State of Wisconsin, Plaintiff-Respondent, v. Raytrell K. Fitzgerald, Defendant-Appellant. State of Wisconsin ex rel. Raytrell K. Fitzgerald, Petitioner-Petitioner, v. Circuit Court for Milwaukee County and the Honorable Dennis R. Cimpl, presiding, Respondents.
CASE NO.: 2018AP1296-CR & 2018AP1214-W
SUPREME COURT OF WISCONSIN
June 13, 2019
2019 WI 69
Dennis R. Cimpl, presiding.
ON BYPASS FROM THE COURT OF APPEALS & REVIEW OF DECISION OF THE COURT OF APPEALS. Oral Argument: March 20, 2019. CONCURRED: ROGGENSACK, C.J. concurs, joined by ZIEGLER, J. (opinion filed). NOT PARTICIPATING: ABRAHAMSON, J. did not participate.
SOURCE OF APPEAL:
COURT: Circuit
COUNTY: Milwaukee
JUDGE: Dennis R. Cimpl
ATTORNEYS:
For the defendant-appellant in 18AP1296-CR, and petitioner-petitioner in 18AP1214-W, there were briefs filed by Colleen D. Ball, assistant state public defender. There were oral arguments by Colleen D. Ball.
For the plaintiff-respondent, there was a brief filed by Maura FJ Whelan, assistant attorney general, with whom on the brief is Brad D. Schimel, attorney general. There was an oral argument by Maura FJ Whelan.
For the respondents, there was a brief filed by Abigail C.S. Potts, assistant attorney general, with whom on the brief if Brad D. Schimel, attorney general. There was an oral argument by Abigail C.S. Potts
An amicus curiae brief was filed in 18AP1296-CR on behalf of National Association for Criminal Defense Lawyers, Bazelon Center for Mental Health Law, National Disability Rights Network, and Disability Rights Wisconsin, by Jeffrey O. Davis, James E. Goldschmidt, Zachary T. Eastburn, and Quarles & Brady LLP, Milwaukee.
NOTICE
This opinion is subject to further editing and modification. The final version will appear in the bound volume of the official reports.
APPEAL from an order of the Circuit Court for Milwaukee County, Dennis R. Cimpl, Circuit Court Judge. Vacated; and REVIEW of a decision of the Court of Appeals. Affirmed.
¶2 We do, however, address Fitzgerald‘s challenge to the constitutionality of
I. BACKGROUND
¶3 In October 2016, the State charged Fitzgerald with possession of a firearm contrary to a harassment injunction.3 The circuit court ordered a competency evaluation, which showed Fitzgerald suffered from “Schizoaffective disorder” and lacked substantial mental capacity to understand the proceedings or to be of meaningful assistance in his own defense. In December 2017, the circuit court signed an Order of Commitment for Treatment requesting an assessment for Fitzgerald‘s participation in the Outpatient Competency Restoration Program (OCRP). Dr. Brooke Lundbohm, a psychologist, sent the circuit court an OCRP assessment letter in February 2018, concluding that Fitzgerald “is clinically appropriate for the Outpatient Competency Restoration Program at this time and has been admitted to the Program,” despite Fitzgerald having a history of refusing to take prescribed medication. In April 2018, Lundbohm informed the circuit court by letter that Fitzgerald‘s “status with the Outpatient Competency Restoration Program has changed,” and he was “no longer clinically appropriate for participation in” OCRP due to safety concerns. The letter also noted that Fitzgerald displayed a lack of motivation to participate in the program. On that basis, the circuit court “deemed [Fitzgerald] no longer clinically appropriate for OCRP,” remanded Fitzgerald to the Department of Health Services’ (DHS) custody, and ordered a second competency evaluation under
¶4 In May 2018, Dr. Ana Garcia, a psychologist, conducted Fitzgerald‘s second competency evaluation and sent her report to the circuit court. The report noted Fitzgerald‘s Schizoaffective Disorder diagnosis and explained he had been “treated with Seroquel (antipsychotic medication) and Benztropine (medication used to treat the side effects of psychotropic medications).” Garcia reported that when Fitzgerald refused to take his medication while hospitalized, “an injectable version of the medication could not be forced upon him” because no order to medicate
¶5 On June 18, 2018, the circuit court held a hearing on whether to issue an order for involuntary medication under Wis. Stat. § 971.14. During that hearing, Garcia testified, explaining why she believed the circuit court should issue an order for involuntary medication:
- “Fitzgerald has continued to exhibit indications of psychotic symptoms” and was “unable to discuss his charges in a reasonable way.”
