In re Hannah C.

NOTICE NO. 5-05-0154
Decision filed 08/16/06. The text of
this decision may be changed or IN THE
corrected prior to the filing of a
Petition for Rehearing or the APPELLATE COURT OF ILLINOIS
disposition of the same.
FIFTH DISTRICT
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In re HANNAH C., Alleged to Be a Person ) Appeal from the Circuit Court of
Subject to Involuntary Admission ) Madison County.
)
(The People of the State of Illinois, Petitioner- ) No. 05-MH-03
Appellee, v. Hannah C., Respondent- )
Appellant). ) Honorable Clarence W. Harrison II,
) Judge, presiding.
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JUSTICE GOLDENHERSH delivered the opinion of the court:
The State filed a petition for the involuntary treatment of Hannah C., a patient at the
Gateway Regional Medical Center. After a hearing, the circuit court of Madison County
found that Hannah C. was subject to involuntary treatment under the Mental Health and
Developmental Disabilities Code (Code) (405 ILCS 5/2-107.1 (West 2004)). Hannah C.
raises numerous issues on appeal, including whether the trial court erred by selectively
authorizing only a part of her treatment plan. We reverse.
Hannah C. makes several unconvincing arguments. Contrary to Hannah C.'s
contention, the record indicates that she had sufficient actual notice of the petition and that
she did not suffer prejudice from the denial of a continuance. See In re R.W., 332 Ill. App.
3d 901, 905, 775 N.E.2d 602, 605 (2002); cf. In re Jill R., 336 Ill. App. 3d 956, 962-64, 785
N.E.2d 46, 51-52 (2003). Furthermore, the record contains clear and convincing evidence
that Hannah C. was a candidate for involuntary treatment. See 405 ILCS 5/2-107.1 (West
2004). The court was presented with testimony from a psychiatrist calling for the involuntary
administration of treatment. The court also observed Hannah C. From this record, the court
could easily determine that Hannah C.'s ability to function was deteriorating and that she
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exhibited threatening behavior. See 405 ILCS 5/2-107.1(a-5)(4)(B) (West 2004); In re
Gwendolyn N., 326 Ill. App. 3d 427, 428, 760 N.E.2d 575, 576 (2001); In re Perona, 294 Ill.
App. 3d 755, 766, 690 N.E.2d 1058, 1066 (1998). The involuntary administration of
treatment would not violate Hannah C.'s rights, because her health was at risk and she was a
danger to others. See In re Robert S., 213 Ill. 2d 30, 47, 820 N.E.2d 424, 434 (2004); In re
C.E., 161 Ill. 2d 200, 213, 641 N.E.2d 345, 351 (1994); Washington v. Harper, 494 U.S. 210,
221, 108 L. Ed. 2d 178, 198, 110 S. Ct. 1028, 1036 (1990).
The court did err, however, in the order for treatment. The court ordered the
administration of psychotropic medications but struck a part of the treatment plan sought in
the petition. The petition and affidavit for involuntary admission requested the
administration of specific dosages of Risperdal and, if ineffective, then Haldol. The court
struck the alternative of Haldol. The Illinois Supreme Court has proscribed such selective
authorization of a treatment plan. In re Mary Ann P., 202 Ill. 2d 393, 405, 781 N.E.2d 237,
244 (2002), overruling In re Nancy M., 317 Ill. App. 3d 167, 178, 739 N.E.2d 607, 616
(2000).
In In re Mary Ann P., the petition listed six different medications. Zeprexa was listed
as the first choice. Five other medications, including Haldol, were listed as alternatives. A
jury returned a general verdict for involuntary treatment. The appellate court reversed,
finding that the jury was required to specify in its verdict form which medications it deemed
more beneficial than harmful. The supreme court reversed the appellate court. In re Mary
Ann P., 202 Ill. 2d at 414, 781 N.E.2d at 249.
The supreme court rejected the practice of selective authorization. In re Mary Ann P.,
202 Ill. 2d at 405, 781 N.E.2d at 244. The court found this to be a matter of statutory
construction. Under the Code, the involuntary administration of treatment may only be
authorized when there is clear and convincing evidence "[t]hat the benefits of the treatment
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outweigh the harm." 405 ILCS 5/2-107.1(a-5)(4)(D) (West 2004). The court held that the
fact finder should weigh the benefits of the treatment plan as a whole and not evaluate the
specific medications in each plan. The court found that selective authorization was contrary
to the legislative history and plain language of the Code:
"Nothing in the language of section 2-107.1 indicates that where the treatment
involves more than one medication, the legislature intended the jury to parse the
treatment and choose among the various medications. Similarly, nothing in the
language of section 2-107.1 indicates that the legislature intended treatment orders to
authorize something less than what the treating physician has prescribed.
Accordingly, where, as here, the recommended treatment consists of multiple
medicationsBsome to be administered alternatively, some to be administered in
combination, and some to be administered only as needed to counter side effectsBit is
only this treatment, in its entirety, that may be authorized." In re Mary Ann P., 202
Ill. 2d at 405-06, 781 N.E.2d at 245.
The court also observed that selective authorization contravenes public policy, stating:
"Construing the statute to permit selective authorization of only certain medications
would permit the jury to substitute a treatment different from the one recommended
by the testifying physician and set forth in the petition. As this court has recognized,
however, the diagnosis and treatment of mental health disorders is a ' "highly
specialized area of medicine which is better left to the experts." ' [In re] C.E., 161 Ill.
