Case Title: In re Mary Ann P.

Citation: 

Docket Number: 92777

State: illinois

Court: Illinois Supreme Court

Date: 2002-11-21T00:00:00Z

Document:
Docket No. 92777-Agenda 18-September 2002.
In re MARY ANN P. (The People of the State of Illinois,
Appellant, v. Mary Ann P., Appellee).
Opinion filed November 21, 2002.
	JUSTICE FITZGERALD delivered the opinion of the court:
	This appeal concerns the operation of section 2-107.1 of the
Mental Health and Developmental Disabilities Code (Code) (405
ILCS 5/1-100 et seq. (West 2000)). Section 2-107.1 permits the
circuit court, upon the filing of a petition and following an
evidentiary hearing, to enter an order authorizing the
administration of involuntary treatment to a recipient of mental
health services. The involuntary treatment involved in this case is
the administration of psychotropic medication. The issue we
consider is whether section 2-107.1 requires the use of a special
verdict form, so that the jury may "selectively authorize" the
involuntary administration of only those medications it deems
appropriate. For the reasons discussed below, we conclude that
section 2-107.1 does not permit selective authorization of
psychotropic medication. Accordingly, we reverse the judgment of
the appellate court and affirm the judgment of the trial court.

BACKGROUND
	On March 13, 2000, the State filed a petition in the circuit
court of Kane County, pursuant to section 2-107.1 of the Code,
seeking an order authorizing the involuntary administration of
psychotropic medication to respondent, Mary Ann P., for a period
of 90 days. The petition was signed by Dr. Donna Luchetta,
respondent's treating psychiatrist at the Elgin Mental Health
Center (EMHC) from December 1998 to June 2000. The petition
listed six medications: Zeprexa, Orap, Haldol, Haldol decanoate,
Cogentin, and Ativan. On the preprinted petition form, Zeprexa
was listed as the "1st choice," and the other five medications were
listed as "Alternatives." The petition also identified a dosage range
for each drug and the tests and procedures necessary for
administration of the drugs.
	At the hearing on the State's petition, Dr. Luchetta testified
that respondent had been transferred from Northwest Community
Hospital to the EMHC on December 28, 1998, and involuntarily
admitted on the petition of her mother. This was not the first time
respondent had been admitted to the EMHC. According to Dr.
Luchetta, respondent suffers from paranoid schizophrenia, a
psychotic disorder marked by paranoid and somatic delusions,
disorganized thought processes, and impaired social and
occupational functioning. Dr. Luchetta described respondent's
delusions and the ways in which her ability to function had
deteriorated.
	Dr. Luchetta further testified that, beginning in July or August
1999, as the result of a prior court proceeding, respondent was
involuntarily administered psychotropic medication. Prolixin was
initially administered but was discontinued after it caused
parkinsonism, a temporary syndrome characterized by symptoms
similar to those associated with Parkinson's disease. In late August
1999, Zeprexa was administered, which lessened respondent's
delusions. In September 1999, Orap was also administered, which
significantly diminished respondent's delusions. While medicated,
and for a short time afterwards, respondent was pleasant,
appropriate, and well-engaged. Respondent was able to participate
successfully in EMHC workshops. She was no longer agitated,
hostile, intrusive, or argumentative. Respondent told Dr. Luchetta
that she felt better. Toward the end of the involuntary medication
period in October 1999, respondent told Dr. Luchetta that she
would like a trial period without medication. Subsequently, in
November 1999, her medications were tapered off. On several
occasions thereafter, Dr. Luchetta recommended that respondent
resume medication. Respondent refused every treatment
recommendation, and by March 2000 she was again psychotic and
delusional. At the time of the hearing, respondent was unable to
work and provide for her own basic needs.
	Dr. Luchetta testified at length about the benefits and potential
side effects of each medication listed in the petition. Dr. Luchetta
stated that Zeprexa was her "first choice" in medication. She
explained that Zeprexa is a relatively new atypical antipsychotic
drug that resolves psychosis by changing the balance of natural
substances in the nervous system, particularly dopamine. Possible
side effects include weight gain, constipation, dry mouth,
hypotension, and a movement disorder known as tardive
dyskinesia. Dr. Luchetta's second medication choice was Orap.