- “[W]e find psychotropic medication to help him better organize his thoughts, reduce the auditory hallucinations, and reduce the delusional beliefs.”
- Fitzgerald refused to take his medications and attempted to hide them in his room.
Garcia testified that “as a psychologist, I don‘t prescribe specific medications” but “I do know that for treating schizophrenia and schizoaffective disorder, the primary treatment is an antipsychotic medication, and he had been prescribed” the generic version of Seroquel during his admission at Mendota Mental Health Institute.
¶6 Fitzgerald also testified at the hearing. He thought he had been misdiagnosed, explained he had “been feeling really fine” without medication, and stated that he did not wish to submit to forced medication, expressing concerns about the dosage.
¶7 After the close of testimony, the circuit court ordered the administration of involuntary medication to restore Fitzgerald‘s competency. The circuit court explained the basis for its order:
[T]here is an important government interest at stake here and that is the fact that he‘s charged with a serious felony. It may be a status offense, but the fact is he is alleged to be carrying a gun while under a prohibition for carrying a gun, and I recall the motion hearing that we had in this matter when the police approached him and searched him, which I found was a valid search. And so, therefore, that is in my opinion an important government interest, the furtherance of this felony.
The fact that he does not take his medication is not facilitating him to be restored to competency. That‘s what this is all about so he can stand trial on whether or not he is guilty of this very serious offense; therefore, the fact that he‘s not taking his meds and has to be given them involuntarily does further that interest and I think it‘s also a necessary reason to further that interest. And we‘ve got testimony from Dr. Garcia, who has reviewed his psychiatrist [sic] that the two meds or the medication that is prescribed for him is appropriate, and it was appropriate back in earlier 2013, when he was not taking and engaged in violence with his mother.4
¶9 On June 27, 2018, the circuit court held another hearing. The circuit court granted the stay, but indicated that it would immediately lift the stay on the State‘s motion. On June 28, 2018, the same day Fitzgerald filed his petition for a supervisory writ in the court of appeals, the circuit court “vacate[d] the [June 27] proceedings” related to the automatic stay. The circuit court expressed uncertainty as to whether Scott‘s automatic stay occurs “after the appeal is filed or is it automatic when there‘s a notice of intent to appeal filed or is it automatic if there‘s merely an allegation that the defendant is going to file an appeal.” In order to “err on the side of caution,” the circuit court ordered its June 18th involuntary medication order stayed and set the matter to be heard again in two weeks. The circuit court reasoned: “[i]f the appeal is not filed I will lift the stay because then clearly [the] Scott case doesn‘t apply,” and “[i]f the appeal is filed the State can then file a motion to lift the stay.” The circuit court then signed a written order granting a stay of the June 18th involuntary medication order, but on that same day, Fitzgerald filed a petition for a supervisory writ in the court of appeals, challenging the circuit court‘s plan to lift the automatic stay without requiring the State to make the showing required under Scott. On July 9, 2018, Fitzgerald also filed a separate notice of appeal seeking review of the circuit court‘s June 18th Order for Commitment, specifically challenging the order for involuntary administration of medication.
¶10 On July 12, 2018, the court of appeals denied Fitzgerald‘s petition for a supervisory writ. State ex rel. Fitzgerald v. Circuit Court for Milwaukee Cty., No. 2018AP1214-W, unpublished order (Wis. Ct. App. July 12, 2018). Because the circuit court‘s stay remained in effect, the court of appeals concluded that “to the extent Scott establishes the automatic stay as a plain duty, the circuit court has complied.” Id. at 5. However, the court of appeals also concluded that “Fitzgerald was not entitled to an automatic stay until he actually had a
¶11 Before this court heard oral argument in Fitzgerald‘s cases, the circuit court found Fitzgerald competent and resumed the criminal proceedings. Fitzgerald pled guilty to the underlying charge on January 11, 2019, and the circuit court sentenced him to time served. Consequently, the State moved to dismiss as moot both of Fitzgerald‘s cases, but we denied the motion. After oral argument, we consolidated the two cases for the purposes of disposition.
