i'm kelly show and i work for the guardianship and advocacy commission for the state of illinois their legal advocacy service and i'm here representing the respondent appellant here will be the main question in this case is whether violation of section one o seven of the mental health and delicate development would require reversal of the commitment and involuntary treatment it's ition and additionally in this case whether it's psychiatry its failure to give written information about the risks and benefits of the proposed treatment to agree to carol prior to that treatment being started show i have a question because we have two things here right we have the admission and then we have the medication and i mean arrested in you standing on your argument as it relates to how the admission there was somehow a problem with the admission because of what occurred that we should reverse and we even if we didn't consider the medication issue this is that your position that even if we didn't get to the medication this case was such an egregious violation of her rights that anything that came after whether it be the hearing on the commitment or the hearing on the medication both both were held on the same day those were both so tainted by what had happened to her in the months prior that it would require a reversal and i know from the record there doesn't seem to be any disagreement her hearing was held in a timely fashion which sounds pretty scary given that she was you know there over a month before she even had a hearing on the admission but is that true is that accurate well what happened in this t you're saying that she went to rome and specifically for the scene came to memorial specifically wrong and couldn't do it the doctors had been not happy with the medication regimen she'd been on they weren't as effective as they hoped so they wanted her to have the c t she had had a c t in the past and in the doctors roman felt that she could have another course of p c t do we know she was at the moment voluntarily i do not know that i would consent to treatment but from june eighteenth through june twentieth she was treated she was given medication easy to was planned she was given medication what about the different  twelve and then there are two separate petitions also go well relating to the of the medication the involuntary treatment part of it is the record clear as to what happened with those initial petitions and the record is clear as to what happened to the medication titian the first medication petition and i represented carol oh so i was involved in this the first a medication petition it was filed on june twenty second did not have factual basis for why they wanted to do the treatment and that's a requirement on the petition i raise that with the state's attorney's office and usually what we would do is allow them to amend we're not trying to trick anybody we want we want the rules to be followed we want everyone to have a fair hearing we want you know our person to get treated if they need it and it's legal and so i raise that with the state's attorney's office subsequently they didn't amend they withdrew both petitions although we had not complained about a commitment protection that was filed on the twentieth of june they withdrew both and for some reason and i do not know it's not record nobody testified to that fact why the delay we don't know why they delaying in till july twelfth for the second commitment petition and july thirteenth for the second treatment titian because by that time she had been on medication from the eighteenth including the first day she was there an advantage challenge to see if she was really catatonic it's what the doctor i think testif and so she has given given this advantage she was maintaining on on medication she'd been on before and then he added other meds a couple other medications between the time she came and the time that the petition was heard also she was given e c t eight treatments and this lady was resisting these treatments she didn't want to go she's resisted she's curled up in a fetal position on that gurney while they're trying to get seven is a criteria for giving anybody psychiatric treatment against their will when they have no capacity so even if she had consented she had no capacity to consent well they actually had someone from the ethics committee at the hospital come in and even speak with her i'm assuming to determine whether or not she had the capacity to consent is that the act that is correct because they were trying to get the husband to be her power of attorney for health care and the doctor was concerned because he knew from from the beginning that she didn't have capacity and so he was afraid she would not have capacity to consent to a carb attorney and so that's why they called in the ethics person the panel on two separate occasions i believe the record reflects and on both occasions they said no that she does not have the capacity so she doesn't have a she didn't have a mental health declaration and yet the hospital continued to treat her husband as if he was somehow her p o way by getting consent from him over the phone for the city and specifically your firm to do one of seven a where basically it states that you can't just give medication treatment to someone willing can't consent unless in the four you had a hearing and the judge's hands are in order and less it's necessary to prevent the person from causing serious and imminent this of harm to him or herself or someone else right and no lesser restrictive mind is available so that's a two part and here she was never at any risk the doctor and i'm not saying at all that the doctors are trying to do the right thing he wanted to do the right thing by her medically but they did not do the right thing by her plea the way the trial court that's quoted  for treatment not for emergency intervention but the doctor and said she was had catatonia was not beating yourself well as the record went on we found out she really was eating she could eat by herself she could eat with the support of staff  she lost five pounds over a month she was there she was never in any danger she never harmed anyone else but because of her inability to care for herself without the assistance of  others that's my understanding of what harm she could cause and that's for the treatment so it's a lesser standard certainly she doesn't have to be an imminent risk she should just be not able to care for herself without the medications and the doctor and the judge decided that that she needed these interventions to help her either maintain or to improve her mental abilities she had other problems she was also possible to mention she was taking arafat for that  one problems in this case is that there are black box warnings on these drops for people who are elderly or she was sixty in or sixty's and who have dementia they're at higher risk for a lot of problems with these drugs including increased depression which happened to her so the problem that we're we're coming to you for is to find out what happens when one seven is violated to such a degree can this lady have a from the situation which would be a lesser restrictive in this case they treated her for a month they gave her in c t which can cause short term memory loss  learn and in during the times of the treatments the medication can cause problems increase depression and this lady never had past the death which is she wasn't actively suicidal but she was wishing she could die she was apathetic she