Opinion ID: 2148855
Heading Depth: 1
Heading Rank: 5

Heading: Fitness Finding

Text: The defendant next contends that the trial court's ruling that he was fit to stand trial must be reversed. The defendant makes several arguments in this regard.
The defendant asserts that the trial court's ruling on fitness was against the manifest weight of the evidence. We find the evidence was sufficient to support the finding of fitness. The due process clause of the fourteenth amendment prohibits the prosecution of a defendant who is not fit to stand trial. Medina v. California, 505 U.S. 437, 439, 112 S.Ct. 2572, 2574, 120 L.Ed.2d 353, 359 (1992); People v. Brandon, 162 Ill.2d 450, 455, 205 Ill.Dec. 421, 643 N.E.2d 712 (1994). Under Illinois law, a defendant is presumed to be fit to stand trial, and will only be considered unfit if, because of his mental or physical condition, he is unable to understand the nature and purpose of the proceedings against him or to assist in his defense. 725 ILCS 5/104-10 (West 1992); People v. Eddmonds, 143 Ill.2d 501, 512, 161 Ill.Dec. 306, 578 N.E.2d 952 (1991). Fitness speaks only to a person's ability to function within the context of a trial; a defendant may be fit to stand trial even though his mind is otherwise unsound. Eddmonds, 143 Ill.2d at 519, 161 Ill.Dec. 306, 578 N.E.2d 952. If a bona fide doubt of the defendant's fitness is raised, the trial court has a duty to hold a fitness hearing before proceeding further. 725 ILCS 5/104-11(a) (West 1992); Brandon, 162 Ill.2d at 456, 205 Ill.Dec. 421, 643 N.E.2d 712. The trial court's ruling on the issue of fitness will be reversed only if it is against the manifest weight of the evidence. People v. Mahaffey, 166 Ill.2d 1, 18, 209 Ill.Dec. 607, 651 N.E.2d 1055 (1995). At the fitness hearing in this case, defense counsel agreed that there was no dispute that the defendant understood the nature and purpose of the proceedings against him. Rather, the dispute centered on the second part of the fitness inquiry, whether the defendant had the capacity to assist in his defense. 725 ILCS 5/104-10 (West 1992). The testimony at the fitness hearing is summarized below. Dr. Mathew Markos, a licensed forensic psychiatrist and acting clinical director of the Psychiatric Institute of the Circuit Court of Cook County (Psychiatric Institute), testified for the State. Dr. Markos testified that he had previously conducted examinations to determine fitness for trial or sanity thousands of times. Dr. Markos met with the defendant, pursuant to court orders, on four occasions between August 27, 1993, and February 15, 1994. Dr. Markos testified that, during his meetings with the defendant, the defendant was calm and cooperative, exhibiting good eye contact and no anxiety. Dr. Markos specifically looked for looseness of association and delusions on the part of the defendant, but saw no evidence of such symptoms. Dr. Markos discussed the defendant's philosophy with him and determined that his beliefs regarding Aryan supremacy did not constitute a delusion in the psychiatric sense. Rather, the defendant's philosophy, Dr. Markos determined, was a highly personalized idiosyncratic belief. Dr. Markos diagnosed the defendant as suffering from a personality disorder with schizoid, narcissistic and paranoid traits, which does not constitute a mental illness or mental disorder. Using the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders (Third Edition-Revised) (DSMIII-R), Dr. Markos concluded that the defendant was not suffering from schizophrenia. The DSMIII-R requires that, for a diagnosis of schizophrenia, there must be the presence of at least two symptoms, and one of those must be a prominent delusion. The defendant exhibited no delusions or delusional thinking. Neither did the defendant exhibit other symptoms of schizophrenia, such as hallucinations, catatonia or incoherence. Dr. Markos further testified that, according to his medical records, the defendant had been treated with various antipsychotic drugs while in custody. There was, however, no change in the defendant's beliefs as a result of the medications. According to Dr. Markos, a true psychiatric delusion would be amenable to treatment