State v. Raytrell K. Fitzgerald
State v. Raytrell K. Fitzgerald
Opinion
*388
¶1 These consolidated cases
1
concern the standard under which
*389
a circuit court may order involuntary medication to restore a defendant's competency to proceed in a criminal case and the timing of the automatic stay of such orders established in
State v. Scott
,
¶2 We do, however, address Fitzgerald's challenge to the constitutionality of
I. BACKGROUND
¶3 In October 2016, the State charged Fitzgerald with possession of a firearm contrary to a harassment injunction. 3 The circuit court ordered a competency evaluation, which showed Fitzgerald suffered from "Schizoaffective disorder" and lacked substantial mental capacity to understand the proceedings or to be of meaningful assistance in his own defense. In December 2017, the circuit court signed an Order of Commitment for Treatment requesting an assessment for Fitzgerald's participation in the Outpatient Competency Restoration Program (OCRP). Dr. Brooke Lundbohm, a psychologist, sent the circuit court an OCRP assessment letter in February 2018, concluding that Fitzgerald "is clinically appropriate for the Outpatient Competency Restoration Program at this time and has been admitted to the Program," despite Fitzgerald having a history of refusing to take prescribed medication.
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In April 2018, Lundbohm informed the circuit court by letter that Fitzgerald's "status with the Outpatient Competency Restoration Program has changed," and he was "no longer clinically appropriate for participation in" OCRP due to safety concerns. The letter also noted that Fitzgerald displayed a lack of motivation to participate in the program. On that basis, the circuit court "deemed [Fitzgerald] no longer clinically appropriate for OCRP," remanded Fitzgerald to the Department of Health Services' (DHS) custody, and ordered a second competency evaluation under
¶4 In May 2018, Dr. Ana Garcia, a psychologist, conducted Fitzgerald's second competency evaluation and sent her report to the circuit court. The report noted Fitzgerald's Schizoaffective Disorder diagnosis and explained he had been "treated with Seroquel (antipsychotic medication) and Benztropine (medication used to treat the side effects of psychotropic medications)." Garcia reported that when Fitzgerald refused to take his medication while hospitalized, "an injectable version of the medication could not be forced upon him" because no order to medicate *169 involuntarily existed. If treated with medication, Garcia opined Fitzgerald would " likely ... be restored to competency within the statutory period," and further noted that Fitzgerald was "incapable of expressing a rational understanding of the benefits and risks of medication or treatment." Accordingly, Garcia concluded that Fitzgerald was " not competent to refuse medication or treatment ," and recommended that treatment continue on an inpatient basis. As to the anticipated effectiveness of the recommended treatment in restoring Fitzgerald's competency, Garcia noted in her report that "[t]reatment with antipsychotic medication is *392 known to be effective in treating symptoms of psychosis, which is precluding [Fitzgerald's] competence to proceed" in his criminal case.
¶5 On June 18, 2018, the circuit court held a hearing on whether to issue an order for involuntary medication under
• "Fitzgerald has continued to exhibit indications of psychotic symptoms" and was "unable to discuss his charges in a reasonable way."
• "[W]e find psychotropic medication to help him better organize his thoughts, reduce the auditory hallucinations, and reduce the delusional beliefs."
• Fitzgerald refused to take his medications and attempted to hide them in his room.
Garcia testified that "as a psychologist, I don't prescribe specific medications" but "I do know that for treating schizophrenia and schizoaffective disorder, the primary treatment is an antipsychotic medication, and he had been prescribed" the generic version of Seroquel during his admission at Mendota Mental Health Institute.
¶6 Fitzgerald also testified at the hearing. He thought he had been misdiagnosed, explained he had "been feeling really fine" without medication, and stated that he did not wish to submit to forced medication, expressing concerns about the dosage.
