State: Illinois
Court: 4th District Appellate
Docket No: 4-97-0261
Case Date: 02/09/1998
NO. 4-97-0261
IN THE APPELLATE COURT
OF ILLINOIS
FOURTH DISTRICT
In The Matter of Bruce Perona ) Appeal from
a Person Found Subject to Involuntary ) Circuit Court of
Admission, ) Peoria County
PEOPLE OF THE STATE OF ILLINOIS, ) No. 96MH294
Petitioner-Appellee, )
v. )
BRUCE PERONA, ) Honorable
Respondent-Appellant ) Richard E. Grawey,
) Judge Presiding.
_________________________________________________________________
PRESIDING JUSTICE GARMAN delivered the opinion of the
court:
In March 1997, respondent Bruce Perona was involuntari-
ly recommitted to Zeller Mental Health Center (Zeller) after a
hearing in absentia conducted pursuant to section 3-806 of the
Mental Health and Developmental Disabilities Code (Code) (405
ILCS 5/3-806 (West 1996)). He appeals, arguing (1) the State
failed to comply with section 3-806 of the Code; (2) the section
is unconstitutional because it violates his right to due process
under the United States and Illinois Constitutions (U.S. Const.,
amends. V, XIV; Ill. Const. 1970, art. I, 2); and (3) the cir-
cuit court erred by entering a subsequent order pursuant to sec-
tion 2-107.1 of the Code (405 ILCS 5/2-107.1 (West 1996)), sub-
jecting him to psychotropic medication against his will. We af-
firm.
I. BACKGROUND
By way of background, on November 9, 1996, Perona was
found naked in his car by police. The police believed he was
hallucinating and in need of psychiatric care. They took him to
Zeller, where he was admitted. On November 13, 1996, the trial
court granted the State's motion to have Perona involuntarily
committed for 90 days. On December 18, 1996, the trial court
granted the State's petition to administer psychotropic medica-
tion involuntarily. On February 11, 1997, the State brought a
petition for involuntary recommitment. Before the hearing began,
Perona's attorney noted Perona did not want to come and waived
Perona's presence on his behalf. The hearing continued in
Perona's absence. The court granted the petition, and Perona was
recommitted for another 30 days.
On March 7, 1997, the State filed the instant motion
for involuntary admission and recommitment. Perona was given
notice of the motion, and counsel was appointed before the peti-
tion was heard on March 12, 1997. He was also given notice of
the instant motion to allow the State to administer psychotropic
drugs to him against his will. At the beginning of the hearing,
Perona's counsel made the following statement:
"I would like to indicate for the record that
I visited with [Perona] yesterday. He indi-
cated that he would not want to attend the
hearing. I believe he did that last time
also. I spoke to him about the idea of con-
solidating the two petitions, but we didn't
get that far. He said he didn't want to come
to court. I ask we proceed just on the one."
The involuntary recommitment hearing proceeded without Perona
present. According to Dr. Jayalakshmi Attaluri, a psychiatrist
at Zeller, Perona suffers from psychosis, coupled with paranoia
and auditory hallucinations. Perona believed people at Zeller
were provoking him by coughing or crossing their legs, thereby
communicating to him that he had to take off his clothes. After
hearing testimony from Attaluri, the trial court entered an in-
voluntary recommitment order.
On March 19, 1997, the State's petition for involuntary
medication was heard. Perona was present and, as the hearing
began, he started unbuttoning his shirt. Attaluri told him he
must not do that, and the judge told him that if he wanted to at-
tend the hearing, he would have to remain clothed. Perona stated
"I don't want to attend it" and left the courtroom. The hearing
proceeded without Perona present.
According to Attaluri, Perona's illness resulted in a
deterioration of his ability to function. She testified Perona
refused to talk to her; his delusions continued, as did accompa-
nying auditory hallucinations. Attaluri testified Perona denied
he has a psychiatric illness and lacked the ability to make a
reasoned decision for himself as to whether it was in his best
interest to take medication.
