Opinion ID: 624293
Heading Depth: 5
Heading Rank: 1

Heading: Dangerousness Finding

Text: Loughner maintains that FMC-Springfield never determined that medication was necessary to mitigate any danger that he posed to himself. In the Justification section of the Involuntary Medication Report that followed the Harper III hearing on September 15, Dr. Tomelleri cited Loughner's deterioration after the discontinuation of antipsychotics authorized by Harper I. Loughner expressed feelings of depression and hopelessness, complained of a radio talking to him inserting thoughts into his mind, . . . engaged in yelling, crying, [and] rocking back and forth for prolonged periods of time, made statements such as that he wanted to die,[and] requested to be given an injection to be killed. His sleep schedule became erratic, including a 50-hour period without sleep. His food intake was poor and he lost weight, and he would pace or spin in circles for hours without interruption. Since involuntary medication resumed, Loughner's agitation has decreased, his sleep has improved, and his communication with staff is progressing, but he is still restless and paces and cries frequently. Dr. Tomelleri concluded that [p]sychotropic medication is the treatment of choice for conditions such as Mr. Loughner is experiencing, and rejected the alternatives. Psychotherapy, he wrote, would not address the fundamental problem; minor tranquilizers are useful to reduce anxiety and agitation and were being used for that purpose; and seclusion and restraints are merely protective temporary measures with no direct effect on the core manifestations of the mental illness. Rejecting the argument that Loughner is no longer a danger to himself, Dr. Tomelleri stated that [d]iscontinuation of current medications is virtually certain to result in an exacerbation of Mr. Loughner's illness as it did when medication was discontinued in July. [14] Loughner attempts to recharacterize his current danger to himself as being caused by his depression, which he attributes to the effects of the antipsychotic drugs because they are making him more lucid. Loughner thus alleges that the antipsychotics are not in his medical interest, but offers no medical opinion or other evidence to counter Dr. Tomelleri's determination. By contrast, Dr. Ballenger testified before the district court that Loughner's depression, borne of his remorse of what happened, is logical and his self-realization [was] an indication that the medication is helping and a very strong indication that his psychosis is better. We must leave such medical judgments to medical staff and professionals. See Harper, 494 U.S. at 230 n. 12, 110 S.Ct. 1028. Based on the substantial evidence in the record, we conclude that FMC-Springfield did not act arbitrarily in finding Loughner to be a danger to himself and that antipsychotic medication was in his best interest.