The Commonwealth of Massachusetts (plaintiff) prosecuted Jacob Shin (defendant) for groping a woman. At his bench trial, Shin pleaded lack of criminal responsibility as his defense. Six years earlier, following his conviction for indecent assault, Shin was diagnosed with schizophrenia and a personality disorder, both of which could have caused him to act in sexually inappropriate ways. Several times over the ensuing years, courts ordered Shin to undergo hospitalization, and a court appointed a guardian to ensure that Shin took medication to control his mental illness. Shin repeatedly failed to take the medication. Initially, Shin blamed this failure on his insurer, who would not pay for the drug. Even after clearing up the insurance problem, Shin still refused to take the drug, despite his doctor's warning that failure to treat his mental illness increased Shin's chances of slipping back into criminal behavior. The judge ruled that Shin's knowing refusal to take his medication made him criminally responsible and guilty as charged. Shin appealed to the Massachusetts Appeals Court.