II. DISCUSSION
A. Standard of Review
¶12 The sole issue we resolve is the constitutionality of the standard for involuntary medication under
B. Analysis
1. Constitutional Principles
¶13 Under the Due Process Clause, individuals have “a significant liberty interest in avoiding the unwanted administration of antipsychotic drugs.” Washington v. Harper, 494 U.S. 210, 221 (1990). “[O]nly an ‘essential’ or ‘overriding’ state interest” can overcome this constitutionally-protected liberty interest. Sell, 539 U.S. at 178-79 (quoting Riggins v. Nevada, 504 U.S. 127, 134 (1992)). In Sell, the United States Supreme Court addressed “whether the Constitution permits the Government to administer antipsychotic drugs involuntarily to a mentally ill criminal defendant—in order to render that defendant competent to stand trial for serious, but nonviolent, crimes.” Sell, 539 U.S. at 169. The Court held that it does, but only under particular circumstances:
[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.
Id. at 179 (emphasis added). Although permissible in certain situations, the Sell Court explained that the “administration of drugs solely for trial competence purposes . . . may be rare.” Id. at 180. The Court established a four-factor test to determine whether such medication is constitutionally appropriate.
¶14 “First, a court must find that important governmental interests are at stake.” Id. “[B]ringing to trial an individual accused of a serious crime” against a person or property is an important interest. Id. The Court did, however, emphasize that prior to entering an order for involuntary medication, courts “must consider the facts of the individual case in evaluating the Government‘s interest in prosecution.” Id.
¶15 “Second, the court must conclude that involuntary medication will significantly further” the government‘s interest in prosecuting the offense. Id. at 181. This means that a court “must find that administration of the drugs is substantially likely to render the defendant competent to stand trial” and “unlikely to have side effects that will interfere significantly with the defendant‘s ability to assist counsel in conducting a trial defense, thereby rendering the trial unfair.” Id.
¶16 “Third, the court must conclude that involuntary medication is necessary to further those interests.” Id. In other words, “[t]he court must find that any alternative, less intrusive treatments are unlikely to achieve substantially the same results.” Id. In order to make this finding, the deciding court “must consider less intrusive means for administering the drugs, e.g., a court order to the defendant backed by the contempt power, before considering more intrusive methods.” Id. In other words, the Sell Court considered an order directed at the defendant, requiring him to accept medication or be found in contempt of court, to be less intrusive than ordering an entity like DHS to forcibly administer medication to the defendant.
¶17 “Fourth, . . . the court must conclude that administration of the drugs is medically appropriate, i.e., in the patient‘s best medical interest in light of his medical condition.” Id. The Sell Court explained that “[t]he specific kinds of drugs at issue may matter here as elsewhere” because “[d]ifferent kinds of antipsychotic drugs may produce different side effects and enjoy different levels of success.” Id.
¶18 The Court explained that “these standards . . . seek[] to determine whether involuntary administration of drugs is necessary significantly to further a particular governmental interest, namely, the interest in rendering the defendant competent to stand trial,” and “[a] court need not consider whether to allow forced medication for that kind of purpose, if forced medication is warranted for a different purpose, such as [one] . . . related to the individual‘s dangerousness, or . . . health.” Id. at 181-82. The Court explained that “[t]here are often strong reasons for a court to determine whether forced administration of drugs can be justified on these alternative grounds before turning to the trial competence question,” in part because “the inquiry into whether medication is permissible, say, to render an individual nondangerous is usually more ‘objective and manageable’ than the inquiry into whether medication is permissible to render a defendant competent.” Id. at 182 (quoted source omitted).
The medical experts may find it easier to provide an informed opinion about whether, given the risk of side effects, particular drugs are medically appropriate and necessary to control a patient‘s
potentially dangerous behavior (or to avoid serious harm to the patient himself) than to try to balance harms and benefits related to the more quintessentially legal questions of trial fairness and competence.
2. Wisconsin Stat. § 971.14
¶19
(c) The examiner‘s opinion regarding the defendant‘s present mental capacity to understand the proceedings and assist in his or her defense.
