*1 (The Involuntary Treatment P., Subject to a Person Found In re STEVEN P., Steven Illinois, Petitioner-Appellee, v. People of the State Respondent-Appellant). 4 — 02—1041

Fourth District No. September filed Opinion Karnes, Guardianship and Penelope S. both of Elvis C. Cameron Advocacy Commission, Anna, appellant. for (Norbert Goetten, J. Piland, Attorney, J. Robert

John C. State’s of Urbana Biderman, Mannchen, E. Attorneys Appellate and David all of State’s Office, counsel), People. Prosecutor’s for the

PRESIDING JUSTICE opinion MYERSCOUGH delivered the the court:

In November respondent, P, named Steven petition drugs and the use of (ECT) therapy electroconvulsive due to his mental condition. Follow- *2 ing hearing, granted a the trial petition court authorizing ECT and administration of medication. (1) appeal,

On respondent argues prove by failed to clear convincing evidence that less-restrictive services other than ECT (2) were inappropriate condition, to treat his he was not advised in writing effects, benefits, of the side and alternatives to the proposed treatment. We affirm.

I. BACKGROUND In November the State named respondent petition administration of authorized involuntary treatment based on his suf- fering from a illness, serious mental namely, bipolar affective disorder psychotic symptoms illness, and manic state. Because of his function, exhibited deterioration of his ability to remained delusional, weigh and was unable to the risks and of treat- ment, and his intermittent use of improved medication had not his symptoms. In petition, Hayng-Sung Dr. Yang found be in need treatment because the benefits of treatment outweighed harm, he lacked the capacity to make a reasoned deci- sion about other, less-restrictive explored services were and found inappropriate. Yang Dr. indicated the administration ECT and psychotropic medication were essential for the safe and ef- fective administration of treatment.

The trial court conducted petition. Yang a on the Dr. testi- fied he psychiatrist has been a since 1974. He stated came under his care at the Provena Covenant Medical Center psychiatric unit about prior hearing. care, three weeks During Yang his Dr. found-respondent delusional,” “religiously believing himself to perfect be in Respondent depressed health. thinks he is while “show- ing elated, excited, [a] rather Yang diagnosed [and] irritable mood.” Dr. manic depression, psychotic a manic condition with symptoms. Respondent did not improvement show much he because regularly did not take Yang opined respondent’s his medication. Dr. mental incapable illness rendered him of rationally weighing the risks and benefits involved in the treatment options available to him. Yang ECT,

Dr. recommended he stated is used when a a manic suicidal, suffering from depressed, extremely patient because other alternative had no Yang stated condition. Dr. lithium, medication, Depakote, such refused to take oral he author- sought court He also his manic condition. Tegretol, improve (a mood including Zyprexa drugs, a number ity to administer Decanoate, and Co- Haldol stabilizer), carbonate, Depakote, lithium Haldol). (to effects of alleviate the side gentin lithium, but Depakote or longer needed testified he no Respondent cooking.” He “more home home and have go he needed to instead scream- day and suffered from every to take pills forced stated was indicated the shaking night. throwing up, and ing, Further, five mind he had ECT about unclear.” [his] lithium “makes [him] it somewhat.” years ago “helped for a days for 90 ECT authority to administer sought The State carbonate, Cogen- times, Depakote, Zyprexa, lithium maximum of anesthesia, restraints, and blood tests. Decanoate, tin, general Haldol The trial court found ability illness, exhibiting a deterioration of a mental

has serious continuing period for a of time marked function that existed The court also found the benefits symptoms. presence other, outweighed the harm and less-restrictive The court then authorized explored inappropriate. and found were Following ap- of ECT and the various medications. respon- Advocacy Commission Guardianship pointment *3 counsel, appeal this followed. dent’s

II. ANALYSIS convinc- to clear and argues prove the State failed make a reasoned decision capacity that he lacked the ing evidence of the side writing because he was not advised about his treatment treatment as risks, benefits, effects, and alternatives concedes this is- disagree though the State required by law. We even sue. treatment, authorized

