Federal prosecutors want to forcibly medicate the man charged with carrying out a deadly mass shooting at a Planned Parenthood clinic in Colorado Springs seven years ago in an attempt to move forward with the long-stalled criminal cases against him.

Robert Dear, 64, has repeatedly admitted to killing three people and wounding nine others during a mass shooting at a Planned Parenthood in Colorado Springs in 2015, but the criminal proceedings against him have been on hold for years as he continually has been found mentally unable to stand trial.

Dear has steadfastly refused medication for his diagnosed mental illnesses, and he objected several times to forced medication during a hearing in U.S. District Court in Denver on Tuesday to determine whether he should be involuntarily medicated.

“It is chemical lobotomy,” Dear said. “That is what they are doing. Chemical lobotomy.”

Dear suffers from significant bizarre delusions that make it impossible for him to assist in his own legal defense, psychologist Lea Ann Preston Baecht testified during the hearing.

Dear believes he is being persecuted by the FBI, that former President Barack Obama is the anti-Christ and sent agents to kill Dear, that staff at the hospital where he is being held are witches and warlocks, and that Masons carried out the 2017 mass shooting in Las Vegas, she testified.

Baecht said Dear’s delusions impact his ability to participate in his own defense, and Dear is likely to remain mentally incompetent to proceed unless he is medicated. He has been diagnosed with delusional disorder and, in the past, schizophrenia, two closely related conditions, she testified.

Dear objected to her assessment of his ability to work with his defense attorneys.

“There is no defense,” he shouted in court. “I did it.”

Federal prosecutors brought 68 criminal counts against Dear in late 2019 in connection with the Planned Parenthood attack in an attempt to move forward with criminal proceedings after the case stalled in state court, but Dear was also found mentally incompetent by the federal courts, stalling those proceedings as well.

Dear’s defense attorneys argued Tuesday’s hearing should be closed to the public to protect Dear’s medical privacy, but Senior Judge Robert Blackburn dismissed that argument, finding the First Amendment right to public court access outweighed Dear’s privacy interests.

During the hearing, Dear’s defense attorneys emphasized the potential adverse side effects of the proposed medications and questioned whether the forced treatment would be effective in helping Dear recover.

Dear has consistently claimed he is not mentally ill in outbursts during court proceedings over the years, including on Tuesday, when he said he’d been declared incompetent as part of a scheme to keep him from firing his attorneys and representing himself.

In other outbursts, Dear applauded the recent U.S. Supreme Court decision to end constitutional protections for abortions and said he was “glad I did what I did” and that the attack was a “success.”

“Planned Parenthood? You lost at the Supreme Court,” he said.

A competency evaluation considers whether a criminal defendant is mentally ill or developmentally disabled, and whether that mental illness impedes the defendant’s ability to understand the court process. It centers on two prongs — whether defendants have a factual and rational understanding of the proceedings, and whether defendants are able to consult with their attorneys and assist in their own defenses.

Competency refers only to a defendant’s current mental capacity and is distinct from an insanity defense, which focuses on the defendant’s mental state at the time of the alleged crime.

Baecht testified that her evaluation found Dear had a solid understanding of the facts and circumstances of his case, but was nevertheless incompetent because he could not assist in his own defense. She estimated his psychosis may have gone untreated for between 15 and 30 years.

Robert Sarrazin, a psychiatrist, testified that medication was the best course of treatment for Dear and that he was likely to be restored to competency if he was forced to be medicated.

The hearing is scheduled to last through Wednesday, after which Blackburn will issue a decision on whether Dear will be medicated against his will.