with medications. Dr. Markos conceded that drugs will not always cure a delusional disorder. Dr. Markos acknowledged that Drs. Fauteck and Rabin, also of the Psychiatric Institute, had diagnosed the defendant as schizophrenic. Dr. Markos took these opinions into account in reaching his own diagnosis. Dr. Markos also acknowledged that other doctors had diagnosed the defendant as suffering from delusional disorder. Dr. Markos testified that the symptoms described by those doctors did not support a diagnosis of delusional disorder, without the additional symptom of a psychiatric delusion. Dr. Markos never personally observed any of the symptoms described in the records of those other doctors. Based upon all of this information, Dr. Markos found the defendant fit to stand trial. In Dr. Markos' opinion, the defendant understood the charges against him and had the capacity to cooperate with counsel if he so chose. The defendant had simply chosen not to cooperate with counsel and had very clearly articulated that he wished to represent himself. The defendant's first witness at the fitness hearing was Assistant Public Defender Thomas Verdun. Verdun was assigned to represent the defendant at his August 9, 1993, bond hearing. Verdun interviewed the defendant for 20 to 30 minutes, during which time the defendant never looked directly at him. While in court at that hearing, the defendant interrupted the judge in order to make a statement condemning fake Aryan beauty. The defendant also stated to the court that he was disgusted by the ugliness of people and that he was honored to give his life for his cause. The judge conducting the bond hearing ordered that the defendant undergo a behavioral clinical examination at the Psychiatric Institute. Dr. Satinder Brar, a clinical psychologist and coordinator of the residential treatment unit of Cook County jail, also testified for the defendant. Dr. Brar had diagnosed the defendant with delusional disorder, grandiose type, which is a mental illness. Dr. Brar determined that the defendant was not willing to cooperate with counsel in his defense because his delusional system was so precious to him that he must protect it. The defense also called Dr. Paul Fauteck, a forensic psychologist at the Psychiatric Institute. Pursuant to court orders, Dr. Fauteck examined the defendant four times between August 19, 1993, and February 15, 1994, administering psychological tests on two occasions. At the first examination, the defendant seemed very intense, maintaining unbroken eye contact, but was overall appropriately behaved. The defendant described to Dr. Fauteck his philosophy, stating that he was alarmed at the increasing ugliness of the American population and believed that it was due to false Aryan cosmetics, specifically plastic surgery, hair coloring and tinted contact lenses. The defendant reported that he believed that the Anti-Defamation League was tracking him and had labelled him a very dangerous man. After the first examination, Dr. Fauteck diagnosed the defendant as suffering from delusional disorder, persecutory type. During the second examination, Dr. Fauteck administered several psychological tests, the Minnesota Multiphasic Personality Inventory (Second) (MMPI-2), the Rorschach Ink Blot Test and the Thematic Apperception Test, to the defendant. After analyzing the test results, Dr. Fauteck diagnosed the defendant as schizophrenic, paranoid type, which is a mental illness. In reaching this diagnosis, Dr. Fauteck also relied on a social history provided by the defendant's parents, showing a history of apparent schizophrenia in the family, the defendant's statements and behavior, and the defendant's medical records while incarcerated. Dr. Fauteck also noted that the defendant exhibited marked looseness of association, in that he did not have an internal consistency in his delusions, and that he had reported experiencing auditory hallucinations in 1983 while mildly intoxicated. Dr. Fauteck further testified that it is not uncommon for a psychosis to be intractable and nonresponsive to medications. In Dr. Fauteck's opinion, the defendant was not fit to stand trial. Dr. Fauteck found that the defendant