¶7 After the close of testimony, the circuit court ordered the administration of involuntary medication to restore Fitzgerald's competency. The circuit court explained the basis for its order:
*393 [T]here is an important government interest at stake here and that is the fact that he's charged with a serious felony. It may be a status offense, but the fact is he is alleged to be carrying a gun while under a prohibition for carrying a gun, and I recall the motion hearing that we had in this matter when the police approached him and searched him, which I found was a valid search. And so, therefore, that is in my opinion an important government interest, the furtherance of this felony.
The fact that he does not take his medication is not facilitating him to be restored to competency. That's what this is all about so he can stand trial on whether or not he is guilty of this very serious offense; therefore, the fact that he's not taking his meds and has to be given them involuntarily does further that interest and I think it's also a necessary reason to further that interest. And we've got testimony from Dr. Garcia, who has reviewed his psychiatrist [sic] that the two meds or the medication that is prescribed for him is appropriate, and it was appropriate back in earlier 2013, when he was not taking and engaged in violence with his mother. [ 4 ]
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¶8 On June 20, 2018, before Fitzgerald filed his notice of intent to pursue postdisposition relief, this court decided
Scott
,
¶9 On June 27, 2018, the circuit court held another hearing. The circuit court granted the stay, but indicated that it would immediately lift the stay on the State's motion. On June 28, 2018, the same day Fitzgerald filed his petition for a supervisory writ in the court of appeals, the circuit court "vacate[d] the [June 27] proceedings" related to the automatic stay. The circuit court expressed uncertainty as to whether Scott 's automatic stay occurs "after the appeal is filed or is it automatic when there's a notice of intent to appeal filed or is it automatic if there's merely an allegation that the defendant is going to file an appeal." In order to "err on the side of caution," the circuit court ordered its June 18th involuntary medication order stayed and set the matter to be heard again in two weeks. The circuit court reasoned: "[i]f the appeal *395 is not filed I will lift the stay because then clearly [the] Scott case doesn't apply," and "[i]f the appeal is filed the State can then file a motion to lift the stay." The circuit court then signed a written order granting a stay of the June 18th involuntary medication order, but on that same day, Fitzgerald filed a petition for a supervisory writ in the court of appeals, challenging the circuit court's plan to lift the automatic stay without requiring the State to make the showing required under Scott . On July 9, 2018, Fitzgerald also filed a separate notice of appeal seeking review of the circuit court's June 18th Order for Commitment, specifically challenging the order for involuntary administration of medication.
¶10 On July 12, 2018, the court of appeals denied Fitzgerald's petition for a supervisory writ.
State ex rel. Fitzgerald v. Circuit Court for Milwaukee Cty.
, No. 2018AP1214-W, unpublished order (Wis. Ct. App. July 12, 2018). Because the circuit court's stay remained in effect, the court of appeals concluded that "to the extent
Scott
establishes the automatic stay as a plain duty, the circuit court has complied."
¶11 Before this court heard oral argument in Fitzgerald's cases, the circuit court found Fitzgerald *396 competent and resumed the criminal proceedings. Fitzgerald pled guilty to the underlying charge on January 11, 2019, and the circuit court sentenced him to time served. Consequently, the State moved to dismiss as moot both of Fitzgerald's cases, but we denied the motion. After oral argument, we consolidated the two cases for the purposes of disposition.
II. DISCUSSION
A. Standard of Review
¶12 The sole issue we resolve is the constitutionality of the standard for involuntary medication under
*397 B. Analysis
1. Constitutional Principles
¶13 Under the Due Process Clause, individuals have "a significant liberty interest in avoiding the unwanted administration of antipsychotic drugs."
Washington v. Harper
,
[T]he Constitution permits the Government involuntarily to administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges in order to render that defendant competent to stand trial, but only if the treatment is medically appropriate, is substantially unlikely to have side effects that may undermine the fairness of the trial, and, taking account of less intrusive alternatives, is necessary significantly *172 to further important governmental trial-related interests.
*398
¶14 "First, a court must find that
important
governmental interests are at stake."
¶15 "Second, the court must conclude that involuntary medication will
significantly further
" the government's interest in prosecuting the offense.
