Court Opinion

ID: 9755527
Source: CourtListenerOpinion
Date Created: 2023-08-28 20:41:30.223092+00
Date Added: 2024-06-11T07:28:08.585547
License: Public Domain

STOWERS, Justice,
dissenting.
In Wetherhorn v. Alaska Psychiatric Institute,1 we considered the constitutionality of Alaska's statutory provisions that govern the cireumstances whereby the State can involuntarily commit a person with mental illness for 30 days in order to evaluate and treat that person. Wetherhorn provides the legal context in which to consider Joan's case.
One of the orders that Wetherhorn appealed was the superior court's order approving her involuntary commitment for 30 days. We began our discussion by observing that "Itlhe United States Supreme Court has characterized involuntary commitment for a mental disorder as a 'massive curtailment of liberty' that cannot be accomplished without due process of law."2 We emphasized the Supreme Court's "repeated admonition that, given the importance of the liberty right involved, a person may not be involuntarily committed if they 'are dangerous to no one and can live safely in freedom.'"3 We explained that the Supreme Court has determined "before a person can be involuntarily committed, the [trial] court must find in addition to mental illness either: (1) that the person presents a danger to self or others; or (2) that the person is 'helpless to avoid the *603hazards of freedom either through his own efforts or with the aid of willing family members or friends.'"4 We stated:
The two findings required in addition to a finding of mental illness are each aimed at different types of harm. The first finding, of "danger to self or others," is concerned with active forms of harm, where the respondent has demonstrated the affirmative ability or inclination to inflict harm to self or another person. The second finding is concerned with a more passive condition, whereby the respondent is so unable to function that he or she cannot exist safely outside an institutional framework due to an inability to respond to the essential demands of daily life.[5]
We then analyzed the Alaska statute that correlates with the requisite findings for both types of harm. We explained:
Alaska statutes address both types of harm. Alaska Statute 47.80.785(c) permits the court to "commit the respondent to a treatment facility for not more than thirty days if it finds, by clear and convincing evidence, that the respondent is mentally ill and as a result is likely to cause harm to the respondent or others or is gravely disabled."[6]
We emphasized the importance of the "clear and convincing" standard of proof. We noted that another Supreme Court case, Addington v. Texas,7 "was concerned with the standard of evidentiary proof required in civil commitment statutes."8 We explained that Addington held that the standard of proof:
must be greater than the preponderance of evidence standard but less than the beyond a reasonable doubt standard. As Adding-ton noted, "[i]ncreasing the burden of proof is one way to impress the factfinder with the importance of the decision and thereby perhaps to reduce the chances that inappropriate commitments will be ordered."[9]
As I will show, in Joan's case the superior court unfortunately failed to give meaning to the heightened "clear and convincing" standard of proof. Now, doubly unfortunate, this court also fails to meaningfully apply this heightened standard on review. In my view, the evidence adduced against Joan was conclusory and speculative, and may not have satisfied even the lower preponderance of the evidence standard. Because Joan was involuntarily committed to the Alaska Psychiatric Institute (APT) by evidence that was far less than clear and convincing, I respectfully dissent from the opinion of the court.
I.
In order to involuntarily commit Joan to API for 30 days, the superior court was required to find by "clear and convincing" evidence that she was "likely to cause harm to [herself] or others" due to her mental illness,10 meaning she posed "a substantial risk of bodily harm" to herself or others "as manifested by recent behavior causing, attempting, or threatening harm," or by "a current intent to carry out plans of serious harm."11 The superior court was also required to consider whether a less restrictive alternative was available.12 I urge the reader to carefully parse and weigh Dr. Bell's and Dr. Parker's testimony in light of these statutory standards as measured by the mandated standard of proof: clear and convincing evidence.
A.
Clear and convincing evidence is evidence that produces "a firm belief or conviction *604about the existence of a fact to be proved."13 Here, the State's experts Dr. Parker and Dr. Bell offered equivocal, speculative, and con-clusory opinions on the issues of whether Joan posed a substantial threat of harm to herself or others and whether a less restrictive alternative was available.
