'Schizophrenic' ....Foreknowledge - Pt.2
M. F. Abernathy
'Schizophrenic' ....Foreknowledge -- Pt.2
Mon Feb 9 18:34:56 2004


Next, Thulin contends that placement at the Brainerd Regional Treatment Center was not the least restrictive alternative. On appeal, the district court decision as to placement will not be reversed unless clearly erroneous. In re King, 476 N.W.2d 190, 193 (Minn. App. 1991).

After a determination that there is no suitable alternative to judicial commitment, the district court must "commit the patient to the least restrictive treatment program or alternative programs which can meet the patient's treatment needs." Minn. Stat. 253B.09, subd. 1 (2000). The court must identify less restrictive alternatives and its reasons for rejecting them. Minn. Stat. 253B.09, subd. 2 (2000).

Thulin contends that the district court failed to consider the least restrictive alternative and did not make specific findings on the facility chosen and reasons for rejecting alternatives. To the contrary, the court made [*11] extensive findings. The court found Thulin had no insight, denies his mental illness, and rejected treatment. The court found that the Brainerd Regional Treatment Center was the least restrictive commitment alternative available that was consistent with appropriate treatment and public safety. No less restrictive alternative was reasonable because of Thulin's deep lack of insight into the causes of his problem and his need for treatment. The court specifically rejected a number of alternatives to involuntary commitment, finding only the regional treatment center was capable of meeting Thulin's needs. The district court made the necessary findings and its decision is supported by the record.


Finally, Thulin challenges the determination that he is not competent to refuse neuroleptic medication, contending he is competent because he understands the effects of the medication. A treatment facility must have court approval to administer neuroleptic medication to a committed person who refuses such treatment. Minn. Stat. 253B.092, subd. 8(a) (2000); Jarvis v. Levine, 418 N.W.2d 139, 150 (Minn. 1988). A patient is presumed capable [*12] to decide whether to take neuroleptic medication, and the district court must determine whether the committed person has the capacity to decide whether to take neuroleptic medication. Minn. Stat. 253B.092, subds. 5(a), 8(d), (e). In deciding this, the court must consider whether the person demonstrates an awareness of the nature of the situation, whether the person demonstrates an understanding of treatment and the risks and benefits, and whether the decision regarding treatment is a reasoned one not based on delusions. Minn. Stat. 253B.092, subd. 5(b).

The court found that Thulin denied his mental illness and never accepted treatment or medication. As to understanding the treatment, the court found him incapable of weighing the advantages and disadvantages and that, in fact, risks were minimal and the medication was reasonably expected to benefit him. Based on the record and the findings, there is convincing evidence that Thulin lacks the capacity to decide whether to take medication.

Thulin also contends that such treatment is a violation of his religious beliefs, because he does not believe in psychology or psychiatry. [*13] He argues that involuntary administration of neuroleptic medication violates his constitutional right to exercise his religion freely under the Freedom of Conscience Clause of the Minnesota Constitution. Minn. Const. art. I, 16.

Section 16 precludes infringement or interference with religious practices. State v. Hershberger, 462 N.W.2d 393, 397 (Minn. 1990). In addition, in deciding whether a reasonable person would decide to take medication, the district court may consider various factors, including the person's religious values. Minn. Stat. 253B.092, subd. 7(c).

The district court found that Thulin has not made specific claims as to his religious beliefs or described the nature of the religion or how long he has maintained the beliefs, except to the extent that he asserted he had them. We agree that Thulin has not made any affirmative showing that the medication order interfered with his religious practices.

Finally, Thulin filed a motion for discharge with this court on the ground that the treatment center had not filed the report as required under Minn. Stat. 253B.12, subd. 1(b), (e) (2000). Respondent [*14] opposes the motion and filed a copy of the report Thulin claimed was missing. We deny Thulin's motion. First, this court may not consider issues that have not been presented to and decided by the district court. Thiele v. Stich, 425 N.W.2d 580, 582 (Minn. 1988). The record indicates this issue was never presented to the district court, but only to this court. Second, the late filing, if it was late, cured any mechanical problem with the record, and Thulin makes no showing of any prejudice.

Affirmed; motion denied.

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