Opinion ID: 885764
Heading Depth: 2
Heading Rank: 4

Heading: Individual liberty and the parens patriae doctrine

Text: ¶ 51 In articulating a standard for effective counsel, it is necessary to recognize and dispel certain stereotypes that serve only to frustrate the legal process that purports to secure the skillful and humane care and treatment of individuals suffering from mental disorders. ¶ 52 In this regard, our citation to the California Supreme Court's decision, Conservatorship of Roulet (1979), 23 Cal.3d 219, 152 Cal.Rptr. 425, 590 P.2d 1, in In re Shennum (1984), 210 Mont. 442, 451, 684 P.2d 1073, 1078, is significant. In Shennum, we voiced the same concerns addressed by the California court in its landmark decision. See In re Shennum, 210 Mont. at 450-51, 684 P.2d at 1078 (stating that the Roulet court nailed it down in addressing the detrimental deprivation of a person's liberty and the inevitable damage to a person's reputation that may result from a civil commitment). ¶ 53 Although decided more than 20 years ago, the Roulet court's recognition that society views the mentally ill with suspicion is still relevant today. See Roulet, 152 Cal. Rptr. 425, 590 P.2d at 6. Due to the potentially socially debilitating stigma that results from the irrational fear of the mentally ill, the court posited that [i]t is implausible that a person labeled by the state as so totally ill could go about, after his release, seeking employment, applying to schools, or meeting old acquaintances with his reputation fully intact. Roulet, 152 Cal.Rptr. 425, 590 P.2d at 7. Thus, the former mental patient is likely to be treated with distrust and even loathing; he may be socially ostracized and victimized by employment and educational discrimination ... the experience may cause him to lose self-confidence and self-esteem. Roulet, 152 Cal.Rptr. 425, 590 P.2d at 7. ¶ 54 Our review of current literature concerning the treatment of the mentally ill as presented by Amicus leads us to once again agree with the California court that [i]n the ideal society, the mentally ill would be the subjects of understanding and compassion rather than ignorance and aversion . . . . [b]ut that enlightened view, unfortunately, does not yet prevail. Roulet, 152 Cal.Rptr. 425, 590 P.2d at 6. ¶ 55 Nevertheless, as suggested by Amicus, we are mindful that such ideals as understanding and compassion are expressed in the Montana Constitution's Declaration of Rights, as well as under Title 53, Chapter 21, as discussed thus far. See, e.g., Matthew O. Clifford & Thomas P. Huff, Some Thoughts on the Meaning and Scope of the Montana Constitution's Dignity Clause with Possible Applications, 61 Mont.L.Rev. 301, 330-32 (2000) (discussing application of the dignity clause to treatment of persons under State supervision: [i]t is natural to speak of the inherent dignity of such . . . mentally ill persons, and to speak of the requirements that such vulnerable persons be treated with dignity); Armstrong, ¶ 39 (discussing the right of each individual to make medical judgments affecting her or his bodily integrity and health in partnership with a chosen health care provider free from the interference of the government). ¶ 56 Amicus addresses this very point in contending that because the fundamental rights attached to decisions within the provider-patient relationship may be overridden by the State's parens patriae duties and police power authority, the role of counsel is all the more critical where a patient may be involuntarily committed. The threats to individual liberty posed by involuntary commitment, according to Amicus, arise at a time when the individual with a mental illness is least able to defend against themduring a time of crisis, confusion, fatigue. See also Bruce J. Winick, Therapeutic Jurisprudence and the Civil Commitment Hearing, 10 J. Contem. Legal Issues 37, 44-45 (1999) (observing that [p]erhaps nothing can threaten a person's belief that he or she is an equal member of society as much as being subjected to a civil commitment hearing and when legal proceedings do not treat people with dignity, they feel devalued as members of society) (hereinafter Winick ). ¶ 57 We therefore question the State's contentions regarding how much process is due to K.G.F. with regard to effective counsel. ¶ 58 According to the State, this Court should keep its sights clearly focussed on the balance between the State's duties under the parens patriae doctrinei.e., the humanitarian or benevolent obligation to protect those citizens unable to protect themselves and the exercise of police power to protect the general public health, safety, welfare and morals from the imminent threat of injury from persons afflicted by mental disorders. See In re Sonsteng (1977), 175 Mont. 307, 314, 573 P.2d 1149, 1153-54. See also In re J.B. (1985), 217 Mont. 504, 509-10, 705 P.2d 598, 602 (stating that the legislature never intended that blood of innocent people must first be shed before the statutory definition of `overt act' has been satisfied). ¶ 59 The Sonsteng decision cited by the State in this regard is particularly instructive. In spite of scientific and social advances in our understanding and treatment of individuals with mental disorders in recent yearsas expressed by the policy set forth under § 53-21-101, MCAthe Court in Sonsteng gave voice to the all-too-familiar common law notion that the State, in its sovereign role as father of the country, retains the authority to act as the general guardian of all . . . idiots and lunatics. In re Sonsteng, 175 Mont. at 