Dr. Parker testified that Joan was "potentially a risk to herself" due to her unstable emotional state (emphasis added), but admitted Joan had not directly expressed any intent to harm herself or anyone else during her present hospitalization and had not actually harmed herself or anyone else, other than by using drugs. When asked what danger, if any, Joan posed to herself based on the fact that she had used illegal substances, Dr. Parker responded, "amphetamines aren't good for the system, but ... I can't say there's some imminent danger from that. It's certainly self-destructive, but ... plenty of people engage in self-destructive behavior." (Emphasis added.)
Dr. Bell testified that Joan had the "potential to cause harm" to herself and others due to her unstable emotions and "excessive anger," and "speculate[d]" that her anger was one of the reasons she had a bruise around her eye.14 (Emphasis added.) When asked if he was aware of any recent threats or attempts to harm herself, Dr. Bell testified that Joan had not expressed any desire to harm herself and had done nothing to purposefully harm herself during her present hospitalization, other than the evidence of her drug use. He testified the harm from using illegal substances would be a "further destabilization" of Joan's mental and emotional state; he could not determine whether Joan had suffered any organic brain damage as a result of drug use. Dr. Bell testified, "I think if she leaves the hospital, [Joan] would go out and do drugs" in order to control the stress caused by her belief that she is responsible for keeping the universe centered. (Emphasis added.)
"Likely" is defined as "an equivalent to probably."15 "Probable" is defined as "likely to be or become true or real."16 "Possible" is defined as "being something that may or may not occur" and "being something that may or may not be true or actual."17 "Potentially" is the adverb form of "potential," which is defined as "existing in possibility" and "capable of development into actuality."18 Garner explains that "probable; likely; possible" "in order of decreasing strength-express gradations of the relative chance that something might happen."19 When an expert witness testifies that something is "possible" or "potential," or that something "might" be true or "might" occur, or that he "thinks" it might, this indicates a lesser chance that something is true or likely than if the expert testified that it was "probable"-'"probable" in this sense meaning more likely true than not true. Certainly testimony that something is "possible" or "potential" does not establish the truth or likelihood of the thing-here specifically a "substantial risk" of causing harm to self or others-and certainly not by clear and convincing evidence, that is, a "firm belief or conviction" that the substantial risk of harm existed.20
*605Based on this speculative and conclusory evidence, and on our decision in v. Alaska Psychiatric Institute,21 the superior court "found that Joan had bipolar disorder and that Joan's mental illness altered her perception of reality. This caused Joan to use drugs, and she was therefore likely to cause serious harm to herself through illegal drug use."22 But the court stressed that Joan was "not being detained because she [was] a drug addict."
This court also relies on E.P. in affirming the superior court's finding. But E.P. is manifestly distinguishable from Joan's case in several respects-there was clear evidence that E.P. was addicted to huffing gas, that his addiction had caused organic brain damage resulting in dementia and personality disorder, and that he intended to continue huffing gas if released.23 Unlike in E.P., there is no evidence that Joan was addicted to any drugs, that her drug use had caused or would likely cause substantial bodily harm such as organic brain damage, and she never expressed a clear intent to continue using drugs if released. Of greater significance are the concessions by both doctors that Joan had not directly expressed any intent to harm herself or anyone else during her present hospitalization and had not actually harmed herself or anyone else, other than by using drugs. It almost appears that the main reason underlying Joan's involuntary commitment was that she had abused drugs.
Though Joan's case is unlike E.P.'s case, E.P. reveals several relevant principles. We cautioned in K.P. that the statutory definition of "mental illness" does not include "drug addiction" in and of itself 24-and by necessary implication mental illness also does not include mere drug use and abuse, even if such abuse is harmful. We explained:
We distinguish [E.P.'s] case from one in which an addicted person with full mental capacity chooses to continue abusing harmful substances, no matter how unwise one might consider that choice. In such a case, the person's intent to harm himself by abusing substances results from drug addiction alone, which the legislature excluded from the definition of "mental illness." In [E.P.'s] case, E.P.'s decision to harm himself by abusing substances results from his brain damage, and therefore meets the statutory standards."[25]