understood the charges against him, but that his mental illness rendered him incapable of assisting in his defense. Dr. Fauteck explained that, for the defendant, the virtual survival of civilization depends on him and on his sacrificing his life to make a statement. In Dr. Fauteck's opinion, because of his delusion, the defendant could not view the trial process as a defendant should view it and could not make rational decisions about his defense. On cross-examination, Dr. Fauteck testified that the defendant was very bright and articulate. Dr. Fauteck admitted that, after his first examination of the defendant, his provisional opinion was that the defendant was fit. Dr. Fauteck acknowledged that the criteria in the DSMIII-R for diagnosing schizophrenia are used almost universally in his profession. Dr. Fauteck also acknowledged that, under the DSMIII-R, more than just a delusion is necessary for a diagnosis of schizophrenia. Dr. Fauteck further conceded that a diagnosis of schizophrenia does not by itself render a person unfit for trial. Dr. Michael Rabin, a forensic psychologist at the Psychiatric Institute, also testified for the defense. Dr. Rabin had particularized training in the scoring of the MMPI and Dr. Fauteck asked him to analyze the defendant's test. Dr. Rabin also sat in on Dr. Fauteck's interviews with the defendant on two occasions. The defendant stated during these interviews that he expects to use the trial as a forum to warn America about the danger posed by fake Aryan cosmetics and that he did not want a lawyer to represent him because his ideas were so unique that only he could fully explain them. Dr. Rabin diagnosed the defendant as a paranoid schizophrenic. In Dr. Rabin's opinion, the defendant was unable to cooperate with counsel due to his delusional beliefs and was therefore unfit for trial. Dr. Rabin agreed, however, that a diagnosis of schizophrenia does not necessarily mean that a person is unfit. In addition, psychiatrists Drs. Rafael Carreira and Usha Kartan testified for the defense. While both had diagnosed the defendant as suffering from delusional disorder, neither offered an opinion on the defendant's fitness. After hearing all of the evidence, the trial court ruled that the defendant had the ability to assist in his defense and was therefore fit to stand trial. This ruling was not against the manifest weight of the evidence. Dr. Markos' testimony provided adequate support for the trial court's finding that the defendant was fit. The only dispute was whether the defendant was capable of assisting in his defense. Dr. Markos, whose qualifications as an expert in this regard were unchallenged, testified that the defendant was capable of assisting in his defense and was therefore fit to stand trial. Dr. Markos' opinion was based on repeated examinations of the defendant and took into consideration all relevant information, including the contrary opinions of his colleagues. While the defendant presented other expert witnesses who testified to a contrary opinion, the trial court was not required to accept the defense experts' view. The credibility and weight to be given to psychiatric testimony are for the trier of fact to determine. Mahaffey, 166 Ill.2d at 18, 209 Ill.Dec. 607, 651 N.E.2d 1055; People v. Bilyew, 73 Ill.2d 294, 302, 22 Ill. Dec. 736, 383 N.E.2d 212 (1978). As this court has previously stated, [t]he ultimate issue was for the trial court, not the experts, to decide. Bilyew, 73 Ill.2d at 302, 22 Ill. Dec. 736, 383 N.E.2d 212. Moreover, the opinions of the defense experts who found the defendant unfit were based on the finding that the defendant's beliefs regarding the Aryan race constituted a psychiatric delusion. Dr. Markos disagreed with the finding that the defendant's beliefs were delusional. The trial court was thus called upon to make a credibility determination and decide between the two opposing views expressed by Dr. Markos and by the defense experts. The judge's decision to accept the conclusion of Dr. Markos and reject that of the defense experts was not manifestly in error. The ruling that the defendant was fit to stand trial was therefore not against the manifest weight of the evidence.