Although Orap is prescribed primarily for the treatment of
Tourette's Syndrome or tic disorders, it also resolves psychosis by
decreasing the amount of dopamine in the system. Orap can also
induce tardive dyskinesia. Dr. Luchetta testified that, during the
period in 1999 when respondent was being treated with Zeprexa
and Orap, she experienced minimal side effects and did not exhibit
any signs of tardive dyskinesia.
	The next two medications listed in the petition were Haldol,
a typical antipsychotic medication, and Haldol decanoate, the
injectable form of Haldol. Dr. Luchetta testified that Haldol
decanoate can last up to four weeks in the patient's system and is
beneficial in cases where the patient is unwilling to take
medication on a daily basis. Haldol can produce significant side
effects, including tardive dyskinesia, which occurs in
approximately one of 100 patients, and neuroleptic malignant
syndrome, a condition that adversely affects regulation of a
person's body temperature and occurs in approximately one of
1,000 patients. Haldol can also produce parkinsonism and
extrapyramidal side affects, i.e., acute muscle contracture. Dr.
Luchetta stated that the drug Cogentin, also listed in the petition,
blocks some of these extrapyramidal side effects. The most
common side effect of Cogentin is blurred vision, a condition that
can be monitored.
	The final medication listed in the petition was Ativan, a mild
tranquilizer. Dr. Luchetta testified that administration of a small
amount of Ativan can greatly reduce the dosages of antipsychotic
medications administered and, in turn, prevent many of the side
effects. The antianxiety effects of Ativan, which is available in
injectable form, also help persuade an otherwise unwilling patient
to take medications, such as Zeprexa and Orap, which are in tablet
or liquid form.
	In addition, Dr. Luchetta testified that the side effects of any
medication can be monitored through observation and testing,
including a complete blood count, a thyroid function test,
urinalysis, a comprehensive metabolic profile, and an
electrocardiogram. The medications would be administered in the
lowest effective dose. It was Dr. Luchetta's opinion that the
benefits of the medications outweigh the harmful side effects and
that respondent lacks the capacity to make a reasoned or informed
decision about such treatment. On several occasions Dr. Luchetta
attempted to discuss with respondent the advantages and
disadvantages of the medications listed in the petition, but
respondent refused to discuss treatment, or responded by swearing,
walking away, or talking about an unrelated matter. Finally, Dr.
Luchetta testified that less restrictive services, such as an
outpatient program or counseling, are not viable options.
	Dr. Nageswara Rao Nagarakanti, respondent's treating
psychiatrist at the time of the hearing, also testified. He agreed
with the medication recommendations set forth in the petition and
had attempted, on three or four occasions, to discuss these
medications with respondent. She denied having a mental illness
and told Dr. Nagarakanti that she did not need any medication. In
light of her psychosis, Dr. Nagarakanti did not believe that
respondent had the ability to understand the advantages and
disadvantages of the medications.
	The State called respondent as its final witness. She testified
that she had been "abducted, drugged and detained" at the EMHC
by a man she had never met. Upon questioning by the State,
respondent recounted her cancer-related surgery and stated that she
had seen no proof that the cancer had not recurred. Dr. Luchetta
had earlier testified that respondent had cervical cancer in 1982,
but that a test performed in September 1999 showed normal
results. When asked about other physical ailments, respondent
testified that the EMHC had sent her to a dentist, she had teeth
removed, and she was given an overdose of penicillin or some
other medication. Respondent stated that, rather than being treated
at the EMHC, she should have been taken to an oncologist for an
examination of the lump in her throat.
	Respondent further testified that Dr. Nagarakanti only wants
to sell her drugs and that "[w]hen something does not agree with
what [Dr. Luchetta's] diagnosis is, it disappears." Respondent
stated that she observed her case worker and other people going
through her medical records and "things being discarded into the
garbage."