It is undisputed that Joan has a diagnosis of bipolar disorder, thus meeting the statutory definition of mental illness. But there was no evidence that Joan was addicted to drugs; rather, it appears that she was simply an abuser of these harmful substances. There was also no evidence that Joan's drug use was caused by any organic brain damage, or even by her bipolar disorder. Joan's case thus appears to fall somewhere between the case of a person "with full mental capacity" (i.e., no mental illness) and E.P.'s case where he suffered organic brain damage from huffing gas and it was his brain damage that caused him to continue to huff gas. Dr. Parker's and Dr. Bell's testimony attempted to relate the risk of harm they argued Joan may cause to herself by her use of drugs to the potentially deleterious effect that these drugs could have on her mental condition. The superior court and this court rely on this testimony to conclude that Joan's case is like E.P.'s case and is not the kind of case that would be excluded because of the limiting definition of "mental illness" and the distin*606guishing example quoted above from E.P.26 I am unconvinced. Joan cannot legally be involuntarily committed merely because she suffers from bipolar disorder. Nor can she legally be involuntarily committed merely because she abuses drugs, or even because her abuse of drugs would be harmful in the same way that drug abuse would be harmful to "an addicted person with full mental capacity."27 Rather, in order to legally involuntarily commit Joan, there must be clear and convincing evidence that as a result of her mental ill-mess she is likely to cause harm to herself or others.28 For the reasons explained above, I believe the evidence is insufficient to support the superior court's finding by a clear and convincing standard of proof that Joan posed "a substantial risk of bodily harm" to herself or others.29
B.
Both doctors also dismissed the possibility of a less restrictive alternative for Joan, even though they had not explored alternative options. Dr. Parker and Dr. Bell testified that they never communicated with any of Joan's family members to see if they could provide a wraparound plan for her. And even though Joan had previously been treated by Dr. Baker, a psychiatrist, neither doctor contacted Dr. Baker to discuss Joan's condition or to see if Dr. Baker could further treat Joan as an alternative to commitment to a psychiatric institution. Dr. Bell testified he did not know whether Joan would be an appropriate candidate for voluntary treatment, but he did not believe a less restrictive alternative would meet her needs because she was "liable to erupt with labile [i.e., changeable] emotions" and it was "possible she could injure another person in that state of mind." (Emphasis added.) Dr. Parker testified that he believed less restrictive options would not work for Joan because of her unstable temperament and because she had not acknowledged that she had a mental illness. Notwithstanding this testimony, the superior court found there were no less restrictive alternatives for Joan.
I start with the proposition that a mentally ill person's belief that she is not mentally ill cannot be the measure by which a court finds that there are no less restrictive alternatives; nor can a doctor's testimony that a person might display changeable emotions or "possibly" cause harm. Of greater significance, it is illogical and insufficient for a doctor to opine that there are no less restrictive alternatives when the doctor has done nothing to evaluate any less restrictive alternative. The doctors were aware, or should have been aware, that Joan was brought to the hospital by her mother. They were aware that Dr. Baker had previously provided psychiatric treatment to Joan. Their failure to contact family and Dr. Baker or to explore any other possible alternative should have caused the superior court to conclude that the State, which bears the burden of proof, failed to prove that there were no less restrictive alternatives.
In Wetherhorn we said:
[We] agree[d] with the Supreme Court of Washington that "[it is not enough to show that care and treatment of an individual's mental illness would be preferred or beneficial or even in his best interests. Indeed, AS 47.80.7830 does require more than a best interests determination. For example, it requires that the petition for commitment "allege that the evaluation staff has considered but has not found that there are any less restrictive alternatives available" .... As further protection, the statute directs the court to make these findings by "clear and convincing" evidence.[30]
