## Facts

- Robert C. Randall, a District of Columbia resident, suffered from advanced glaucoma that threatened progressive loss of vision and blindness.
- Randall was treated with conventional glaucoma medications, but the treatments became ineffective; he had total blindness in one eye and severe impairment in the other.
- Randall discovered that smoking marijuana reduced his intraocular pressure and improved visual functioning.
- Randall cultivated and possessed marijuana at home for personal medical use.
- The United States charged Randall with marijuana possession under D.C. Code § 33-402.
- Randall did not dispute that he grew and possessed marijuana; he asserted the affirmative defense of common-law necessity, framed as medical necessity.
- Medical testimony, including from a government-sponsored experimental program, supported that (i) standard medications were ineffective for Randall, (ii) surgery carried significant risk of immediate blindness, and (iii) smoked marijuana produced beneficial, measurable effects on intraocular pressure and visual function.

## Issues

1. Whether District of Columbia law recognizes a common-law necessity defense applicable to marijuana possession under D.C. Code § 33-402.
2. Whether a defendant with glaucoma may establish “medical necessity” by showing marijuana use was necessary to avoid otherwise inevitable blindness and no effective lawful alternative existed.
3. Whether prior narcotics decisions rejecting necessity defenses, or the absence of an express willfulness element in the statute, barred the defense.

## Decision

- The court held that a common-law necessity defense is available in District of Columbia prosecutions for marijuana possession.
- The court concluded Randall met the necessity requirements: he did not cause the medical emergency, no adequate lawful alternative would prevent blindness, and the harm avoided outweighed the harm of the prohibited conduct.
- The court distinguished prior narcotics cases rejecting necessity defenses as involving different drugs, different conditions, and different justification theories.
- The court ruled necessity could apply even though the possession statute did not require an express showing of willfulness.
- The court dismissed the charge and found Randall not guilty by reason of medical necessity.

## Legal Principles

- Common-law necessity may justify otherwise criminal conduct where:
  - the defendant did not create the emergency;
  - no less illegal alternative can achieve the same objective; and
  - the harm avoided is greater than the harm of violating the law.
- Necessity operates as a justification defense and may apply even when the charged offense lacks an express willfulness element.
- In applying the harm-balancing element, a court may weigh the government’s interest in enforcing drug prohibitions against medically documented, imminent, and severe harm to the defendant when no effective lawful treatment exists.

## Conclusion

The court recognized medical necessity as a justification for marijuana possession where competent medical evidence showed the defendant faced otherwise inevitable blindness, lawful treatments were ineffective or unacceptably risky, and marijuana provided the only effective means to preserve vision.


United States v. Randall, No. 65923-75 (D.C. Super. Ct. Nov. 24, 1976)