¶16 "Third, the court must conclude that involuntary medication is
necessary
to further those interests."
¶17 "Fourth, ... the court must conclude that administration of the drugs is
medically appropriate
,
i.e.
, in the patient's best medical interest in light of his medical condition."
¶18 The Court explained that "these standards ... seek[ ] to determine whether involuntary administration of drugs is necessary significantly to further a particular governmental interest, namely, the interest in rendering the defendant
competent to stand trial
," and "[a] court need not consider whether to allow forced medication for that kind of purpose, if forced medication is warranted for a
different
purpose, such as [one] ... related to the individual's dangerousness, or ... health."
The medical experts may find it easier to provide an informed opinion about whether, given the risk of side effects, particular drugs are medically appropriate and necessary to control a patient's *173 potentially dangerous behavior (or to avoid serious harm to the patient himself) than to try to balance harms and benefits related to the more quintessentially legal questions of trial fairness and competence.
*400 2. Wisconsin Stat. § 971.14
¶19 Wisconsin Stat. § 971.14 requires a circuit court to enter an order for involuntary medication to restore a criminal defendant's competency to proceed provided the statutory parameters are met. Under the statute, the circuit court shall order a competency examination if "there is reason to doubt a defendant's competency to proceed." § 971.14(1r)(a), (2). The circuit court appoints "one or more examiners having the specialized knowledge determined by the court to be appropriate to examine and report upon the condition of the defendant." § 971.14(2)(a). "The examiner shall submit to the court a written report." § 971.14(3). Among other things, the report must include:
(c) The examiner's opinion regarding the defendant's present mental capacity to understand the proceedings and assist in his or her defense.
(d) If the examiner reports that the defendant lacks competency, the examiner's opinion regarding the likelihood that the defendant, if provided treatment, may be restored to competency within the time period permitted under sub. (5)(a)....
(dm) If sufficient information is available to the examiner to reach an opinion, the examiner's opinion on whether the defendant needs medication or treatment and whether the defendant is not competent to refuse medication or treatment. The defendant is not competent to refuse medication or treatment if , because of mental illness, developmental disability, alcoholism or drug dependence, and after the advantages and disadvantages of and alternatives to accepting the particular medication or treatment have been explained to the defendant, one of the following is true :
*401 1. The defendant is incapable of expressing an understanding of the advantages and disadvantages of accepting medication or treatment and the alternatives.
2. The defendant is substantially incapable of applying an understanding of the advantages, disadvantages and alternatives to his or her mental illness, developmental disability, alcoholism or drug dependence in order to make an informed choice as to whether to accept or refuse medication or treatment .
§ 971.14(3)(c)-(dm) (emphasis added).
¶20 After the report's submission, the circuit court must hold a hearing.
3. Wisconsin Stat. § 971.14(3)(dm) and (4)(b) do not conform with Sell 's constitutional parameters.
¶21 As a preliminary matter, we explain this court's denial of the State's motion to dismiss Fitzgerald's cases on mootness grounds. "An issue is moot when its resolution will have no practical effect on the underlying controversy."
Portage Cty. v. J.W.K.
,
¶22 We may, however, decide an otherwise moot issue if it fits under one of the following exceptions: (1) "the issues are of great public importance;"
*403
(2) "the constitutionality of a statute is involved;" (3) the situation arises so often "a definitive decision is essential to guide the trial courts;" (4) "the issue is likely to arise again and should be resolved by the court to avoid uncertainty;" or (5) the issue is "capable and likely of repetition and yet evades review because the appellate process usually cannot be completed and frequently cannot even be undertaken within a time that would result in a practical effect upon the parties."
G.S. v. State
,
¶23 Fitzgerald argues that
¶24 The State contends that
¶25 We hold that
¶26 A comparison of the text of the statutory standard with the constitutional standard outlined in
Sell
illustrates how the statute falls short of protecting the significant liberty interest in avoiding the unwanted administration of psychotropic drugs. Specifically, paragraph (3)(dm) does not require the circuit court to find that an important government "interest in bringing to trial an individual accused of a serious crime" is at stake, as required by the first
Sell
factor.