you know she felt like the e c t was frying her brain why do i have to do this if i if i don't want it she she was worse the doctor thinks shooting better but her her the pression for one of the better  was was were she was would even come to our hearing would she have come before would she have come the day if she had been as she came on the eighteenth that the doctor and said that she felt happy we don't know because the hospital in the physicians treated her that whole time and the city and our position is that that is such an egregious violation that it does require and the violations that i noted in my in my brief a procedural violations many of those work reversal but here's this massive to the heart a man or a violation and nothing happens they think filing a petition the two new petitions were done ok except they were almost a month late so our question to you and we're asking you to rule that  just violation like this and frankly any violation of white house or any medication any e c t given when it is not walk should warrant a reversal and that would give the hospitals counsel said it was so is tainted but the issues the violation of one of seven has nothing to do with the commitment of a case at all the violation occurred because of the medication and the medication has nothing to do with involuntary commitments and the spine it argues that this case is not moot per the two exceptions however as i said the put the first the first exception is the public interest exception ye those the reply has burned to prove all three yet she's not and she's unable to prove those three requirements of the first one is that there's no public there's no question of public nature because that's the violation of one of seven for treatment providers to understand that you cannot prior to admission it minister treatment and less you comply with one of the seven a and this requirement that a serious and imminent physical that was filed in june eighteenth so they were not been able to have a hearing the they would have to give medication during that time or during the meeting between june eighteenth when the one she was admitted why if they don't meet the standard showing that it's an emergency well your honor is it your position that they can administer medication prior to the hearing even if they don't show that she's likely to cause serious and imminent physical harm to herself or someone else and that no alternative is available is that your position no your honor that would that would have to comply everything would have to comply with the section at the time when she was committed to the doctor believe you know that she was there even though he was wrong but with the involuntary commitment case she was this having she was committed on june eighteenth she was committed we can i mean she was a minute on on june eighteenth maybe add made it but not right committed right correct and let me hearing in the medication we're going to place on the same day in july right here correct i'm sorry but the the petition was filed on june twenty so that's seven that just even though one tried are trying to say is that even though there was a violation it doesn't matter with the the involuntary commitment he's ok while opposing counsel raises in her briefing here today she's saying well if you're a minister in this medication to someone you're altering their thought process or altering their body all of that and so we really don't know what if he impact that had and here we have a situation where all this happened in these alterations took place before she even had the opportunity to be heard by the court on the admission well your honor i would say the issues are you going through some of th better so are you saying that the the doctor already you know he tried to do everything he could to do to help her and even though some you know there was a violation of one of the seven here's just trying to do the best thing he can possibly do for  honestly know  so going back your honour's with the second exception obviously the first exception is proven but the second as i said there's there must be a substantial likelihood that this issue presented this case would have some  similar issue and it's a safe position that that is as well the state does agree that case three six six and that's the medication is not mute however as you already heard responded argues that on responded however he honors even though that even though that the medication itself can be harmful these are these these medications are they're sold that they can help or i mean  capacity to function as an adult and with these kind of medications even though that they might do these side effects they're there for a reason that's why the statue was created so they can give these kind of medications for this for the response threat to their to oneself and how did he justify using that standard as opposed to what the statute requires i don't think he ever did just that i mean i i don't think i think you try to stay like you know she was in desperate need of stuff but that's i don't think that's the court found or ruled that that was not the standard that it's in this kind on the time cases that dr reddy described this as a practice is that we know how rebel this practice was if it expanded beyond this particular case i wish i knew i was talking to response counsel about that earlier before and i wish i knew i don't over all this issue does come down to medication even though want to seven was a mile it went to seven point one wasn't on that's the basis for the actual medications after she was committed and the procured the next issue comes down to the written documentation the statute does state and there's case all this says that if there's no written information it should be reversed however she did receive  people with cancer and can refuse they have the right to refuse they have the right to live their life and however they want they have the right to not have dangerous substances put in their bodies carol didn't have the ability to consent so she has to rely on the law to protect her and in this case the law didn't work because it was just i'm wondering you mean is there culture of we know what's best for them they don't  me this isn't an isolated incident and that's because we don't go into other patients treatments in our hearings we haven't brought up other examples however the form that the doctor  that document tracks the elements that are required to be proven under one zero seven point one the treatment part not the emergency part of the mental health code so they are thinking well if we think in our wisdom the person needs this treatment to make them feel better and to make them to improve their life or we're just going to see what happens sometimes it's a little of both we can go ahead and do it because we have the best intentions we have this form we think that you know she l capacity we think it'll help or we think in those forms were filled out every twenty four hours but they never justified emergency this is a practice at this little the doctor made a quote in her her in her chart on june twenty third and i quote i will continue to give her medications at my discretion and with consent from husband as it is in her best interest to improve her functionality and quality of life that finally did come to hearing she would have completed her entire around the electro convulsive therapy and it never would have been a record basically that is correct and right and that's why i refuse to allow