*607Under these circumstances, where the testifying doctors utterly failed to make any effort to contact Joan's prior treating physician or her family to explore less restrictive alternatives, I believe the doctors' conclusory opinions are insufficient under any standard of proof to support the superior court's finding that no less restrictive option was available for Joan.
Because there was no clear and convincing evidence that Joan presented a substantial risk of harm to herself or others, and that she was "helpless to avoid the hazards of freedom ... with the aid of willing family members or friends"31 or her prior treating psychiatrist-in other words, that there were no less restrictive alternatives to involuntary commitment-I would reverse the superior court's involuntary commitment order.
II.
I also disagree with this court's resolution of the mootness question. The court today recognizes for the first time that the collateral consequences doctrine will permit an appeal of an otherwise moot order of involuntary commitment, provided that no previous commitments have been ordered. The court hedges on whether it will recognize in later cases the collateral consequences exception to the mootness doctrine for persons who have been involuntarily committed more than onee. While I agree that collateral consequences justify not applying the mootness doctrine in involuntary commitment cases, I would go farther: it is my view that the supreme court must accept and decide on the merits every appeal of an order of involuntary commitment.
The mootness doctrine is a judicially constructed doctrine to give the courts a means to avoid addressing cases that no longer present "live controversies.32 But the Alaska Legislature has codified by statute the citizen's right to appeal a superior court order for involuntary commitment, and rightly so. Alaska Statute 47.30.765 unambiguously provides that a "respondent has the right to an appeal from an order of involuntary commitment." The statute's language could not be any plainer. I believe that the statute supplants the judicially created mootness doctrine in the limited cireumstance of involuntary commitment orders. This is similar to the situation where the legislature supplants the common law with statutory law: the courts are bound to apply statutory law that supersedes common law.33
The right to appeal is no right at all if it is merely the right to pay the filing fee and file an appellate brief, only to be told that your appeal is moot and the court will not reach the merits. Even though the respondent will in every case have already completed her 80-day commitment by the time her appeal is ripe, and therefore the supreme court could not undo the commitment if the respondent's commitment order were wrongly issued, I contend that any order for involuntary commitment that is erroneously issued remains a "live controversy" for the respondent for the remainder of the respondent's life. Of first importance, the citizen's liberty has been alleged to have been wrongfully taken by court process; the court should afford the citizen the opportunity to prove the error and, if proven, obtain judicial acknowledgment that the order was erroneously issued. Giving the citizen this opportunity will assure the citizen that she will be heard, and that if a lower court has erred, that error will not go unnoticed or unremedied, at least to the extent that the erroneous order will be reversed and vacated. Public confidence in the *608judicial branch demands that we hold ourselves accountable.
Second, in this age of prevalent information mining, collection, and storage into increasingly large, interconnected, and search-able data banks, the fact that a citizen has been involuntarily committed to a mental institution will follow that individual for all of her life. She should be given the means to effectively challenge that order through appeal regardless of the fact that by the time her appeal is ripe for decision, the 30 days will have long since expired and she will have been released from State custody. The injury inflicted by an erroneously issued order of involuntary commitment "lives" until the wrong is righted. I am at a loss to understand how a citizen can be ordered to be involuntarily committed for 230 days and be precluded from appealing this order merely because it is practically impossible to perfect an appeal of an order that by its terms will expire in 30 days.
Ending where I began, we-the Alaska Supreme Court-along with our legislature and the United States Supreme Court, have recognized that "involuntary commitment for a mental disorder [is] a 'massive curtailment of liberty' that cannot be accomplished without due process of law."34 I believe that this court should accept every appeal of an order of involuntary commitment as a matter of being faithful to the citizen's right to due process of law. I also believe that, apart from considerations of due process, where the legislature has codified the right to appeal, we have a duty to honor and give real meaning to the law and to the right that it bestows.