314, 573 P.2d at 1153 (citing and quoting Hawaii v. Standard Oil Co., 405 U.S. 251, 257, 92 S.Ct. 885, 888, 31 L.Ed.2d 184 (1972)). ¶ 60 The use of such stereotypical labels which, as numerous commentators point out, helps create and reinforce an inferior second-class of citizensis emblematic of the benign prejudice individuals with mental illnesses face, and which are, we conclude, repugnant to our state constitution. [8] See generally Michael L. Perlin, On Sanism, 46 SMU L.Rev. 373, 374 (1992) (identifying prejudice toward the mentally ill among well-meaning citizens as the same quality and character of other prevailing prejudices such as racism, sexism, heterosexism and ethnic bigotry, which in turn is reflected in our legal system); Winick, at 45 (stating that because people with a mental illness already have been marginalized and stigmatized by a variety of social mechanisms, self-respect and their sense of their value as members of society are of special importance to them throughout legal proceedings). ¶ 61 Nevertheless, our concept of due process regarding state action involuntarily imposed on individuals with mental disorders has surely progressed since the U.S. Supreme Court's decision in Buck v. Bell . In that case, Justice Holmes described a feeble-minded white woman, who was the daughter of a feeble-minded mother and the mother of an illegitimate feeble-minded child. The Court declared that the woman, who was committed to the State Colony for Epileptics and Feeble Minded, could be involuntarily sterilized in the best interest of the patients and of society because: It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. . . . Three generations of imbeciles are enough. Buck v. Bell (1927), 274 U.S. 200, 205-207, 47 S.Ct. 584, 584-85, 71 L.Ed. 1000 (Holmes, J.) . [9] ¶ 62 However enlightened we, as a society, may have become in the intervening 75 years since Buck v. Bell , we must nevertheless be cautious and critical of signs of paternalism legitimized by the parens patriae doctrine, where State actors purport to have an absolute understanding of what is in the best interests of an individual, whose liberty, dignity and privacy are at issue, and whose voice is muted by the swift and overriding authority of court-appointed professionals. See generally In re J.B, 217 Mont. at 511, 705 P.2d at 603 (stating that although the evidence against J.B. proved him to be bizarre, the decision of the majority sets a dangerous precedent for incarceration of those deemed to be different) (Morrison, J., dissenting). As Justice Brandeis cautioned in Olmstead v. United States , [e]xperience should teach us to be most on our guard to protect liberty when the government's purposes are beneficent. Olmstead v. United States (1928), 277 U.S. 438, 479, 48 S.Ct. 564, 572-73, 72 L.Ed. 944 (Brandeis, J., dissenting). See also Roulet, 152 Cal.Rptr. 425, 590 P.2d at 9 (stating that [i]t would be small solace to a person wrongly judged mentally incompetent that his road to commitment was paved with good intentions). ¶ 63 We must recognize, after all, that an involuntary commitment is supposed to help, not punish, the person who may be suffering from a mental disorder. See § 53-21-101, MCA. See also Addington v. Texas (1979), 441 U.S. 418, 428, 99 S.Ct. 1804, 1810, 60 L.Ed.2d 323 (providing that a state's power in a civil commitment proceeding, as opposed to a criminal prosecution, is not exercised in a punitive sense). As discussed by numerous scholars, the legislated involuntary commitment process must, as a matter of public policy, strive to maintain the therapeutic influence of the legal system on the individual. See generally Winick, at 52-60 (discussing the need to reconceptualize the attorney-client relationship in civil commitment proceedings to augment the potential therapeutic effects). However, as argued by Amicus, rather than helping the individual afflicted with a mental disorder, the legal system's paternalistic influence too often turns such individuals away from seeking treatment due to the imminent fear of involuntary commitment. See National Institute for Mental Health, U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General, at 457 (1999) (stating that [o]ne point is clear: the need for coercion should be reduced significantly when adequate services are readily accessible to individuals with severe mental disorders who pose a threat of danger to themselves or others and that coercion should not be a substitute for effective care that is sought voluntarily). ¶ 64 Thus, with the foregoing in mind, it is imperative that we construct a constitutionally sound framework detailing the deliberate steps counsel should take to effectively protect his or her client's best interestsin particular the liberty interests addressed hereinand ensure that the client receives a formal and fair adversarial hearing at which the State bears the burden of proof. See § 53-21-126(2), MCA; Winick, at 40. ¶ 65 Further, it is incumbent upon courts to meaningfully respect and facilitate the exercise of the following requisite standards, in fully discharging the responsibility of safeguarding the due process rights of individuals at every stage of the proceedings. See In re L.C.B., 253 Mont. at 7, 830 P.2d at 1303. Thus, it is imperative in applying the following standards to the matter at bar, and all subsequent cases, that the constitutional and legislated rights discussed herein are formally and fairly balanced with the State's ultimate power to protect both the individual and the public from actual or perceived harm.