(d) If the examiner reports that the defendant lacks competency, the examiner‘s opinion regarding the likelihood that the defendant, if provided treatment, may be restored to competency within the time period permitted under sub. (5)(a). . . .
(dm) If sufficient information is available to the examiner to reach an opinion, the examiner‘s opinion on whether the defendant needs medication or treatment and whether the defendant is not competent to refuse medication or treatment. The defendant is not competent to refuse medication or treatment if, because of mental illness, developmental disability, alcoholism or drug dependence, and after the advantages and disadvantages of and alternatives to accepting the particular medication or treatment have been explained to the defendant, one of the following is true:
- The defendant is incapable of expressing an understanding of the advantages and disadvantages of accepting medication or treatment and the alternatives.
- The defendant is substantially incapable of applying an understanding of the advantages, disadvantages and alternatives to his or her mental illness, developmental disability, alcoholism or drug dependence in order to make an informed choice as to whether to accept or refuse medication or treatment.
¶20 After the report‘s submission, the circuit court must hold a hearing.
3. Wisconsin Stat. § 971.14(3)(dm) and (4)(b) do not conform with Sell‘s constitutional parameters.
¶21 As a preliminary matter, we explain this court‘s denial of the State‘s motion to dismiss Fitzgerald‘s cases on mootness grounds. “An issue is moot when its resolution will have no practical effect on the underlying controversy.” Portage Cty. v. J.W.K., 2019 WI 54, ¶11, 388 Wis. 2d 1, 930 N.W.2d 209 (quoted source omitted); see also City of Racine v. J-T Enters. of Am., Inc., 64 Wis. 2d 691, 700, 221 N.W.2d 869 (1974) (“This court has consistently adhered to the rule that a case is moot when ‘a determination is sought which, when made, cannot have any practical effect upon an existing controversy.‘“) (quoted source omitted)). As a general matter, we decline to reach moot issues. J.W.K., 388 Wis. 2d 1, ¶12. Fitzgerald is no longer subject to the medication order he challenges; he regained competency and pled guilty. Therefore, the issues presented in reviewing that order are moot. See Winnebago Cty. v. Christopher S., 2016 WI 1, ¶31, 366 Wis. 2d 1, 878 N.W.2d 109 (explaining that “when an appellant appeals an order to which he or she is no longer subjected, the case is moot).
¶22 We may, however, decide an otherwise moot issue if it fits under one of the following exceptions: (1) “the issues are of great public importance;” (2) “the constitutionality of a statute is involved;” (3) the situation arises so often “a definitive decision is essential to guide the trial courts;” (4) “the issue is likely to arise again and should be resolved by the court to avoid uncertainty;” or (5) the issue is “capable and likely of repetition and yet evades review because the appellate process usually cannot be completed and frequently cannot even be undertaken within a time that would result in a practical effect upon the parties.” G.S. v. State, 118 Wis. 2d 803, 805, 348 N.W.2d 181 (1984); see also J.W.K., 388 Wis. 2d 1, ¶12. In this case, Fitzgerald challenges the constitutionality of
¶23 Fitzgerald argues that
¶24 The State contends that
¶25 We hold that
The mere inability of a defendant to express an understanding of medication or make an informed choice about it is constitutionally insufficient to override a defendant‘s “significant liberty interest in avoiding the unwanted administration of antipsychotic drugs.” Harper, 494 U.S. at 221.
¶26 A comparison of the text of the statutory standard with the constitutional standard outlined in Sell illustrates how the statute falls short of protecting the significant liberty interest in avoiding the unwanted administration of psychotropic drugs. Specifically, paragraph (3)(dm) does not require the circuit court to find that an important government “interest in bringing to trial an individual accused of a serious crime” is at stake, as required by the first Sell factor. Sell, 539 U.S. at 180.