To administer alia, that, recipi inter the convincing evidence prove by must the treat decision about to make a reasoned capacity ent lacks the 186, 162, 166, 698 N.E.2d 188 S., App. 298 Ill. 3d ment. In re Edward (1998). evidence, the trial court’s sufficiency of the reviewing the When weight of the the manifest only against reversed if it is decision will be 1090, 1094, C., 769 N.E.2d 329 Ill. 3d evidence. In re Richard (2002). weight manifest against the 1071, judgment “A is 1075 evident, plain, clearly opposité the conclusion evidence when 341, 335, 760 N.E.2d M., Cathy In re indisputable.” (2001). 107.1(a)(4)(E) Develop Section Health and Mental 2— (Code) provides mental Disabilities Code the State must respondent capacity lacked the to make a reasoned decision about 107.1(a)(4)(E) (West 2000). necessary treatment. 405 ILCS A 5/2 — predicate making this informed is that the respondent decision be informed of the risks and must medication M., Cathy treatment. 760 N.E.2d at 585. To end, the Code states: “If the include the authorized treatment, physician physician’s designee recipient, effects, risks, shall in writing, advise the of the side benefits of the to the proposed well alternatives to the extent such is consistent advice recipient’s ability to understand the information communicated.” 102(a—5)(West2000). 405 ILCS 5/2— M., Cathy given In respondent the evidence showed no writ- or oral treating ten advice about the effects. The medications’ side so psychiatrist respondent testified. The doctor never spoke about away the side effects because she walked For spoke when to her. reason, the court written required provide found notice was the minimal amount of notice required under Code. *** cause, “In this the written should given information precisely because refused to discuss

matter with Dr. Anwar when she left the discussion before Dr. Anwar could advise about the medications’ risks By information, giving benefits. the written she would have been afforded minimal amount notice that Cathy M., under the Code.” N.E.2d contrast, Barry B., 1080, 1086, In re (1998), N.E.2d to listen to the refused So, the doctor treatment options. when told about his therefore, through actions, the own side effects were meaningfully. not discussed But see In re John (2003). case, In our the record is silent on written attempts notify oral Steven E of E side effects. Steven clearly present testimony. at the and heard doctor’s previously He also testified and had taken most these medications hearing, helped and received ECT treatment and been both. In this *4 adequately requested. notified of the treatment any evidence as to notification. Absent presented prior No did objection, complied we assume the statute and Any he was do. absence of written advice what should addressed, have been it could court, where in the trial raised been cured. it could have a problem, if there were failing to by issue the notification forfeited has Ill. Bull, 185 v. People motion. posttrial it at the raise Enoch, Ill. 2d (1998); v. People (1988). Moreover, the evidence 176, 185-86, 522 N.E.2d a rational not make could convincing was clear weigh or to mental illness for his to seek choice whether options. of the treatment the risks and benefits (Assistant Attorney)]: your In State’s “Q. FLETCHER [MR. making an informed capable [E]Mr. expert opinion is for his medical treatment to seek choice about whether rational illness? mental YANG]:No. [DR.

A. HAYNG-SUNG rationally weighing capable he Q. opinion is your expert available to options in the treatment involved risks him?

A. No.

Q. mental illness? And that’s because of A. Yes. not past has been

Q. Okay. [respondent] You indicated that you Do now for his mental illness. willing to receive treatment cooperative he be now? any have reason to believe would for the any cooperation [sic] A. Last December he has not shown him, three and the last that will work what believe told psychiatric hospital. years he has been in and out of before he became cooperating even that he was my patient.”

Therefore, the State has shown clear being able to him from prevented emotional state medication. and benefits of understand the risks (2003), P., Christopher in In re Recently, decisions, previous recognized the error of its the Fifth District writing before always be in information must held the risk-benefit authorized, and concluded: may be forced medication upon competent medical determine, circuit court must based “[A] ability to understand has the testimony, patient whether the patient pathological treatment or if the has and benefits of risks understanding him from prevent or beliefs that perceptions require no ability, there is patient If the lacks this information. op of these ment, statute, given written advisements P., disadvantages.” Christopher tions, advantages, 3d at failed to the State had P., court found Christopher *5 respondent the

show lacked capacity to understand the risks and of the benefits medication. circumstances,

Under to respondent these the advice about the involuntary writing. treatment did not have be in The in language to actually contemplates the statute can- respondent this situation where *** comprehend not written advice—“shall advise such extent recipient’s ability advice is consistent the to the understand 102(a—5) (West 2000). information communicated.” 405 ILCS 5/2 — Moreover, the options respondent were made clear to in the available hearing, and, therefore, any error was harmless.