	Respondent also made reference to being restrained at the
EMHC and described various incidents in which she had been
injured by other patients. She indicated that the EMHC staff is not
responsive when such incidents occur.
	Finally, respondent testified that she did not want to be
medicated because it caused her pain, although she also stated that
the pain occurs both on and off the medication. She also indicated
that the medication made her dry and constipated, caused her nose
to bleed, blurred her vision, and impaired her concentration.
	Respondent called no witnesses and the trial court denied her
motion for a directed verdict. Following deliberations, the jury
returned a verdict in favor of the State and against respondent,
finding her to be "someone who qualifies for the involuntary
administration of psychotropic medication." The trial court entered
an order authorizing the administration of psychotropic medication
for a period not to exceed 90 days. The order listed the six
medications and dosage ranges. Respondent appealed, arguing that
she was denied her right to due process when the trial court
improperly instructed the jury under the 1998 version of section
2-107.1, and when the trial court gave the jury a general verdict
form that did not permit it to specify which medications were
appropriate.
	With one justice dissenting, the appellate court reversed. No.
2-00-1130 (unpublished order under Supreme court Rule 23).
Citing In re Nancy M., 317 Ill. App. 3d 167 (2000), the appellate
court held that the jury was required to specify in its verdict which
medications were appropriate, and that the general verdict form
"failed to show that the jury clearly intended to authorize the
administration of all six medications listed in the trial court's
subsequent written order." The dissenting justice disagreed, citing
the reasons set forth in his dissent in In re Frances K., 322 Ill.
App. 3d 203, 211-13 (2001) (Grometer, J., dissenting). In that
case, the dissenting justice criticized Nancy M., stating that,
"under the holding of Nancy M., the jury is, in effect, being asked
to prescribe the medication and treatment" and that "[s]uch a
requirement *** goes far beyond the clear legislative scheme."
Frances K., 322 Ill. App. 3d at 213. The appellate court found it
unnecessary to consider respondent's argument that the jury was
instructed under the wrong version of section 2-107.1.
	We allowed the State's petition for leave to appeal (see 177
Ill. 2d R. 315(a)), and allowed the Illinois State Medical Society
and the Illinois Psychiatric Society to file an amicus curiae brief
in support of the State (see 155 Ill. 2d R. 345).

ANALYSIS
I
	At the outset, we observe that this case is moot. Section
2-107.1 provides that an order authorizing the administration of
involuntary treatment shall, in no event, be effective for more than
90 days. 405 ILCS 5/2-107.1(a-5)(5) (West 2000).(1) The trial
court's order granting the petition for involuntary administration
of psychotropic medication was entered on September 18, 2000.
The 90 days have long since passed and the trial court's
order-valid or invalid-no longer has any force or effect. Thus, it
is impossible for this court to grant effectual relief to either party,
and any decision we render is essentially an advisory one. See In
re Barbara H., 183 Ill. 2d 482, 490 (1998); In re A Minor, 127 Ill. 2d 247, 255 (1989). Generally, a reviewing court will not consider
moot or abstract questions or render advisory decisions.
Steinbrecher v. Steinbrecher, 197 Ill. 2d 514, 523 (2001); Barbara
H., 183 Ill. 2d  at 491. We find, however, that this case qualifies for
review under the "public interest exception" to the mootness
doctrine. The criteria for application of this exception are: (1) the
public nature of the question; (2) the desirability of an
authoritative determination for the purpose of guiding public
officers; and (3) the likelihood that the question will recur. In re
Adoption of Walgreen, 186 Ill. 2d 362, 365 (1999); Radazewski v.
Cawley, 159 Ill. 2d 372, 376 (1994). This case satisfies all three
criteria.
