State v. D.E.C., 2024AP1789-CR & 2024AP1799-CR, 12/27/24, District IV (recommended for publication); case activity
In yet another published decision pertaining to an involuntary medication order entered in conjunction with pretrial competency proceedings, COA holds that the testimony of a treating psychiatrist, in conjunction with the proposed treatment plan, was legally sufficient and affirms the order for treatment.
D.E.C. appeals an order for involuntary medication under § 971.14(5)(am). “He argues that the State did not meet its burden on the second and fourth [Sell] factors, namely, to prove that involuntary medication consistent with the treatment plan will significantly further the State’s interest or that it is medically appropriate.” (¶33). Notably, COA acknowledges that the standard of review for assessing the sufficiency of the evidence in this context is unsettled; however, as Wisconsin courts have consistently done, it does not resolve that question because it finds that the evidence was sufficient “regardless of which standard of review we apply.” (¶35).
As to the second factor, which requires a relatively exacting degree of specificity with respect to the treatment plan, D.E.C. argues that the plan–as written–lists a number of potential medications and does not adequately advise the reader as to “which particular medications will in fact be administered and in what sequence.” (¶39). COA appears to acknowledge that, in a vacuum, the plan (and ensuing order) may be ambiguous. However, it ultimately holds that any ambiguities are cured by the treating psychiatrist’s testimony, which adequately informed the circuit court as to how and why medication choices would be made for D.E.C. (¶50). COA therefore rejects what it views as a request for an overly specific order, one that would include a “annotated flowchart” of how medical decisions would be made. (¶51). It also rejects D.E.C.’s broader argument that an assessment of whether due process requirements have been met is cabined to the order in isolation, without considering the supplemental and explanatory testimony of the person who authored the report and will administer treatment. (¶56).
As to the fourth factor–whether the treatment plan is medically appropriate–D.E.C. makes a series of laser-focused attacks on the court order. However, while he challenges the inclusion of specific medications with novel arguments developed from his review of medical literature on appeal, COA holds that these arguments are forfeited as they were not presented to the circuit court. (¶75). COA therefore explicitly discourages appellate lawyers in these appeals from using publicly-available sources to impeach specific instances of medical testimony on appeal when those questions were not first posed to the expert at the hearing below. (Id.).
This is a LONG opinion; we’ve done our best here to condense the holdings for the majority of our readers who likely do not regularly engage with this niche practice area. As usual, however, we recommend that readers confronting such appellate issues to read this case–and its many factually-derived subholdings–carefully.
