In re Craig H.
Veronique Baker and Kelly R. Choate, of Guardianship and Advocacy Commission, of Springfield, for appellant.
Daniel K. Wright, State‘s Attorney, of Springfield (Patrick Delfino, David J. Robinson, and Timothy J. Londrigan, of State‘s Attorneys Appellate Prosecutor‘s Office, of counsel), for the People.
JUSTICE
Presiding Justice Steigmann and Justice DeArmond concurred in the judgment and opinion.
OPINION
¶ 1 Respondent, Craig H., appeals from the trial court‘s order finding him subject to involuntary administration of psychotropic medication pursuant to
¶ 2 Although we conclude respondent‘s claim regarding involuntary administration is moot, we address respondent‘s claims under the capable of repetition yet evading review and the public interest exceptions to the mootness doctrine. For the following reasons, we affirm the judgment of the trial court.
¶ 4 In November 2018, Dr. Aura Eberhardt, a psychiatrist at Andrew McFarland Mental Health Center (McFarland), filed a petition for administration of psychotropic medication under
¶ 5 On December 6, 2018, the trial court held a hearing on the motion to dismiss. The State argued
¶ 6 Respondent argued the decision of a power of attorney must be honored. Further, respondent argued the
¶ 7 The trial court acknowledged the case law shed little light on the specific issue before the court. For the reasons set forth by the State, the court denied the motion to dismiss and set the matter for a hearing on the petition for involuntary administration of psychotropic medication.
¶ 8 On December 28, 2018, the trial court held a hearing on the petition for involuntary administration. The court heard the following evidence.
¶ 9 Dr. Eberhardt testified respondent was admitted on November 29, 2016, as unfit to stand trial for a felony burglary charge in La Salle County. Dr. Eberhardt testified respondent was diagnosed with schizoaffective disorder, bipolar type, at age 25. At the time of trial respondent was 54 years old. Dr. Eberhardt described respondent‘s symptoms as follows:
“[Respondent] presents at this time with psychotic symptoms, consisting оf
hallucinations, as evidenced by him responding to hallucinations by talking to himself, talking about himself in third person, saying things like, [‘]Craig, don‘t touch food. Craig, don‘t sleep. Craig, you need to marry.[‘] He presents with paranoia. For example, he believes that his belongings are stolen. He presents with inability to sleep. He averages 1.9 hours of sleep per day. He presents with poor impulse control, hypersexuality, and psychomotor agitation. As examples, he‘s pacing when—the entire time when he is awake. As far as hypersexuality, I have examples where [respondent] approached female peers and female staff, trying to kiss them, trying to sniff them, standing in their door while they were sleeping at night. As far as poor impulse control, I have the examples of physical aggression.”
According to Dr. Eberhardt, respondent‘s symptoms worsened at the end of June or beginning of July when he began to present with hypersexuality, physical aggression, irritability, and hostility. Dr. Eberhardt testified respondent lacked the capacity to make treatment decisions. When approached regarding his psychiatric illness, respondent denied having such an illness and talked about getting out of McFarland “to marry a German girl and make her rich.”
¶ 10 Dr. Eberhardt opined respondent had no insight into his illness and lacked the ability to rationally weigh the pros and cons of medication. Since July 2018, respondent exhibited a deterioration of his ability to function due to his mental illness. Dr. Eberhardt testified respondent failed to sleep for days in a row, followed by days when he slept continuously and missed meals. Respondent recently began collecting urine in cups in his room and required prompts to bathe and eat.
¶ 11 In late June 2018, respondent became aggressive with a roommate who tripped him. Another peer intervened, and respondent hit him. The peer fell to the ground and went to the emergency room for stitches. In September 2018, respondent “shoved a peer to the ground because he said he was tired of that peer.” Dr. Eberhardt detailed numerous threats respondent made to kill various people, including staff. Further, Dr. Eberhardt testified about multiple aggressive incidents, including respondent threatening someone with a coffee pitcher, striking walls and windows, digging through trash, urinating on floors, and writing on walls. According to Dr. Eberhardt, respondent received emergency forced medications on at least 10 occasions in the last five months.