Finally, clearly the convincingly prove State did less-restrictive were inappropriate. medications, a less- Psychotropic treatment, appropriate restrictive were not available and Dr. here. Yang, respondent, concede that respondent counsel medications, to take psychotropic refused the respondent had improved during stay. hospital

III. CONCLUSION stated, For the we judgment. reasons affirm the trial court’s Affirmed.

COOK, J., concurs. TURNER, dissenting:

JUSTICE respectfully The the dissent. State concedes trial order court’s be vacated, must and the State’s is for good concession reason. If the is not in respondent writing informed risks and the the benefits of medication and involuntary court’s order for the administration of medication or therapy Cathy must reversed. See M., 585; S., 326 Ill. N.E.2d at Edward 298 Ill. 698 N.E.2d at 188.

In the case Dr. judice, Yang sub did not indicate he informed in respondent orally writing either benefits and risks therapy or drug supports ECT. A review of the record the State’s respondent concession it failed to was informed of the risks Thus, required by of the treatment as the Code. ordering subjected the trial court to be erred therefore, would, of ECT and medication. trial accept judgment. State’s concession reverse the court’s support compliance its conclusion strict with the statute necessary, majority Yang’s was not only segment cites a brief of Dr. if testimony. Yang 3d at 459. When Dr. asked “ and benefits the risks rationally weighing ‘capable ” him,’ opined the doctor available options treatment involved “ ” inasmuch hardly surprising 459. This is ‘No.’ posed question Neither the petition. doctor initiated issue the ultimate response addresses the doctor’s doctor nor otherwise) (or writing advised the doctor whether as alterna as well effects, risks, and benefits side the circum that under Nonetheless, majority concludes tives. about case, of this “the advice stances in the statute language The writing. to be in did not have cannot this situation where actually contemplates gener at 460. This advice ***.” 343 written comprehend important statutory language ignores interpretation ous similarly recipients situated any liberty interests of See In re Jill involved in mental health cases. *6 (2003) need for compelling “a

963, 46, (recognizing 52 785 N.E.2d in mental health cases statutory requirements with compliance strict in liberty interests are involuntary and because commitment 1219, 972, 974, N.E.2d Lanter, 576 volved”); In re (1991). who treats majority opinion, physician the same Under the testify allega- to the may petition for recipient language of ignore mandatory and petition, tions set forth in the would not have understood by opining recipient the statute that the utterly mandate statutory renders the anyway. the advice This court, particularly not be countenanced this meaningless and should Here, respondent, a former case now before in instances like the us. Illinois, articulating of University capable of professor law at the testimony, though and anxieties. His expressing thoughts lucid, important, more rambling, demonstrates by the statute. required the written advice incapable comprehending facts, reason to deviate from I conclude there is no Under these the risks and benefits statutory requirement advise proposed treatment. at R., Ill. 3d at 785 N.E.2d In Jill capacity she lacked that the State failed to argued appeal on failed medication, alleging the State decision about to make a reasoned and benefits of the risks informed present proof sufficient she was noting the disagreed, writing. in This court of the medication advising her of the benefits a written statement respondent received R., Jill effects of the medication. and side plan contained treatment Further, multidisciplinary N.E.2d at 52. effects of side potential the benefits signed a statement been provided medications had discussed in with writing, along informing right her to refuse medication. Here, Jill N.E.2d at 52. State of nothing fered show informed either in writing orally of the proposed risks benefits of the by the Code.

Although court, acknowledge reverse the would trial the record as a whole ultimate appears justify the trial court’s determination to allow the administration of the recommended treatment. The trial court voluntary testimony no doubt considered the judgment rendered a it deemed best respondent. would serve law, bad bad majority, my opinion, facts make and the in today establishes precedent, logical ill-advised obviates a and com- statutory requirement recipients monsense should be advised of the benefits and detriments the treatment to be adminis- tered to them. matter,

As a final I strongly disagree majority’s with the dicta that it presume will complied the statute absent evidence contrary. statutory procedures “That the may certainty liberty followed offers little have, fact, original.) interests been safeguarded.” (Emphasis (1994). Luttrell, 221, 229, re Moreover, presumption such a cannot be the statutory inferred from language, support and I no authority majority’s position. find *7 HALL, al., Plaintiff-Appellant, RANDALL v. JOYCE A. FLOWERS et

Defendants-Appellees. Fourth District No. 4 — 03—0006 Argued Opinion September Rehearing June filed 2003. 2003. denied November