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Medication order supported by sufficient evidence

Calumet County v. J.M.K., 2020AP1183-FT, District 2, 12/23/20 (one-judge decision; ineligible for publication); case activity

The evidence proved J.M.K. (“Jane”) was not competent to refuse psychotropic medication.

To get a medication order under § 51.61(1)(g)4., the petition must prove that a subject individual has been given an explanation of the advantages and disadvantages of, and the alternatives to, the prescribed medication, but is either: (a) unable to articulate an understanding of that information; or (b) unable to apply that understanding to his or her situation. The evidence here proved the second prong:

¶11     …. First, with respect to the “understanding” component of this standard, Bales [the court-appointed examiner] did not merely parrot the statutory language when he testified that Jane was unable to understand the advantages and disadvantages of, and alternatives to, medication. Cf. Winnebago County v. S.H., 2020 WI App 46, ¶17, 393 Wis. 2d 511, 947 N.W.2d 761. Rather, his testimony and other evidence amply support this conclusion. For example, at one point, Jane came to believe that her medications were switched without her knowledge; this was one of her stated reasons for stopping her medications. There was no evidence, however, of this switch, and thus Jane’s belief otherwise is likely the type of delusional or disordered thinking that may indicate a lack of basic understanding about the medication. ….

¶12     Second, even if Jane were capable of understanding the effects of medication, the evidence was fairly overwhelming that she could not apply that understanding to her situation. Bales did not limit discussion to Jane’sunderstanding in the abstract, but linked it back to Jane’s own condition: she downplayed, to the point of denying, any benefits of the medication to her illness and she exaggerated the side effects, as justifications for her refusal to take medication. In short, in refusing her medication, Jane was not making anything that could be described as an “informed choice.” See Wis. Stat. § 51.61(1)(g)4.b.; [Outagamie County v.] Melanie L., [2013 WI 67,] 349 Wis. 2d 148, ¶76[, 833 N.W.2d 607] (“‘Informed choice’ means a choice based on an informed understanding of the viable options with respect to medication or treatment.”).

Jane’s appeal is moot, but in the absence of any argument about disposing of the case on mootness grounds, the court addresses the merits. (¶11 n.6).

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