	First, the procedures which must be followed and the proofs
that must be made before a court may authorize involuntary
treatment to recipients of mental health services are matters of a
public nature and of substantial public concern. See generally In
re C.E., 161 Ill. 2d 200, 213-19 (1994) (discussing the state's
parens patriae interest in furthering the treatment of mentally ill
persons and the liberty interests implicated where treatment is
involuntarily administered). The question we consider
here-whether the Code permits selective authorization of
psychotropic medication-is likewise a matter of substantial public
concern. Second, an authoritative determination is desirable in
light of the conflict in the case law on this issue. Compare Nancy
M., 317 Ill. App. 3d at 178-79 (holding that the jury was required
to make findings, either in special interrogatories or in its verdict,
as to whether the benefits of a particular medication outweighed
the harm), and Frances K., 322 Ill. App. 3d at 209-10 (following
Nancy M. and holding that the verdict form, which did not include
any space for the jury to determine the medications or doses to be
administered, required reversal), with In re R.W., 332 Ill. App. 3d
901, 911 (2002) (holding that section 2-107.1 does not require a
specialized verdict addressing each particular medication), petition
for leave to appeal pending No. _____. Finally, because of the
relatively short duration of involuntary treatment orders, the
circumstances present in this case will recur. Review is, therefore,
appropriate.

II
	Section 2-107.1 of the Code sets forth the standards and
procedures that must be satisfied for the administration of
"[a]uthorized involuntary treatment" to adult recipients of mental
health services. "Authorized involuntary treatment" is defined as
"psychotropic medication or electro-convulsive therapy [ECT],
including those tests and related procedures that are essential for
the safe and effective administration of the treatment." 405 ILCS
5/1-121.5 (West 2000). Section 2-107.1 applies where a person
who is receiving mental health services is unable to make a
decision in his or her own behalf regarding the administration of
psychotropic medication or ETC. See C.E., 161 Ill. 2d  at 228. The
procedures set forth in this section of the Code ensure that
involuntary treatment will be used for therapeutic purposes only
and not simply as a means to manage or discipline recipients of
mental health services. See C.E., 161 Ill. 2d  at 218-19.
	Proceedings under section 2-107.1 are initiated by the filing
of a petition in the circuit court. The court is required to hold an
evidentiary hearing on the petition within the prescribed period.
See 405 ILCS 5/2-107.1(a-5)(2) (West 2000) (setting forth the
initial time frame and allowable continuances). Significantly,
section 2-107.1 provides that authorized involuntary treatment
shall not be administered unless it is determined, by clear and
convincing evidence, that the following seven factors are present:
			"(A) That the recipient has a serious mental illness or
developmental disability.
			(B) That because of said mental illness or
developmental disability, the recipient exhibits any one of
the following: (i) deterioration of his or her ability to
function, (ii) suffering, or (iii) threatening behavior.
			(C) That the illness or disability has existed for a period
marked by the continuing presence of the symptoms set
forth in item (B) of this subdivision (4) or the repeated
episodic occurrence of these symptoms.
			(D) That the benefits of the treatment outweigh the
harm.
			(E) That the recipient lacks the capacity to make a
reasoned decision about the treatment.
			(F) That other less restrictive services have been
explored and found inappropriate.
			(G) If the petition seeks authorization for testing and
other procedures, that such testing and procedures are
essential for the safe and effective administration of the
treatment." 405 ILCS 5/2-107.1(a-5)(4) (West 2000).
The focus of this appeal is factor (D): "That the benefits of the
treatment outweigh the harm."
	Consistent with the appellate court's decision, respondent
maintains that a special verdict form is required in a section
2-107.1 hearing so that the jury may selectively authorize the
involuntary administration of only those medications it has
determined are more beneficial than harmful. See Nancy M., 317
Ill. App. 3d at 178-79; Frances K., 322 Ill. App. 3d at 209-10. The
State argues that section 2-107.1 only requires the jury to pass on
the propriety of the treatment as a whole and that the legislature
did not intend for jurors to "pick and choose" among the medicinal
components of the treatment. According to the State, the use of a
special verdict form, listing specific medications and dosages,
would allow the jury to invade the province of qualified and
knowledgeable physicians. See Frances K., 322 Ill. App. 3d at 213
(Grometer, J., dissenting); R.W., 332 Ill. App. 3d at 911 (finding
the dissent in Francis K. persuasive). Whether section 2-107.1
permits selective authorization of psychotropic medication, and
thus requires the use of a special verdict form, is a matter of
statutory construction. Our review, therefore, proceeds de novo.