2d at 229[, 641 N.E.2d at 358], quoting In re Ingersoll, 188 Ill. App. 3d 364, 368[,
544 N.E.2d 409, 412] (1989). Indeed, section 2-107.1 vests the physician authorized
to administer the involuntary treatment 'complete discretion' not to administer the
treatment. 405 ILCS 5/2-107.1(a-5)(6) (West 2000). It is thus not for the trial court
or the jury to 'develop a course of treatment and then dictate that course to the treating
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physician. That would constitute role reversal.' In re Gwendolyn N., 326 Ill. App. 3d
427, 431[, 760 N.E.2d 575, 579] (2001). In the words of amici curiae, allowing the
layperson jury to determine which of the various medications should be involuntarily
administered 'dangerously approaches the practice of medicine.' Certainly the
legislature could not have intended such an unreasonable result." (Emphasis in
original.) In re Mary Ann P., 202 Ill. 2d at 406, 781 N.E.2d at 245.
The State points out that the stance taken by Hannah C. is contrary to the position of
the respondent in In re Mary Ann P. In In re Mary Ann P., the respondent was calling for
mandatory selective authorization, whereas the State was asserting that a general verdict was
sufficient. In this case, Hannah C. is criticizing selective authorization and the State is
advocating its benefits. We are aware of the irony that Hannah C. is challenging an order
that appears to be less intrusive than the treatment requested by the State. Nonetheless, we
find that In re Mary Ann P. controls our decision.
We hold that the factual distinctions from In re Mary Ann P. are irrelevant. The
directive of In re Mary Ann P. is clear: courts should not engage in selective authorization.
The language of the Code is the same regardless of whether the State or a respondent raises
the issue of selective authorization. And although the treatment plan in the court's order
could arguably be seen as less intrusive than the treatment plan requested in the petition, In re
Mary Ann P. makes clear that the institutionalized are best protected by leaving the scope of
treatment plans to medical practitioners rather than lay people.
Similarly, the fact that Haldol was listed as an alternative in the petition does not
affect our decision. In In re Mary Ann P., the treatment plan also had a first choice and
alternatives. The supreme court saw no consequence in this classification. The court stated
that even though some medication was "to be administered alternatively," "it is only this
treatment, in its entirety, that may be authorized." In re Mary Ann P., 202 Ill. 2d at 405, 405-
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06, 781 N.E.2d at 245, 245.
We are compelled to address this case despite the fact the trial court's order has
expired. Although neither party raises the issue, this case is moot. Nonetheless, we find that
the public-interest exception calls for our review. In re Louis S., 361 Ill. App. 3d 774, 777,
838 N.E.2d 226, 230 (2005). Similar to In re Mary Ann P., this case raises a question of a
public nature that is likely to recur. In re Mary Ann P., 202 Ill. 2d at 402, 781 N.E.2d at 242;
see In re John R., 339 Ill. App. 3d 778, 785, 792 N.E.2d 350, 356 (2003). The final criterion
for the application of the public-interest exception is the desirability of an authoritative
determination for the purpose of guiding public officers. In re Louis S., 361 Ill. App. 3d at
777, 838 N.E.2d at 230. By addressing this case, we hope to eliminate any confusion caused
by a respondent contesting selective authorization. In light of the pronouncements made in
In re Mary Ann P., there should be no distinction based on which party is contesting selective
authorization. Public policy and the language of the Code instruct us against selective
authorization, no matter which party complains on appeal.
In re Mary Ann P. dictates our decision. The supreme court found that selective
authorization is contrary to the plain language and legislative history of the Code. The court
denounced selective authorization as dangerously approaching the practice of medicine.
Accordingly, the judgment of the circuit court of Madison County is hereby reversed.
Reversed.
McGLYNN and WELCH, JJ., concur.
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NO. 5-05-0154
IN THE
APPELLATE COURT OF ILLINOIS
FIFTH DISTRICT
___________________________________________________________________________________
In re HANNAH C., Alleged to Be a Person ) Appeal from the Circuit Court of
Subject to Involuntary Admission ) Madison County.
)
(The People of the State of Illinois, Petitioner- ) No. 05-MH-03
Appellee, v. Hannah C., Respondent- )
Appellant). ) Honorable Clarence W. Harrison II,
) Judge, presiding.
___________________________________________________________________________________
Opinion Filed: August 16, 2006
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Justices: Honorable Richard P. Goldenhersh, J.
Honorable Stephen P. McGlynn, J., and
Honorable Thomas M. Welch, J.,
Concur
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Attorney Anthony E. Rothert, Staff Attorney, Legal Advocacy Service, Guardianship and
for Advocacy Commission, Metro East Regional Office, 4500 College Avenue, Suite 100,
Appellant Alton, IL 62002
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Attorneys Hon. William A. Mudge, State's Attorney, Madison County Courthouse, 157 N. Main
for Street, Edwardsville, IL 62025; Norbert J. Goetten, Director, Stephen E. Norris,
Appellee Deputy Director, Sharon Shanahan, Contract Attorney, Office of the State's Attorneys
Appellate Prosecutor, 730 E. Illinois Hwy. 15, Suite 2, P.O. Box 2249, Mt. Vernon,
IL 62864
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