Sell
,
¶27 The directive to order medication under
¶28 As to the third
Sell
factor, the statute falls short of the constitutional prerequisite espoused in
Sell
requiring the circuit court to conclude that involuntary treatment is necessary to further important government interests. This factor commands the circuit
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court to consider and rule out-as unlikely to achieve substantially the same results-less intrusive options for treatment as well as for administering the drugs. In contrast,
¶29 The fourth
Sell
factor requires the circuit court to conclude that medication is "medically appropriate" meaning "in the patient's best medical interest in light of his medical condition."
Sell
,
¶30 The State's reliance on extrinsic materials to support the constitutionality of
¶31 Application of the statutory mandate requires an order for involuntary medication based solely on the defendant's inability to express an understanding of treatment or make an informed choice of whether to accept or refuse it, resulting in the unconstitutional deprivation of the defendant's significant liberty interest in avoiding the unwanted administration of medication. The fortuity of circuit courts sometimes following
Sell
as a result of using Form CR-206, the special materials to the jury instructions, and the Benchbook despite
¶32 To the extent
¶33 Applying this holding to the present case, the State conceded at oral argument that the circuit court did not consider the side effects of the proposed medication or whether those side effects would interfere significantly with Fitzgerald's ability to assist in his defense.
12
After reviewing the circuit court's decision, we agree with the State. The circuit court never found, as it must, "that administration of the drugs is substantially likely to render the defendant competent to stand trial" and "unlikely to have side effects that will interfere significantly with the defendant's ability to assist counsel in conducting a trial defense, thereby rendering the trial unfair."
See
Sell
,
4. Supervisory Writ
¶34 In his petition for a supervisory writ, Fitzgerald argues this court should exercise its superintending authority and hold that the stay established in
Scott
begins automatically upon entry of the order for involuntary medication. The State opposes his request, arguing that "Fitzgerald did not establish the requisite elements for a supervisory writ" and requests that we "decline to exercise [our] superintending authority" to grant relief to Fitzgerald. The court is equally divided on the issue of when the automatic stay established in
Scott
begins. Therefore, we affirm the decision of the
*411
court of appeals denying Fitzgerald's petition for a supervisory writ.
See
State v. Garcia
,
III. CONCLUSION
¶35 Circuit courts may order involuntary medication to restore a defendant's competency to proceed in a criminal case, provided the four factors the United States Supreme Court established in
Sell
are met. To the extent
¶36 Because the court is equally divided on Fitzgerald's petition to review the court of appeals decision denying his request for a supervisory writ, we affirm the decision of the court of appeals.
By the Court. -The order of the circuit court is vacated; the decision of the court of appeals is affirmed by an equally divided court.
¶37 SHIRLEY ABRAHAMSON, J., withdrew from participation before oral argument.
ROGGENSACK, C.J. concurs, joined by ZIEGLER, J. (opinion filed).
PATIENCE DRAKE ROGGENSACK, C.J. (concurring).
¶38 The issue presented by this review is whether the circuit court unconstitutionally ordered Raytrell K. Fitzgerald to be involuntarily medicated because his mental
*179
condition prevented him from
*412
being competent to stand trial. The majority opinion focuses its attention on
¶39 I agree that generally the Sell factors must enter into the circuit court's consideration of whether to order involuntary medication so as to render an incompetent defendant competent to stand trial. However, there are occasions when a defendant who is not competent to stand trial also will be dangerous to himself or to others. In those occasions, the Sell factors will not be relevant. As the United States Supreme Court has explained:
A court need not consider whether to allow forced medication for that kind of purpose, if forced medication is warranted for a different purpose, such as ... the individual's dangerousness.