People ex rel. Devine v. $30,700 United States Currency, 199 Ill. 2d 142, 148-49 (2002).
	The primary rule of statutory construction is to ascertain and
give effect to the intent of the legislature. Belleville Toyota, Inc. v.
Toyota Motor Sales, U.S.A., Inc., 199 Ill. 2d 325, 342 (2002);
Lulay v. Lulay, 193 Ill. 2d 455, 466 (2000). The most reliable
indicator of the legislature's intent is the language used in the
statute, which must be given its plain and ordinary meaning.
Where the statutory language is clear and unambiguous, it will be
given effect without resort to other aids of construction. Lulay, 193 Ill. 2d  at 466. Based on the plain language of section 2-107.1, we
hold that the statute does not permit selective authorization of
psychotropic medication.
	Section 2-107.1(a-5)(4)(D) requires the fact finder to
consider, inter alia, whether the benefits of the recommended
"treatment" outweigh the harm. 405 ILCS 5/2-107.1(a-5)(4)(D)
(West 2000). Although treatment with psychotropic medication
may involve the administration of a single drug (see, e.g., In re
Miller, 301 Ill. App. 3d 1060, 1065-66 (1998)), treatment
frequently involves the administration of several medications (see,
e.g., R.W., 332 Ill. App. 3d at 903-04; In re Williams, 305 Ill. App.
3d 506, 507-08 (1999); In re Barry B., 295 Ill. App. 3d 1080, 1083
(1998); In re Perona, 294 Ill. App. 3d 755, 767 (1998)). Nothing
in the language of section 2-107.1 indicates that where the
treatment involves more than one medication, the legislature
intended the jury to parse the treatment and choose among the
various medications. Similarly, nothing in the language of section
2-107.1 indicates that the legislature intended treatment orders to
authorize something less than what the treating physician has
prescribed. Accordingly, where, as here, the recommended
treatment consists of multiple medications-some to be
administered alternatively, some to be administered in
combination, and some to be administered only as needed to
counter side effects-it is only this treatment, in its entirety, that
may be authorized.
	Respondent contends that because the statute does not
expressly prohibit selective authorization, it is impliedly allowed.
We disagree. Statutes should be construed in a manner that avoids
absurd, unreasonable, unjust or inconvenient results. In re B.C.,
176 Ill. 2d 536, 543 (1997); Collins v. Board of Trustees of the
Firemen's Annuity & Benefit Fund, 155 Ill. 2d 103, 110 (1993).
Construing the statute to permit selective authorization of only
certain medications would permit the jury to substitute a treatment
different from the one recommended by the testifying physician
and set forth in the petition. As this court has recognized, however,
the diagnosis and treatment of mental health disorders is a
" 'highly specialized area of medicine which is better left to the
experts.' " C.E., 161 Ill. 2d  at 229, quoting In re Ingersoll, 188 Ill.
App. 3d 364, 368 (1989). Indeed, section 2-107.1 vests the
physician authorized to administer the involuntary treatment
"complete discretion" not to administer the treatment. 405 ILCS
5/2-107.1(a-5)(6) (West 2000). It is thus not for the trial court or
the jury to "develop a course of treatment and then dictate that
course to the treating physician. That would constitute role
reversal." In re Gwendolyn N., 326 Ill. App. 3d 427, 431 (2001).
In the words of amici curiae, allowing the layperson jury to
determine which of the various medications should be
involuntarily administered "dangerously approaches the practice
of medicine." Certainly the legislature could not have intended
such an unreasonable result.
	The appellate court's decision in Nancy M., cited by
respondent as well as the appellate court below, does not persuade
us that selective authorization is permitted under the statute. In
Nancy M., the circuit court, following a jury trial, entered an order
authorizing the involuntary administration of three psychotropic
medications. The appellate court reversed, agreeing with the
respondent that the verdict form should have listed each requested
medication and that the general verdict form failed to afford the
jurors an opportunity to determine which medication the
respondent should have been involuntarily administered. Nancy
M., 317 Ill. App. 3d at 176-79. The Nancy M. decision, in turn,
was based on the reasoning and analysis in In re Len P., 302 Ill.
