In re Terraza, E077170

Warden petitioned under Penal Code §§ 2670–2680 to authorize electroconvulsive therapy (ECT) for inmate Rudy Terraza, who has a long-standing schizoaffective/bipolar disorder and has resided in a psychiatric hospital since 2019.
The treating psychiatrist recommended ECT as the "gold standard," describing benefits and risks; Terraza’s counsel disputed capacity and benefit.
The superior court found Terraza lacked capacity (§ 2679(a)) but, under § 2679(b), found by clear and convincing evidence that ECT would be beneficial, was medically appropriate, and there were no less onerous alternatives, and authorized ECT for up to six months.
Terraza filed a habeas petition asserting a state constitutional privacy right requiring appointment of a surrogate decisionmaker to protect his previously expressed wishes; the appellate court stayed the ECT order.
The Court of Appeal held that the state need not appoint a surrogate under the constitution but must, upon request of the inmate’s counsel, determine whether the inmate, when competent, expressed values or views indicating refusal of ECT; if such opposition exists, it may preclude ECT unless legitimate penological interests justify overriding it.
The writ was granted: the trial court’s ECT order was vacated and the court was directed to hold a hearing addressing Terraza’s prior expressed wishes; if none found, the court may again order ECT.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Does the state constitutional right to privacy require appointment of a surrogate decisionmaker before imposing ECT on an incompetent inmate?	Terraza: Yes — a surrogate should determine medical necessity and consistency with his wishes.	State: No — parens patriae and § 2679 judicial findings suffice; no surrogate required.	No — appointment of a surrogate is not constitutionally required.
Must a court consider an inmate’s previously expressed wishes when authorizing ECT under the organic therapy statutes?	Terraza: Yes — prior competent refusals or values must be considered and can bar treatment.	State: § 2679 findings (benefit, compelling interest, no less onerous alternative, medical appropriateness) are sufficient.	Yes — upon counsel’s request the court must determine if the inmate, when competent, expressed opposition; such evidence can preclude treatment unless overridden by penological interests.
Are § 2679 statutory findings alone sufficient to authorize ECT without inquiry into prior competent directives or expressed views?	Terraza: No — statutory scheme omits consideration of prior expressed wishes; that omission is constitutionally inadequate.	State: The § 2679 process adequately protects inmates’ interests.	No — § 2679 findings alone are insufficient when credible evidence exists of prior competent refusal; the court must inquire into prior wishes.

In re Qawi, 32 Cal.4th 1 (2004) (California privacy right protects competent adults’ refusal of medical treatment and recognizes limits based on countervailing state interests)
Conservatorship of Wendland, 26 Cal.4th 519 (2001) (privacy and personal autonomy survive incapacity when exercised while competent; advance directives and prior values inform later decisions)
Washington v. Harper, 494 U.S. 210 (1990) (prison interests can justify forced medication with due process safeguards)
Late Corp. of the Church of Jesus Christ of Latter-Day Saints v. United States, 136 U.S. 1 (1890) (discussion of parens patriae as a state power)
Love v. State Dept. of Education, 29 Cal.App.5th 980 (2018) (privacy right yields to public health/policy needs in some contexts)