¶ 12 Dr. Eberhardt testified the following medications were her first choice for treating respondent: (1) risperidonе to treat psychotic symptoms, including hallucinations and disorganized thinking (2 to 8 milligrams by mouth per day, or 20 to 50 milligrams intramuscular long acting every 14 days); (2) lithium to stabilize his mood (450 to 1800 milligrams per day); (3) lorazepam to treat his agitation and lack of sleep (2 to 6 milligrams per day); (4) benztropine to address possible side effects from the other medications (1 to 6 milligrams per day). According to Dr. Eberhardt, the following medications were alternatives to risperidone and had the same benefits: (1) olanzapine (10 to 30 milligrams per day); (2) clozapine (25 to 600 milligrams per day); and (3) haloperidol (10 to 40 milligrams by mouth per day, 10 to 30 milligrams intramuscular per day, or 100 to 400 milligrams intramuscular every 28 days).
¶ 13 Dr. Eberhardt testified regarding the possible side effects and risks of these medications and methods to treat the possible side effects. According to Dr. Eberhardt,
¶ 14 The Stаte offered into evidence People‘s exhibit No. 1, a lengthy written document extensively detailing the benefits, side effects, and risks for the first-choice and alternative medications with which Dr. Eberhardt sought to treat respondent. Also offered into evidence was People‘s exhibit No. 2, which was a written document outlining alternatives to psychotropic medications. Dr. Eberhardt testified she attempted to discuss the benefits, risks, side effects, and alternative treatments with respondent and attempted to provide copies of People‘s exhibit Nos. 1 and 2. Respondent told Dr. Eberhardt to throw the documents away, so Dr. Eberhardt placed the written materials outlining the benefits, risks, side effects, and alternative treatments in respondent‘s mailbox, to which respondent always had access.
¶ 15 Dr. Eberhardt opined the benefits of the medications outweighed the potential harm from the adverse side effects. Without treatment, respondent was aggressive, hypersexual, could not take care of himself, and would be unable to live anywhere other than a hospital. With treatment, respondent could reduce his violent behavior, regain capacity, and eventually live in a nursing home.
¶ 16 Dr. Eberhardt acknowledged respondent‘s 82-year-old mother was his agent under the
¶ 17 If respondent had capacity and refused medication, Dr. Eberhardt testified she would not file a petition with the court for involuntary medication. Dr. Eberhardt acknowledged treatment alternatives when someone with capacity refused medication included seclusion, emergency forced medication, and restraints. When asked whether any psychiatrist examined Teresa H. to determine her competency, the State objected on relevance grounds. Respondent argued the State had the burden of proving the power of attorney lacked capacity. The trial court, based on the law of the case, sustained the objection and found the issue of the power of attorney‘s competence was irrelevant in a petition filed under
¶ 18 Respondent‘s “theme date” for release from McFarland was February 28, 2018, so he would have approximately one month after the medications took effect before he was released. Dr. Eberhardt testified that untreated schizoaffective disorder worsened over time and had “an element of cycling.” According to Dr. Eberhardt, respondent did not have access to a gun or vehicle with which to carry out his threats. When asked if respondent‘s behaviors could be addressed by less-restrictive
¶ 19 Regarding respondent‘s possible release in February 2018, Dr. Eberhardt testified as follows: “The plan, as of now, is for his mother, power of attorney for health, to take him home. She indicated that she‘s going to lock him in his room. I know from review of records that he hit her in the emergency room. She‘s 82 years old. So if I continue being his psychiatrist, I would attempt to civilly commit him if he experiences these symptoms. I don‘t think he would be safe to be released.”
¶ 20 Respondent moved for a directed verdict at the close of the State‘s case and the close of evidence. The trial court denied both motions. In delivering its ruling on the motion for directed verdict, the court opined that the State had proved respondent‘s lack of capacity and the burden should shift to respondеnt to prove the power of attorney had the ability to refuse medication. The court further indicated its position that the mere existence of a power of attorney did not end the inquiry when the agent‘s actions were questionably unreasonable. The court granted the petition for involuntary administration of psychotropic medication, which expired on its own terms 90 days later.
