Finding of incompetence to refuse medication or treatment supported by evidence

Ozaukee County v. C.Y.K., 2015AP1080-FT, District 2, 9/9/15 (one-judge decision; ineligible for publication); case activity

Even though the examining psychiatrist opined that C.Y.K. was not substantially incapable of making an informed choice about accepting or refusing medication or treatment, the record as a whole supported the circuit court’s order for involuntary medication and treatment.

C.Y.K. argues that the court’s finding that she was substantially incapable of applying her understanding of her medications to make an informed choice about taking them was clearly erroneous in light of the opinion of the expert (Rawski) about C.Y.K. was presently competent to accept or refuse medication. But the circuit court was not obligated to accept his opinions, even if they are uncontradicted, State v. Kienitz, 227 Wis. 2d 423, 438-40, 597 N.W.2d 712 (1999), or could accept as much or as little from Rawski’s report and testimony as it found probative, State v. Wenk, 2001 WI App 268, ¶9, 248 Wis. 2d 714, 637 N.W.2d 417.

Moreover, Rawski hedged his opinion by saying that “her competency to refuse meds is subject to change depending on her level of symptomology” and, noting her history of failing to comply with treatment, testified that if C.Y.K. had expressed a refusal to take medication, he would have opined that she was substantially incapable of applying her understanding to her mental illness. (¶18). There was also evidence from which the court could infer C.Y.K. would stop taking her medications if the commitment expired. (¶19). Therefore:

¶20 It is reasonable to infer from the evidence that C.Y.K. would stop her medication once the commitment was over and that C.Y.K. “is substantially incapable of applying an understanding of the advantages, disadvantages and alternatives to … her mental illness.” WIS. STAT. § 51.61(1)(g)4.b. While C.Y.K. told Rawski that she intended to keep taking her medication, he questioned her credibility given her history of noncompliance and comments she had made to others that she would stop taking her medication when the commitment ended. C.Y.K., Rawski, and C.Y.K.’s case worker gave conflicting testimony regarding whether C.Y.K. intended to continue taking her medication if the commitment were not extended. Ultimately, the credibility of these witnesses was a fact for the circuit court to determine. Dickman v. Vollmer, 2007 WI App 141, ¶14, 303 Wis. 2d 241, 736 N.W.2d 202 (credibility of witnesses is for the circuit court). The circuit court was free to make that determination based on the evidence it had before it, which was sufficient to support the conclusion. And given the totality of the evidence before the circuit court, including Rawski’s testimony and written report and [the case worker’s] testimony, the circuit court could conclude that C.Y.K. was substantially incapable of applying an understanding of the advantages and disadvantages of and alternatives to accepting the particular medications to treat her mental illness.