App. 3d 281 (1999). In Len P., the respondent challenged the trial
court's involuntary treatment order because it failed to specify the
drugs to be administered and the dosages, contrary to the express
requirements of the Code. See 405 ILCS 5/2-107.1(a-5)(6) (West
2000). The appellate court reversed. The appellate court noted that
the type of medication to be used is a necessary component of the
State's burden to prove that the benefits of the medication
outweigh the harm. The physician's testimony on this subject,
however, was vague. Because the trial transcript could not provide
the essential information missing from the trial court's order, the
error was more substantive than procedural, and reversal was
required. Len P., 302 Ill. App. 3d at 285-86.
	Plainly, the issue addressed in Len P. is not the same issue we
address in the instant case. Len P. considered only whether the
circuit court's treatment order must be reversed where neither the
order, nor the trial transcript, provided the required specificity as
to the medications and dosages. Here, we consider whether the
statute permits the fact finder in a section 2-107.1 proceeding to
parse the recommended treatment and selectively authorize only
certain requested medications. Because Nancy M. relied on Len P.,
and Len P. considered a different issue than the one raised in this
case, Nancy M. does not provide a sound basis for construing
section 2-107.1 in the manner advanced by respondent and set
forth in the appellate court's order. Further, to the extent Nancy M.
and subsequent cases conflict with our holding today, they are
overruled.
	Respondent also argues that the statute's requirement that
treatment orders specify the medications and dosages authorized
is evidence that the legislature intended selective authorization of
medication. We disagree. In light of the substantially invasive
nature of involuntary treatment, the liberty interests implicated
when a person is medicated against his or her will, and the
potential for misuse of psychotropic medication (see C.E., 161 Ill.
2d at 213-15), we believe that the specificity requirement for
involuntary treatment orders reflects the legislature's legitimate
concern that only qualified health care professionals, familiar with
the respondent's mental and physical status, be permitted to
administer the treatment and that the respondent, as well as the
treaters, be notified of the exact nature of the treatment authorized.
See Williams, 305 Ill. App. 3d at 510-11; Miller, 301 Ill. App. 3d
at 1072; accord In re Cynthia S., 326 Ill. App. 3d 65, 68-69
(2001). That the legislature has prudently provided for specificity
in treatment orders entered by the trial court does not lead to the
conclusion, however, that the legislature intended a similar
requirement in the verdict form so that the jury may decide which
of the medicinal components of the proposed treatment should be
administered. 
	We note first that the legislature has employed different
language in the subsection requiring specificity in treatment orders
and the subsection addressing the findings necessary before
involuntary treatment may be authorized. The subsection setting
forth the requirements for treatment orders states:
			"An order issued under this subsection *** shall
designate the persons authorized to administer the
authorized involuntary treatment under the standards and
procedures of this subsection ***. Those persons shall
have complete discretion not to administer any treatment
authorized under this Section. The order shall also specify
the medications and the anticipated range of dosages that
have been authorized." 405 ILCS 5/2-107.1(a-5)(6)
(West 2000).
In contrast, the subsection addressing the findings required before
involuntary treatment may be authorized states that "involuntary
treatment shall not be administered to the recipient unless it has
been determined by clear and convincing evidence that *** the
benefits of the treatment outweigh the harm." 405 ILCS
5/2-107.1(a-5)(4)(D) (West 2000). It is a basic rule of statutory
construction that, "by employing certain language in one instance
and wholly different language in another, the legislature indicates
that different results were intended." In re K.C., 186 Ill. 2d 542,
549-50 (1999). Accordingly, we will not assign the same meaning
to these two subsections or engraft the specificity requirement
from one subsection onto the other subsection.
