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Involuntary medication order was supported by the evidence

Winnebago County v. B.C., 2015AP1192-FT, District 2, 10/14/15 (one-judge decision; ineligible for publication); case activity

Applying Outagamie County v. Melanie L., 2013 WI 67, 349 Wis. 2d 148, 833 N.W.2d 607, the court of appeals holds the County proved B.C. was incompetent to refuse medication, § 51.61(1)(g)4.(intro.) and b., rejecting B.C.’s arguments that: 1) the record doesn’t document how and when he was advised of advantages, disadvantages, and alternatives to medication; and 2) the evidence doesn’t prove B.C. was incapable of making an informed choice about accepting or refusing medication.

Andrade, B.C.’s doctor, testified she had been working with B.C. for about two years and “over time at different meetings” during that period had explained to B.C. the advantages, disadvantages, and alternatives to his current medication regimen. (¶¶3-6). Relying on Melanie L., B.C. argued that the evidence failed to show when the explanations were given and that Andrade should have provided documentation of those explanations. But Melanie L. does not mandate that documentation must be presented in court regarding the timing of the explanations. (¶15). Thus:

¶17     While it would have been better if Andrade had provided more specific details as to precisely when she discussed the advantages and disadvantages of Abilify and other medications with B.C., the fact that such specificity was not provided does not mean the County failed to meet its burden of proof that the required explanations in fact were provided, …. Andrade clearly testified that she had an ongoing professional relationship with B.C., seeing him “[a]t least once a month if not more” since June 2013, and that she discussed the advantages and disadvantages with B.C. “over time at different meetings.” There is no requirement that B.C. be provided the required explanations within a certain number of days prior to a hearing. The circuit court found that B.C. had been “fully informed about treatment needs, medication needs, all of the other things that go along with that by the doctor” and there was sufficient evidence presented to support the conclusion—again, which was unchallenged at the hearing—that B.C. was provided the required explanations and in a sufficiently timely manner since Andrade began seeing him in June 2013.

The evidence also proved that B.C. was unable to make a connection between the advantages and disadvantages of medication and his mental illness, given his mistaken beliefs about the side effects caused by the drug he was on:

¶19     The record supports the circuit court’s conclusion that B.C. did not understand “what the medication does to benefit him.” Further, the record demonstrates B.C. is “substantially incapable of applying an understanding of the advantages, disadvantages and alternatives to his or her mental illness … in order to make an informed choice as to whether to accept or refuse medication,” Wis. Stat. § 51.61(1)(g)4., because his belief as to the advantages and disadvantages is so askew from the actual advantages and disadvantages, despite Andrade discussing them with him. Simply put, if a person does not understand the actual advantages and/or disadvantages related to the use of a particular medication, that person cannot apply an understanding of those advantages and/or disadvantages “in order to make an informed choice as to whether to accept or refuse medication.” See § 51.61(1)(g)4.b.

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