According to the doctor, Perona started demonstrating
signs of depression in addition to his psychoses. Attaluri tes-
tified an aide at Zeller recently found Perona lying naked in
his room, hoping someone would come and "do something and then
everything would be back to normal like *** he was four years
ago." Frequently in the past month, Perona has refused to eat.
For two weeks prior to the hearing, he had been eating at least a
meal a day, but he was still losing a lot of weight. Perona had
been on an antidepressant earlier, but Attaluri discontinued it
once Perona stopped eating regularly because the drug caused
hypotension.
Attaluri testified Perona showed improvement in Janu-
ary, when he was on Olanzapine, a neuroleptic drug that was
crushed into his food, but his condition worsened when she start-
ed giving him the drug in pills. Attaluri suspected he stopped
taking it. Attaluri testified Perona's condition fluctuated, but
this was accounted for by his fluctuating compliance with the
medication regimen. Attaluri testified Perona had been taking
medication for 10 days prior to the hearing. He showed no signs
of improvement, but Attaluri testified this was because of the
delay before the medication takes effect. The morning of the
hearing the prior medication order expired and Perona refused to
take his medication.
Attaluri testified the benefits of psychotropic medica-
tion would outweigh the side effects. She had attempted to treat
Perona using outpatient therapy and both individual and group
counseling. However, she found medication was necessary for
Perona to improve. Attaluri testified she would be able to moni-
tor for possible harm or side effects at the hospital.
Perona's attorney rested without presenting evidence.
The judge stated that the evidence was clear and convincing,
there was a need for administration of psychotropic medicine, and
the order would not exceed 90 days. Perona appeals both the
March 12 and the March 19 orders.
II. ANALYSIS
A. The Recommitment Order
1. Compliance With Section 3-806
On appeal, Perona first argues the trial court failed
to comply with section 3-806 because it did not find his atten-
dance would subject him to a substantial risk of serious physical
or emotional harm. Section 3-806 provides, in pertinent part:
"(a) The respondent shall be present at
any hearing held under this Act unless his
attorney waives his right to be present and
the court is satisfied by a clear showing
that the respondent's attendance would sub-
ject him to substantial risk of serious phys-
ical or emotional harm.
"(b) *** If the recipient's attorney
advises the court that the recipient refuses
to attend, the hearing may proceed in his or
her absence.
"(c) No inference may be drawn from the
recipient's non-attendance pursuant to either
subsection (a) or (b) of this Section."
(Emphasis added.) 405 ILCS 5/3-806 (West
1996).
It is undisputed that the trial court did not make a finding of
substantial risk of harm, as required by section 3-806(a). How-
ever, this finding is not required by the text of section 3-
806(b). The comments of Perona's counsel at the March 12 hearing
indicate this case falls squarely within this provision. Section
3-806(c) demonstrates these two provisions provide distinct meth-
ods for a proceeding to continue in a respondent's absence. Sec-
tion 3-806(a) demonstrates the legislature knew how to impose a
requirement of a finding of substantial harm and chose not to in
cases where the respondent refuses to attend. See Village of
Southern View v. County of Sangamon, 228 Ill. App. 3d 468, 473,
592 N.E.2d 639, 642 (1992) (where a particular provision appears
in a statute, the failure to include that same requirement in
another section of the statute will not be deemed to have been
inadvertent).
2. Constitutional Challenge to Section 3-806
Citing this court's recent opinion in In re Branning,
285 Ill. App. 3d 405, 674 N.E.2d 463 (1996), Perona next argues
section 3-806 of the Code violates both his procedural and sub-
stantive due process rights by allowing a hearing to continue in
his absence without adequate assurances his waiver of the right
to be present is voluntary. While procedural due process governs
the methods by which a protected interest may be deprived, sub-
stantive due process imposes absolute limits on the state's abil-
ity to act without regard to any procedural protections in place.
Collins v. City of Harker Heights, 503 U.S. 115, 125, 117 L. Ed.
2d 261, 273, 112 S. Ct. 1061, 1068 (1992); Dennis E. v. O'Malley,
256 Ill. App. 3d 334, 349, 628 N.E.2d 362, 373 (1993).
We address only Perona's procedural due process claim.
