Case Title: In re E.T.

Citation: 177 Vt. 405, 2004 VT 111, 865 A.2d 416

Docket Number: 

State: vermont

Court: Vermont Supreme Court

Date: 2004-10-29T00:00:00Z

Document:
In re E.T. (2003-536); 177 Vt. 405; 865 A.2d 416

2004 VT 111

[Filed 29-Oct-2004]

       NOTICE:  This opinion is subject to motions for reargument under
  V.R.A.P. 40 as well as formal revision before publication in the Vermont
  Reports.  Readers are requested to notify the Reporter of Decisions,
  Vermont Supreme Court, 109 State Street, Montpelier, Vermont 05609-0801 of
  any errors in order that corrections may be made before this opinion goes
  to press.

                                 2004 VT 111

                                No. 2003-536

  In re E.T.	                                 Supreme Court

                                                 On Appeal from
                                                 Chittenden Family Court

                                                 June Term, 2004

  David A. Jenkins, J.

  Jean L. Murray, Vermont Legal Aid, Montpelier, for Appellant.

  William H. Sorrell, Attorney General, and Bridget C. Asay, Assistant
    Attorney General, Montpelier, for Appellee.

  PRESENT:  Amestoy, C.J., (FN1) Dooley, Johnson and Reiber, JJ., and 
            Allen, C.J. (Ret.),  Specially Assigned

       ¶  1.  JOHNSON, J.   Appellant E.T. appeals the Chittenden Family
  Court's decision to renew his order of nonhospitalization (ONH).  E.T.
  asserts that the court erred in failing to discharge him from court-ordered
  treatment when the evidence demonstrates that he is willing and able to
  continue treatment voluntarily.  We affirm.
   
       ¶  2.  E.T. is a 63 year old man who suffers from paranoid
  schizophrenia. His mental illness was first diagnosed in 1965 after he
  allegedly shot and wounded a police officer.   In 1974, E.T. killed his
  employer with an axe, but was found not guilty by reason of insanity.  He
  was committed to the Vermont State Hospital, but was discharged in 1978 on
  the condition that he continue receiving bi-weekly injections of an
  anti-psychotic medication to control auditory hallucinations and paranoid
  delusions.  On two occasions, once in 1983, and again in 1988, E.T. missed
  an injection and had to be briefly re-hospitalized after displaying signs
  of psychosis.   E.T. has consistently taken his medication since 1988, but
  was briefly hospitalized again in 1992 after making threats during an
  argument with his neighbor.   Since then, he has taken his medication as
  ordered and has not required further hospitalization.
        
       ¶  3.  Upon release from the hospital in 1983, E.T. was placed under
  an ONH requiring him to continue taking his medication.   The ONH was
  initially of indefinite duration, but in 1988 Vermont law was revised to
  require annual judicial review.   See 18 V.S.A. §§ 7621 (limiting
  court-ordered periods of hospitalization or nonhospitalization to one
  year).  For fifteen years, E.T. voluntarily agreed to annual renewal of his
  ONH without a court hearing.  In 2003, however, he did not consent to
  renewal, and the Chittenden County Family Court held a hearing on the
  State's application for continued treatment. 
   
       ¶  4.  At the hearing, the State contended that E.T. remained
  "patient in need of further treatment," (FN1) that an ONH is the least
  restrictive feasible means of treatment in his case, and that the court
  should therefore renew his ONH.   E.T. did not argue that he is no longer
  mentally ill, that his treatment plan should be changed in any way, or that
  he no longer poses a threat to others if his treatment is discontinued.  
  His sole contention was that an ONH is no longer necessary because his long
  record of compliance shows he is capable of pursuing treatment voluntarily. 

       ¶  5.  It is undisputed that, under medication, E.T. is a pleasant
  person who maintains a stable, independent living situation, is helpful to
  his neighbors and friends, and is relatively unlikely to have further
  episodes of psychosis or violent behavior.  Both parties agree, however,
  that E.T. is likely to show signs of psychosis if he discontinues
  treatment, and that swift intervention would be important to minimize the
  chance of serious deterioration in E.T.'s long-term mental stability.

       ¶  6.  In its Opinion and Order, the family court found that the State
  produced clear and convincing evidence that E.T. was a "patient in need of
  further treatment," and that because of his history of discontinuing
  treatment and becoming violent, voluntary treatment was not feasible.  The
  court then issued a one-year ONH requiring E.T. to take his medication,
  meet regularly with his treatment providers, and refrain from violent
  behavior.  This appeal followed.
   
       ¶  7.  We begin by observing that, contrary to the State's
  contentions, the family court did not err in considering the feasibility of
  voluntary treatment in E.T.'s case.  The State argues that to put voluntary
  treatment in issue a patient should be required to affirmatively consult
  with his or her treatment providers before initiating judicial proceedings. 
  To meet constitutional requirements, the review process for orders of
  nonhospitalization must be consistent with the Vermont Constitution's
  presumption that freedom from restraint is a fundamental, inalienable
  right.  See In re G.K., 147 Vt. 174, 179,