¶ 21 This appeal followed.
II. ANALYSIS
¶ 23 On appeal, respondent argues the court‘s judgment should be reversed because (1) the case falls under an exception to the mootness doctrine, (2) the trial court erred by denying respondent‘s motion to dismiss, and (3) the court‘s order for involuntary administration of psychotropic medication stripped respondent of his right to self-determination under the
A. Mootness
¶ 25 The December 28, 2018, involuntary-administration order expired on its own terms 90 days after it was entered; accordingly, the appeal of this order is moot. “As a general rule, courts in Illinois do not decide moot questions, render advisory opinions, or consider issues where the result will not be affected regardless of how those issues are decided.” In re Alfred H.H., 233 Ill. 2d 345, 351, 910 N.E.2d 74, 78 (2009). However, we will consider an otherwise moot case where it falls under a recognized exception. Here, respondent argues his case falls into two of the mootness exceptions: (1) the capable-of-repetition-yet-evading-review exception and (2) the public interest exception. See id. This court considers these exceptions on a case-by-case basis. Id. at 354. “All of the exceptions to the mootness doctrine are ‘to be construed narrowly and require a clear showing of each criterion to bring the case within the terms.‘” In re Sharon H., 2016 IL App (3d) 140980, ¶ 20, 52 N.E.3d 698 (quoting In re J.T., 221 Ill. 2d 338, 350, 851 N.E.2d 1, 8 (2006)).
1. Capable-of-Repetition-Yet-Evading-Review Exception
¶ 27 An exception to the mootness doctrine exists for cases where the events are capable of repetition yet are of such a short duration as to evadе review. J.T., 221 Ill. 2d at 350.
¶ 28 There is no question the first criterion has been met, as the involuntary-medication order expired by its own terms in 90 dаys, and appellate review could not have taken place prior to its expiration. See id. Respondent has also met the second criterion. Respondent challenges the interpretation of both the
2. Public Interest Exception
¶ 30 “Application of the public interest exception requires (1) the existence of a question of public importance; (2) the desirability of an authoritative determination for the purpose of guiding public officers in the performance of their duties; and (3) the likelihood that the question will recur.” J.T., 221 Ill. 2d at 350. Respondent argues his claims raise questions of public importance and there is a need for an authoritative determination to guide public officers. We agree. Our research has revealed no cases considering the question of whether the State may pursue a petition for involuntary administration of psychotropic medication where a power of attorney refused to consent to the treatment. As respondent‘s claim raises an issue of first impression, we conclude the public interest exception to the mootness doctrine applies, and we address his claims. See In re Shelby R., 2013 IL 114994, ¶¶ 19-22, 995 N.E.2d 990 (discussing cases where the public interest exception to the mootness doctrine applied to issues of first impression).
B. Mental Health Code
¶ 32 Respondent argues that the trial court erred by denying his motion to dismiss and that the court‘s order for involuntary administration of psychotropic medication stripped respondent of his right to self-determination under the
¶ 33 Respondent first contends the trial court erred by denying his motion to dismiss pursuant to
¶ 34 Respondent next contends the trial court‘s order for involuntary administration
¶ 35 Statutory construction presents a question of law, which as discussed above we review de novo. Id. “The primary objective of this court when construing the meaning of a statute is to ascertain and give effect to the intent of the legislature.” Id. The plain language is the most reliable indication of the legislature‘s intent. Id. When the statutory language is clear, it is applied as written without resort to tools of statutory construction. Id.
¶ 36 If, however, the statutory language is ambiguous, we may employ tools of statutory construction to ascertain the meaning of a statute. Id. We may consider similar and related statutes, although not strictly in pari materia. Id. at 59-60. “We must presume that several statutes relating to the same subject are governed by one spirit and a single policy, and that the legislature intended the several statutes to be consistent and harmonious.” Id. at 60. “A fundamental principle of statutory construction is to view all provisions of a statutory enactment as a whole. Accordingly, words and phrases should not be construed in isolation, but must be interpreted in light of other relevant provisions of the statute.” Id. We presume the legislature did not intend absurdity, inconvenience, or injustice. Id.