¶27 The directive to order medication under
¶28 As to the third Sell factor, the statute falls short of the constitutional prerequisite espoused in Sell requiring the circuit court to conclude that involuntary treatment is necessary to further important government interests. This factor commands the circuit court to consider and rule out—as unlikely to achieve substantially the same results—less intrusive options for treatment as well as for administering the drugs. In contrast,
¶29 The fourth Sell factor requires the circuit court to conclude that medication is “medically appropriate” meaning “in the patient‘s best medical interest in light of his medical condition.” Sell, 539 U.S. at 181. In contrast,
¶30 The State‘s reliance on extrinsic materials to support the constitutionality of
¶31 Application of the statutory mandate requires an order for involuntary medication based solely on the defendant‘s inability to express an understanding of treatment or make an informed choice of whether to accept or refuse it, resulting in the unconstitutional deprivation of the defendant‘s significant liberty interest in avoiding the unwanted administration of medication. The fortuity of circuit courts sometimes following Sell as a result of using Form CR-206, the special materials to the jury instructions, and the Benchbook despite
¶32 To the extent
¶33 Applying this holding to the present case, the State conceded at oral argument that the circuit court did not consider the side effects of the proposed medication or whether those side effects would interfere significantly with Fitzgerald‘s ability to assist in his defense.12 After reviewing the circuit court‘s decision, we agree with the State. The circuit court never found, as it must, “that administration of the drugs is substantially likely to render the defendant competent to stand trial” and “unlikely to have side effects that will interfere significantly with the defendant‘s ability to assist counsel in conducting a trial defense, thereby rendering the trial unfair.” See Sell, 539 U.S. at 181. We therefore vacate the circuit court‘s order for involuntary medication.
4. Supervisory Writ
¶34 In his petition for a supervisory writ, Fitzgerald argues this court should exercise its superintending authority and hold that the stay established in Scott begins automatically upon entry of the order for involuntary medication. The State opposes his request, arguing that “Fitzgerald did not establish the requisite elements for a supervisory writ” and requests that we “decline to exercise [our] superintending authority” to grant relief to Fitzgerald. The court is equally divided on the issue of when the automatic stay established in Scott begins. Therefore, we affirm the decision of the court of appeals denying Fitzgerald‘s petition for a supervisory writ. See State v. Garcia, 2019 WI 40, ¶1, 386 Wis. 2d 386, 925 N.W.2d 528 (per curiam) (affirming the court of appeals decision because the court was equally divided); see also, Gruhl Sash & Door Co. v. Chicago, M. & St. P. Ry. Co., 173 Wis. 215, 215, 180 N.W. 845 (1921) (explaining that where the supreme court is equally divided, the “established rule” is to affirm the court of appeals decision).
III. CONCLUSION
¶35 Circuit courts may order involuntary medication to restore a defendant‘s competency to proceed in a criminal case, provided the four factors the United States Supreme Court established in Sell are met. To the extent
¶36 Because the court is equally divided on Fitzgerald‘s petition to review the court of appeals decision denying his request for a supervisory writ, we affirm the decision of the court of appeals.
By the Court.—The order of the circuit court is vacated; the decision of the court of appeals is affirmed by an equally divided court.
¶37 SHIRLEY ABRAHAMSON, J., withdrew from participation before oral argument.
¶38 PATIENCE DRAKE ROGGENSACK, C.J. (concurring). The issue presented by this review is whether the circuit court unconstitutionally ordered Raytrell K. Fitzgerald to be involuntarily medicated because his mental
¶39 I agree that generally the Sell factors must enter into the circuit court‘s consideration of whether to order involuntary medication so as to render an incompetent defendant competent to stand trial. However, there are occasions when a defendant who is not competent to stand trial also will be dangerous to himself or to others. In those occasions, the Sell factors will not be relevant. As the United States Supreme Court has explained:
A court need not consider whether to allow forced medication for that kind of purpose, if forced medication is warranted for a different purpose, such as . . . the individual‘s dangerousness.
Id. at 181-82 (citing Washington v. Harper, 494 U.S. 210, 225-26 (1990)). Furthermore, determining whether medication is necessary to control dangerous behavior is often an easier task for a medical expert than it is for the expert to balance the harms and benefits related to opining on legal competence. Id. at 182.
¶40
¶41 The record reveals that Fitzgerald was removed from outpatient treatment because of incidents of violent conduct in relation to others. This was not the focus of the circuit court. However, a statutory provision in addition to the forced medication found in
¶42
¶43 While I join the majority opinion‘s concern for adding a Sell gloss to our interpretation of
¶44 I am authorized to state that Justice ANNETTE KINGSLAND ZIEGLER joins this concurrence.