	In addition, we note that the legislature has seen fit to amend
the Code numerous times, and that the legislature amended section
2-107.1 in 1997, adding the express requirement that treatment
orders specify the medications and dosages. See Pub. Act 90-538,
eff. December 1, 1997. Had the legislature also intended to permit
selective authorization of medication, it could have done so. The
legislature has not seen fit to amend the statute in this fashion, and
we will not, under the guise of statutory construction, inject this
provision into the statute. See People ex rel. Devine, 199 Ill. 2d  at
150-51 (court will not depart from plain language of statute by
reading into it exceptions, limitations or conditions not expressed
by the legislature); People v. Tucker, 167 Ill. 2d 431, 437 (1995)
(court would not rewrite statute under guise of statutory
construction).
	Respondent argues in the alternative that section 2-107.1 of
the Code must be construed in harmony with other statutes relating
to the same subject matter. See People v. Maya, 105 Ill. 2d 281,
286-87 (1985). Respondent directs our attention to the Powers of
Attorney for Health Care Law (755 ILCS 45/4-1 et seq. (West
2000)) and the Mental Health Treatment Preference Declaration
Act (755 ILCS 43/1 et seq. (West 2000)).
	The Powers of Attorney for Health Care Law allows an
individual, the "principal," to designate a "trusted agent *** to
make personal and health care decisions" in the event the principal
becomes disabled. 755 ILCS 45/4-1 (West 2000). Health care
powers that the individual may delegate to his or her agent
"include, without limitation, all powers an individual may have to
be informed about and to consent to or refuse or withdraw any
type of health care for the individual." 755 ILCS 45/4-3 (West
2000). The agent's authority "may extend beyond the principal's
death if necessary to permit anatomical gift, autopsy or disposition
of remains." 755 ILCS 45/4-3 (West 2000). The agent has the
same access to the principal's medical and mental health records
as the principal would have. 755 ILCS 45/4-7(c) (West 2000).
	The Mental Health Treatment Preference Declaration Act
allows an "adult of sound mind" to make an advance "declaration
of preferences or instructions regarding mental health treatment."
755 ILCS 43/10(1) (West 2000). The declaration may include
"consent to or refusal of mental health treatment." 755 ILCS
43/10(1) (West 2000). "Mental health treatment" includes, among
other things, treatment with psychotropic medication. 755 ILCS
43/5(7) (West 2000). The declaration may designate an adult to act
as "attorney-in-fact" to make decisions about treatment when the
declarant is incapable. 755 ILCS 43/15, 43/30 (West 2000). The
form of declaration set forth in the statute provides that the
declarant may indicate that he or she consents to, or does not
consent to, the administration of particular psychotropic
medications. 755 ILCS 43/75 (West 2000). A declaration
designating an attorney-in-fact remains in effect until it is revoked
or the attorney withdraws. 755 ILCS 43/10(2), 50, 70 (West 2000).
	Respondent contends that the foregoing statutes, and section
2-107.1, all relate to the provision of health care treatment and
should be construed in a single fashion. Specifically, respondent
contends that the fact finders in a section 2-107.1 proceeding, like
the "surrogate decision makers" in the foregoing statutes, must be
allowed to selectively authorize only some of the medications
comprising the prescribed treatment plan.
	Although the Powers of Attorney for Health Care Law, the
Mental Health Treatment Preference Declaration Act, and the
Code each provide a mechanism for making treatment decisions
where an individual is deemed incapable of doing so, the jury in
a section 2-107.1 proceeding functions differently than an
individual's "trusted agent" (755 ILCS 45/4-1 (West 2000)) or
"attorney-in-fact" (755 ILCS 43/15 (West 2000)). The jury in a
section 2-107.1 proceeding has no prior relationship with the
respondent, no prior knowledge of the respondent's preferences
regarding mental health treatment, and no on-going relationship
with the respondent or the respondent's treating physicians.
Rather, the jury functions within the framework of an adversarial
proceeding and is called upon, as an impartial fact finder, to make
a single decision regarding the respondent's mental health
treatment based solely on the evidence and argument presented at
the hearing. Once the jury renders its verdict, the jury is discharged
and its limited involvement with the respondent's health care
ceases. These significant differences persuade us that section
2-107.1 should not be construed to provide the jury the same
powers expressly accorded to an individual's "trusted agent" or
"attorney-in-fact." Consequently, we will not read section 2-107.1
to permit selective authorization of medication.
