, let alone homicide.

She claims that as a result of the effect, people with mental illnesses are imprisoned for as long as the sentences they face. Then all of a sudden you have individuals who go through the whole process, they go to trial, and then even if they’re convicted, they’re just released,” having already served their time, she said, adding that some are not even convicted.