¶40 Wisconsin Stat. § 971.14 addresses competency proceedings. Paragraph (1r) instructs that "[t]he court shall proceed under this section whenever there is reason to doubt a defendant's competency to proceed." The statute permits the court to order an examination of the defendant "for competency purposes at any stage of the competency proceedings by physicians or other experts." § 971.14(2)(g)
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¶41 The record reveals that Fitzgerald was removed from outpatient treatment because of incidents of violent conduct in relation to others. This was not the focus of the circuit court. However, a statutory provision in addition to the forced medication found in
¶42 Wisconsin Stat. § 971.14(2)(f) provides that a defendant who is charged with a crime, is incompetent and also is dangerous to himself or others is not affected by § 971.14(3)(dm). Instead, paragraph (2)(f) provides a different test for refusing medication. It provides that a defendant "may refuse medication and treatment except in a situation where the medication or treatment is necessary to prevent physical harm to the defendant or others." § 971.14(2)(f). Therefore, if medication is ordered under paragraph (2)(f), as the United States Supreme Court has explained, the
Sell
factors do not apply.
Sell
,
¶43 While I join the majority opinion's concern for adding a
Sell
gloss to our interpretation of
¶44 I am authorized to state that Justice ANNETTE KINGSLAND ZIEGLER joins this concurrence.
Our decision resolves two cases,
State v. Fitzgerald
, 2018AP1296-CR and
State ex rel. Fitzgerald v. Circuit Court for Milwaukee Cty.
, 2018AP1214-W. We decide the merits of 2018AP1296-CR by vacating the circuit court's order. This part of our decision addresses the constitutionality of
All subsequent references to the Wisconsin Statutes are to the 2017-18 version unless otherwise indicated.
The charge alleged violations of
Although the circuit court also listed several violent incidents outlined in Garcia's report and opined that "those things that I've read into the record I think exhibit that Mr. Fitzgerald, while not on the prescribed medications, is dangerous to himself and to others," the circuit court's written order for involuntary medication was not based on Fitzgerald's dangerousness. Rather, the circuit court checked the box on the form order reflecting the following grounds for involuntary medication: Fitzgerald was "mentally ill" and "charged with at least one serious crime," and the treatment was (1) "necessary to significantly further important government interests," (2) "substantially likely to render the defendant competent to stand trial," (3) "substantially unlikely to have side effects that undermine the fairness of the trial," (4) "necessary because alternative, less intrusive treatments are unlikely to achieve substantially the same results," and (5) "medically appropriate." The circuit court did not check the box indicating treatment was necessary because Fitzgerald was dangerous.
The letter is dated June 25, 2018, and marked "Received 06-25-2018" in the upper right corner. Counsel asserts in the letter that it was being filed "simultaneously" with the Notice of Intent, but according to the electronic record, the letter was not filed until June 27, 2018.
When a defendant claims to be competent,
Fitzgerald additionally argues that the circuit court incorrectly calculated his sentence credit during the hearing on the order for involuntary medication. We do not review this issue because he pled guilty and was sentenced to time served; the issue is moot and review is unwarranted under the exceptions to dismissal for mootness.
The statute directs that the circuit court "shall" issue the order for involuntary medication if paragraph (3)(dm) is met.
Wisconsin Stat. § 971.025(1) ("In all criminal actions ... the parties and court officials shall use the standard court forms adopted by the judicial conference.").
Form CR-206 lists the
Sell
factors, but does not identify their source.
See
Sell v. United States
,
The box the circuit court checked on Form CR-206 listed the Sell factors, including the second factor, but the court never addressed the side effects on the record.
Majority op., ¶2.
Reference
- Full Case Name
- STATE of Wisconsin, Plaintiff-Respondent, v. Raytrell K. FITZGERALD, Defendant-Appellant. State of Wisconsin Ex Rel. Raytrell K. Fitzgerald, Petitioner-Petitioner, v. Circuit Court for Milwaukee County and the Honorable Dennis R. Cimpl, Presiding, Respondents.
- Cited By
- 51 cases
- Status
- Published