Reuben Cahn, a lawyer for Jared Lee Loughner, told a three-judge panel of the 9th U.S. Circuit Court of Appeals that Loughner "has fair trial rights ... that might be grievously harmed" if he continues to be involuntarily medicated.
Loughner has pleaded not guilty to 49 charges in the Jan. 8 shooting that killed six people and wounded 13 others, including Rep. Gabrielle Giffords.
He has been at a federal prison in Springfield, Mo., since late May after mental health experts determined he suffers from schizophrenia and a judge ruled him mentally unfit to stand trial. He was sent to the facility in a bid to restore his mental competency so he can assist in his legal defense.
Loughner was forcibly medicated from June 21 to July 1 after prison doctors concluded that he was a danger.
After an appeals court temporarily stopped Loughner's forced medication, the prison put Loughner under round-the-clock suicide watch in mid-July after he asked a prison psychologist to kill him. Prison staff said Loughner's psychological condition was deteriorating, noting that he had been pacing in circles near his cell door, screaming loudly and crying for hours at a time.
Prison officials decided to medicate Loughner after a brief administrative hearing on July 18 inside the prison. Loughner wasn't represented by an attorney at the hearing.
Cahn argued before the judges Tuesday that a judge, rather than the prison, should make the decision whether to force pretrial inmates to take medications against their will,.
But Assistant U.S. Attorney Christina Cabanillas said that prison officials have authority to order prisoners in their care to take medication if it's likely to defuse a dangerous situation.
Prison officials usually have wide latitude with prisoners convicted of crimes and serving sentences who have forfeited many of their rights to order them to take medication. But since Loughner has pleaded not guilty and is presumed innocent, the legal question is a murky one.
Two of the three judges expressed skepticism over whether a judge and a full-blown court hearing were the best way to handle a dangerous prison situation where officials believe a mentally ill detainee should be medicated for safety reasons.
"All of the bells and whistles of an adversarial procedure" being argued by Loughner's attorney would likely take too long to address an emergency safety issue inside a prison, Circuit Judge John Clifford Wallace said.
Judge Jay Bybee also expressed skepticism about judges making medical decisions about what drugs and dosages to authorize.
Nonetheless, Bybee and Wallace along with Judge Marsha Berzon appeared to grapple with finding a solution during the 90-minute hearing.
The court didn't rule and gave little indication the direction it was leaning.