	Respondent additionally argues that prohibiting selective
authorization of medication could result in a petitioner requesting
authority to administer an "unlimited" number of medications,
thus "forcing" fact finders to condone a physician's "mere
experimentation." Although we are aware of the potential for
misuse of psychotropic medication (see C.E., 161 Ill. 2d at 215),
we do not share respondent's fear that mental health patients will
be subjected to "mere experimentation" if trial judges and juries
are not allowed to selectively choose which medications should be
administered. The specificity requirement for involuntary
treatment orders (405 ILCS 5/2-107.1(a-5)(6) (West 2000))
precludes a court from entering an order permitting an "unlimited"
number of medications to be administered to the respondent.
Further, the statute's requirement that the petitioner demonstrate,
by clear and convincing evidence, "[t]hat the benefits of the
treatment outweigh the harm" (405 ILCS 5/2-107.1(a-5)(4)(D)
(West 2000)) militates against the petitioner presenting a treatment
plan that is so ill-defined as to constitute mere experimentation.
Finally, respondent's concern that, in the absence of selective
authorization, physicians will be permitted to experiment on their
mental health patients is contrary to respondent's position that the
"complete discretion" physicians enjoy under the Code (405 ILCS
5/2-107.1(a-5)(6) (West 2000)) actually ensures that
improvidently entered treatment orders pose no risk to the patient.
Accordingly, we reject respondent's "mere experimentation"
argument.
	Because we hold that section 2-107.1 of the Code does not
permit selective authorization of psychotropic medication, we also
hold that a special verdict form, listing each individual medication
and accompanying dosage range, is not required in a section
2-107.1 proceeding. Thus, a general verdict form, like the one
used in this case, comports with the statute. By signing the general
verdict form, the jury necessarily found that the State had proved
each of the factors set forth in section 2-107.1, including that "the
benefits of the treatment outweigh the harm." 405 ILCS
5/2-107.1(a-5)(4)(D) (West 2000).

III
	As a final matter, we consider whether remand to the
appellate court is appropriate. As indicated earlier, respondent
raised two issues in the appellate court. Based on the appellate
court's ruling on the selective-authorization issue, the court found
it unnecessary to consider respondent's argument that she was
denied due process when the trial court instructed the jury
pursuant to the 1998 version of section 2-107.1, rather than,
presumably, the version in effect at the time of the proceeding in
2000. Respondent has not pressed this argument before this court
and we find it unnecessary to remand this matter to the appellate
court for consideration of this issue.
	A reviewing court's determination of whether the jury was
properly instructed can have no effect on the outcome of the case
in light of the significant time that has passed since the 90-day
treatment order was entered. Thus, the issue is moot. See Barbara
H., 183 Ill. 2d  at 490-91. Further, it is highly unlikely that the
claimed error would recur. Thus, it does not qualify for review
under the recognized exceptions to the mootness doctrine. See In
re A Minor, 127 Ill. 2d  at 257-58. Assuming arguendo that this
issue was appropriate for review, based on our examination of the
record, the claimed error in the jury instructions would not have
affected the outcome of the proceeding.

CONCLUSION
	As discussed above, we conclude that (i) the issue of selective
authorization of psychotropic medication under section 2-107.1 of
the Code qualifies for review under the public interest exception
to the mootness doctrine; (ii) the Code cannot reasonably be
construed to permit selective authorization of psychotropic
medication and, thus, a special verdict form is not required in a
section 2-107.1 proceeding; and (iii) remand to the appellate court
is unnecessary. Consequently, we reverse the judgment of the
appellate court and affirm the judgment of the circuit court.
Appellate court judgment reversed;
circuit court judgment affirmed.
 



1.      1All citations to the Code are to that version in effect at the time of
the section 2-107.1 hearing in this case.