ST. LOUIS -- A suburban St. Louis dentist accused of Medicaid fraud and plotting to kill a witness and federal agent can be forced to take anti-psychotic drugs meant to make him mentally fit to stand federal trial, a divided federal appellate court has ruled.

The 2-1 decision Thursday by a 8th U.S. Circuit Court of Appeals panel upheld a federal judge's ruling last year that Dr. Charles "Tom" Sell would be delusional and incompetent for trial without drugs the government wants to give him against his will.

In the 8th Circuit's majority opinion, Senior Judge Gerald Heaney wrote that "the government may forcibly administer anti-psychotic medication for the sole purpose of rendering a pretrial detainee competent to stand trial without violating the accused's due process rights."

The same standard might not apply in all cases, Heaney noted, particularly if the issue involved medicating a prisoner to make him fit for execution.

An attorney for Sell, 52, of Town and Country, told the St. Louis Post-Dispatch he will ask the federal appellate court to reconsider its conclusion that the government showed that its interest in trying Sell outweighs his interest in remaining free from medication.

In Thursday's dissent, Judge Kermit Bye wrote that "the charges against Dr. Sell are not sufficiently serious to forcibly inject him with anti-psychotic drugs on the chance it will make him competent to stand trial."

63 counts

Sell and his wife were accused in a 1997 federal complaint of submitting false claims to Medicaid and private insurance companies for dental services not provided. Two months later, the couple was indicted on 56 counts of mail fraud, six counts of Medicaid fraud and one count of money laundering.

In April 1998, a second indictment accused Sell of conspiring and attempting to kill a witness -- a former worker in his dental office -- and the FBI agent who arrested him.

The status of the cases involving Sell's wife was not immediately available.

Since being charged, Sell has spent most of his time confined to the U.S. Medical Center for Federal Prisoners in Springfield.