. 156 P.3d 371 (Alaska 2007).

. Id. at 375-76 (quoting Humphrey v. Cady, 405 U.S. 504, 509, 92 S.Ct. 1048, 31 L.Ed.2d 394 (1972)).

. Id. at 377 (quoting O'Connor v. Donaldson, 422 U.S. 563, 575, 95 S.Ct. 2486, 45 L.Ed.2d 396 (1975).

. Id. at 376 (quoting O'Connor, 422 U.S. at 575 & n. 9, 95 S.Ct. 2486).

. Id.

. Id. (emphasis added).

. 441 U.S. 418, 426, 99 S.Ct. 1804, 60 L.Ed.2d 323 (1979).

. Wetherhorn, 156 P.3d at 378 n. 26.

. Id. at 378 (quoting Addington, 441 U.S. at 427, 431-33, 99 S.Ct. 1804) (emphasis added).

. AS 47.30.735(c) (emphasis added).

. AS 47.30.915(10) {(emphasis added).

. See AS 47.30.655(2); AS 47.30.735(d).

. In re Johnstone, 2 P.3d 1226, 1234 (Alaska 2000) (quoting Buster v. Gale, 866 P.2d 837, 844 (Alaska 1994)).

. When Joan was admitted to Fairbanks Memorial Hospital for her initial evaluation, she had a bruise around her eye. The record does not reveal what caused the bruise.

. Bryan A. Garner, Garner's Modern American Usage 514 (2009).

. Webster's Ninth New Collegiate Dictionary 937 (1987).

. Id. at 918.

. Id. at 921.

. Bryan A. Garner, A Dictronary Of American Legal Usage 693 (2d. ed. 1995).

. This discussion is not about semantics. Trial and appellate courts know that there are real and important differences in standards of proof; much turns on whether something is proved by the correct quantum of proof. An injured plaintiff can win a civil tort case by proving by a preponderance of the evidence that the defendant was negligent and that negligence proximately caused the plaintiff's harm. But the State cannot win a murder trial by a preponderance of the evidence, or even by clear and convincing evidence: the State's burden is to prove that the defendant committed the crime beyond a reasonable doubt. I also emphasize that I do not suggest the superior court would have been justi*605fied to order involuntary commitment if the State's doctor witnesses had simply opined that they had a "firm belief or conviction" that Joan was likely to harm herself: it is the evidence underlying their opinions-or rather the lack thereof-that fails the clear and convincing standard. The doctors' conclusory and equivocal testimony simply highlights the weakness of the evidence. Given the great "importance of the liberty right involved" and the "massive curtailment of liberty" when a citizen is involuntarily committed to a mental institution, courts must give careful and exacting attention to the evidence presented by the State to ensure that it meets the high threshold of clear and convincing before depriving a citizen of her liberty.

. 205 P.3d 1101 (Alaska 2009).

. Op. at 595.

. 205 P.3d at 1104-05, 1110.

. Id. at 1109 (quoting AS 47.30.915(12) ("'drug addiction [and] alcoholism do not per se constitute mental illness)).

. Id. at 1111.

. Id.

. See id.

. Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 376 (Alaska 2007) (Alaska Statute 47.30.735(c) permits the court to 'commit the respondent to a treatment facility for not more than thirty days if it finds, by clear and convincing evidence, that the respondent is mentally ill and as a result is likely to cause harm to the aar respondent or others ....' ") (quoting O'Connor v. Donaldson, 422 U.S. 563, 575 & n. 9, 95 S.Ct. 2486, 45 L.Ed.2d 396 (1975)) (emphasis added).

. AS 47.30.735(c), AS 47.30.915(10) (emphasis added).

. Wetherhorn, 156 P.3d at 378 (quoting In re LaBelle, 107 Wash.2d 196, 728 P.2d 138, 146 (1986); and citing AS 47.30.730(a)(2) and (3) (emphasis added)).

. Id. at 376 (quoting O'Connor, 422 U.S. at 575 & n. 9, 95 S.Ct. 2486).

. See, e.g., Green Party of Alaska v. State, Div. of Elections, 147 P.3d 728, 732 (Alaska 2006) ("'Mootness functions as a doctrine of judicial restraint; we generally refrain from deciding questions where events have rendered the legal issue moot. A case is moot if 'it has lost its character as a present, live controversy.'"); see also Fairbanks Fire Fighters Ass'n, Local 1324 v. City of Fairbanks, 48 P.3d 1165, 1167-68 (Alaska 2002) ("'In most cases, mootness is found because the party raising an appeal cannot be given the remedy it seeks even if the court agrees with its legal position.").

. See, e.g., Kodiak Island Borough v. Exxon Corp., 991 P.2d 757, 761 (Alaska 1999) ('This [statutory] language evinces the legislature's intent to abrogate all otherwise applicable common-law doctrines....").

. Wetherhorn, 156 P.3d at 375-76 (quoting Humphrey v. Cady, 405 U.S. 504, 509, 92 S.Ct. 1048, 31 L.Ed.2d 394 (1972)).