¶ 37
“If the services include the administration of electroconvulsive therapy or psychotropic medication, the physician or the physician‘s designee shall advise the recipient, in writing, of the side effects, risks, and benefits of the treatment, as well as alternatives to the proposed treatment, to the extent such advice is consistent with the recipient‘s ability to understand the information communicated. The physician shall determine and state in writing whether the recipient has the capacity to make a reasoned decision about the treatment. The physician or the physician‘s designee shall provide to the recipient‘s substitute decision maker, if any, the same written information that is required to be presented to the recipient in writing. If the recipient lacks the capacity to make a reasoned decision about the treatment, the treatment may be administered only (i) pursuant to the provisions of Section 2-107 or 2-107.1 or (ii) pursuant to a power of attorney for health care under the Powers of Attorney for Health Care Law or a declaration for mental health treatment under the Mental Health Treatment Preference Declaration Act.”
405 ILCS 5/2-102(a-5) (West 2018) .
“The petition shall state that the petitioner has made a good faith attempt to determine whether the recipient has executed a power of attorney for health care under the Powers of Attorney for Health Care Law or a declaration for mental health treatment under the Mental Health Treatment Preference Declaration Act and to obtain copies of these instruments if they exist. If either of the above-named instruments is available to the petitioner, the instrument or a copy of the instrument shall be attached to
the petition as an exhibit.” Id. § 2-107.1(a-5)(1) .
¶ 38 Based on the plain language of the provisions in the
¶ 39 This reading of the statute is supported by the statutory provision that allows a guardian to consent to involuntary medication over objection by the recipient only if the strictures of
¶ 40 Moreover, the plain language of
¶ 41 Our construction of the
¶ 42 The
¶ 43 Finally, the
“This Article applies to all health care providers and other persons in relation to all health care agencies on and after the effective date of this Article. This Article supersedes all other Illinois Acts or parts thereof existing on the effective date of this Article to the extent such other Acts are inconsistent with the terms and operation of this Article; provided, that this Article does not affect the law governing emergency health care. If the principal has a living will under the ‘Illinois Living Will Act‘, as now or hereafter amended, the living will shall not be operative so long as an agent is available who is authorized by a health care agency to deal with the subject of life-sustaining or death-delaying procedures for and on behalf of the principal.”
Id. § 4-11 .
¶ 44 The plain language of the
¶ 45 Although the supremacy clause employs broad language declaring it supersedes all other acts to the extent the other acts are inconsistent, this does not preclude the State from filing a petition for involuntary administration of psychotropic medication. As the Statе correctly points out, it has both a parens patriae interest in providing for those suffering from mental illness and lacking capacity to make reasoned treatment decisions and a penological interest in restoring respondent to fitness to stand trial. In re C.E., 161 Ill. 2d 200, 217, 641 N.E.2d 345, 353 (1994) (“We believe that section 2-107.1 embodies this State‘s significant parens patriae interest in providing for persons who, while suffering from a serious mental illness or developmental disability, lack the capacity to make reasoned decisions concerning their need for medication.“); Sell v. United States, 539 U.S. 166, 179 (2003) (“[T]he Constitution permits the Government involuntarily to administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges in order to render that defendant competent to stand trial, but only if the treatment is medically appropriate, is substantially unlikely to have side effects that may undermine the fairness of the trial, and, taking account of less intrusive alternatives, is necessary significantly to further important governmental trial-related interests.“).
¶ 46 Moreover, “where there are two statutory provisions, one of which is general and designed to apply to cases generally, and the other is particular and relates to only one subject, the particular provision must prevail.” Village of Chatham v. County of Sangamon, 216 Ill. 2d 402, 431, 837 N.E.2d 29, 46 (2005). Here, the
III. CONCLUSION
¶ 48 For the reasons stated, we affirm the judgment of the trial court.
¶ 49 Affirmed.