Cite as: 505 U. S. 437 (1992)
Blackmun, J., dissenting
The Court suggests that "defense counsel will often have the best-informed view of the defendant's ability to participate in his defense." Ibid. There are at least three good reasons, however, to doubt the Court's confidence. First, while the defendant is in custody, the State itself obviously has the most direct, unfettered access to him and is in the best position to observe his behavior. In the present case, Medina was held before trial in the Orange County jail system for more than a year and a half prior to his competency hearing. 3 Tr. 677-684. During the months immediately preceding the competency hearing, he was placed several times for extended periods in a padded cell for treatment and observation by prison psychiatric personnel. Id., at 226, 682-684. While Medina was in the padded cell, prison personnel observed his behavior every 15 minutes. Id., at 226.
Second, a competency determination is primarily a medical and psychiatric determination. Competency determinations by and large turn on the testimony of psychiatric experts, not lawyers. "Although competency is a legal issue ultimately determined by the courts, recommendations by mental health professionals exert tremendous influence on judicial determinations, with rates of agreement typically exceeding 90%." Nicholson & Johnson, Prediction of Competency to Stand Trial: Contribution of Demographics, Type of Offense, Clinical Characteristics, and Psycholegal Ability, 14 Int'l J. Law and Psych. 287 (1991) (citations omitted). See also S. Brakel, J. Parry, & B. Weiner, The Mentally Disabled and the Law 703 (3d ed. 1985) (same). While the testimony of psychiatric experts may be far from infallible, see Barefoot v. Estelle, 463 U. S. 880, 916 (1983) (Blackmun, J., dissenting), it is the experts and not the lawyers who are credited as the "best informed," and most able to gauge a defendant's ability to understand and participate in the legal proceedings affecting him.
Third, even assuming that defense counsel has the "best-informed view" of the defendant's competency, the lawyer's
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