In a further attempt to obtain reversal of the fitness finding, the defendant charges that the trial court's ruling cannot be upheld because the trial court made a factual finding which compelled the opposite conclusion. The defendant refers to the following statement by the trial court, made while delivering its ruling on fitness: The fact that an individual has deep-seated, delusional beliefs which are fixed and which do not change in the light of more reasoned beliefs does not lift such feelings to the level of being unable, and I underscore unable, to assist counsel who may not hold or agree with such delusional thought. The defendant asserts this statement reveals that the trial court found the defendant's beliefs were delusional. The defendant contends all of the expert witnesses testified that, if the defendant's beliefs were delusional, he was not fit to stand trial. Accordingly, the defendant concludes, this factual finding by the trial court required the court to rule that the defendant was unfit. The defendant's argument fails. When the trial judge's comment is considered in context, it is clear that he had accepted Dr. Markos' testimony that the defendant's belief system did not preclude him from cooperating with counsel. The trial court stated that he found the defendant fit because, he determined, the defendant was capable of assisting in his defense. The judge's use of the term delusional does not render his ultimate conclusion erroneous. Viewed in context, it is apparent that the judge was using the term in a lay or nontechnical sense and was not demonstrating agreement with the opinion of the defense experts. See People v. Scott, 148 Ill.2d 479, 507-08, 171 Ill.Dec. 365, 594 N.E.2d 217 (1992) (fitness finding upheld despite trial court's comment that the defendant was unable to cooperate with his own counsel, where it was clear that the court found that the defendant was simply unwilling, not unable, to cooperate and the evidence supported that finding).
The defendant next contends that a comment by the trial judge revealed that he had prejudged the fitness issue. The record does not support this contention. As discussed earlier in this opinion, prior to the start of the fitness hearing, an issue was raised concerning the defendant's desire to waive a jury for the proceeding. In connection with this issue, the trial court asked the parties for a synopsis of the evidence which would be presented at the fitness hearing. Defense counsel stated that doctors were expected to testify that the defendant was schizophrenic, and argued that this would render the defendant incompetent to waive a jury for fitness. The trial court responded with the following comment: Well I do because I do not think that a paranoid schizophrenicBy nature of that disease, I do not think you are going to find anything that says that they are impaired because of the disease, if they are actively suffering from that disease, in making decisions. Their decisions may be bad, but it does not say anything. The defendant contends that these remarks reveal that the trial court had prejudged the issue of the defendant's fitness. We disagree. It is clear from the context of these remarks that the trial judge was not prejudging fitness, but was simply addressing defense counsel's claim that the defendant was not competent to waive a jury for the fitness hearing.
The defendant finally asserts that the trial court improperly relied on the statutory presumption of fitness in finding the defendant fit. For this contention, the defendant relies on the following comment by the trial court in delivering its ruling: It is, therefore, the finding of this Court that the State has borne its burden by a preponderance of the evidence as to fitness and that the legal presumption of fitness has not been overborne and that the defendant is adjudged to be legally fit to stand trial. The defendant correctly asserts that, once the trial court finds that a bona fide doubt of fitness exists, the presumption of fitness no longer adheres and the burden shifts to the State to prove the defendant's fitness. 725 ILCS 5/104-11(c) (West 1992); People v. Yonder, 44 Ill.2d 376, 383-84, 256 N.E.2d 321 (1969); People v. Brown, 252 Ill.App.3d 377, 383, 192 Ill.Dec. 140, 625 N.E.2d 100 (1993). The defendant contends the above comment demonstrates that the trial court improperly required the defendant to overcome a presumption of fitness and thereby diluted the State's burden of proof. The defendant's argument is groundless. The trial court's comments as a whole indicate that it properly allocated the burden of proving fitness to the State and did not, as the defendant suggests, require the defendant to overcome a presumption of fitness. The trial court repeatedly stated the correct burden of proof in making its ruling. The incidental reference to the presumption of fitness does not support a finding that the court improperly allocated the burden of proof. See Yonder, 44 Ill.2d at 384, 256 N.E.2d 321 (harmless for trial court to instruct jury both that there was a presumption of competency and that the State had the burden of proving competency); People v. Coulter, 230 Ill.App.3d 209, 217, 171 Ill.Dec. 643, 594 N.E.2d 1163 (1992).