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Evidence at ch. 51 extension hearing sufficient to prove dangerousness, need for medication order

Portage County v. L.E., 2020Ap1239-FT, District 4, 10/29/20 (one-judge decision; ineligible for publication); case activity

The evidence presented at L.E.’s ch. 51 extenstion hearing was sufficient to prove she was dangerous and was not competent to refuse medication.

¶21     …. [Doctor] Khalil’s testimony was not so vague, equivocal, or lacking [as to fail to prove a substantial probability of physical harm or inability of L.E. to care for herself if treatment were withdrawn]. He testified that she flooded her house multiple times without knowing why, and, more significantly, that she is at extreme risk of not surviving without her medication and that “she [would] crash” because she suffers severe delusions and acts impulsively to such a degree as to risk her health and life. Such details as whether L.E. was at home during the flooding or the extent of the flooding are not necessary to prove a substantial risk of physical harm to L.E. from her conduct or to prove her inability to satisfy her basic needs if her treatment were withdrawn, given Khalil’s description of the severity of the “decompensation” that would result from L.E.’s failure to follow her treatment.

¶22     L.E. argues that this case is like D.J.W., in which our supreme court reversed an involuntary commitment extension order because the evidence was not sufficient to show dangerousness. [Langlade County v.] D.J.W., [2020 WI 41,] 391 Wis. 2d 231, ¶3[, 942 N.W.2d 277]. To the contrary, this case is easily distinguished from D.J.W. …. The court [in D.J.W.] concluded that the testimony showed only that without treatment D.J.W. would experience delusions to a greater degree such that he would be unable to maintain a job, would have to rely on disability for income, and would have to continue living with family, but that such consequences do not constitute the substantial probability of death or serious physical injury or impairment that is required under the second and fourth dangerousness standards in the statute. Id., at ¶¶51-57. Here, in contrast, Kahlil did testify that L.E.’s delusions would prevent her from functioning (that “she [would] “crash”) and prevent her from dealing with others, and that the delusions combined with her impulsivity would cause her engage in more dangerous conduct than the flooding, which would harm herself (“extreme risk” of not surviving) and others.

As to the medication order, Khalil testified L.E. “has just the basic competent [sic] level” and was doing well in taking her medication, so she argues this shows she is competent to make her own treatment decisions. The court isn’t persuaded, finding Khalil’s reference to basic competence to refer to L.E.’s not wanting an injection and his reference to her doing well to refer to her present compliance under supervision. Further, Khalil said repeatedly L.E. wasn’t able to understand her need to be subject to the medication and treatment prescribed and her resulting history of noncompliance, and he explicitly stated L.E. was not competent when he examined her. (¶23).

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