Where a due process claim framed by a party in terms of substan-
tive due process is better resolved under procedural due process
standards, it is within the authority of a court of review to re-
structure its analysis accordingly. See Gasick v. O'Connor, 201
Ill. App. 3d 1013, 1017, 559 N.E.2d 574, 577 (1990). Branning
dealt with the constitutionality of a part of the Code that al-
lowed a caregiver to give consent for a respondent to be subject-
ed to electroconvulsive therapy. While our decision in Branning
relied in part on substantive due process, that case implicated
the fundamental substantive right to refuse psychotropic treat-
ment. Branning, 285 Ill. App. 3d at 411-12, 674 N.E.2d at 468,
citing In re C.E., 161 Ill. 2d 200, 214, 641 N.E.2d 345, 351
(1994). Here, by contrast, Perona seeks additional procedural
protections for waiver of his procedural right to be present.
While the procedural right to be present may relate to the sub-
stantive right to be free from unwanted treatment, Perona has
presented no precedent or argument as to this relationship. To
the extent Perona's claim arises under substantive due process,
Perona has waived the issue by failing to brief it adequately.
155 Ill. R. 341(e)(7).
Perona's procedural due process argument does not
clearly indicate whether his constitutional attack on section 3-
806 is a facial attack or an attack on the statute as applied to
him. However, the record does not demonstrate, and Perona does
not allege, that his waiver of the right to attend was, in fact,
involuntary. Consequently, we assume Perona's constitutional
attack is a facial one. To survive a facial challenge, the pro-
cedures a statute provides must at least be adequate to authorize
the liberty deprivation with respect to some of the persons sub-
ject to it. United States v. Salerno, 481 U.S. 739, 751, 95 L.
Ed. 2d 697, 711, 107 S. Ct. 2095, 2103 (1987); Branning, 285 Ill.
App. 3d at 412-13, 674 N.E.2d at 469. The second district re-
cently declared both sections 3-806(a) and (b) facially uncon-
stitutional on procedural due process grounds. See In re Barbara
H., 288 Ill. App. 3d 360, 370-71, 680 N.E.2d 471, 478 (1997).
Barbara H. declared section 3-806(a) unconstitutional
only after an extensive analysis of pertinent federal precedent.
See Barbara H., 288 Ill. App. 3d at 368-70, 680 N.E.2d at 476-78,
discussing Doremus v. Farrell, 407 F. Supp. 509 (D. Neb. 1975),
Suzuki v. Quisenberry, 411 F. Supp. 1113, 1129 (D. Haw. 1976),
Bell v. Wayne County General Hospital, 384 F. Supp. 1085 (E.D.
Mich. 1974), and Kendall v. True, 391 F. Supp. 413 (W.D. Ky.
1975). Under this line of cases, due process requires a patient
to be present at a civil commitment hearing unless the right is
intelligently waived by himself and counsel (Doremus, 407 F.
Supp. at 515), and may not be waived by a third party acting in
what he perceives to be the best interest of the recipient (see
Bell, 384 F. Supp. at 1094). The Barbara H. court also relied on
the similar holding in Branning (285 Ill. App. 3d 405, 674 N.E.2d
463).
However, the Barbara H. court's analysis of section 3-
806(b) was less detailed. The court simply incorporated its
constitutional analysis of section 3-806(a) and concluded subsec-
tion (b) unconstitutionally allowed a commitment hearing to pro-
ceed after a recipient refused to attend, with no showing the
refusal was knowing or intelligent. Barbara H., 288 Ill. App. 3d
at 372-73, 680 N.E.2d at 479-80. For the reasons stated below,
we disagree with the portion of Barbara H. that invalidates sec-
tion 3-806(b). Unlike section 3-806(a) and the statutory provi-
sion at issue in Branning, subsection (b) does not authorize a
third party to make decisions for the respondent. Instead, sec-
tion 3-806(b) relates to a respondent's own actions, his refusal
to attend, as related to the court through his counsel. 405 ILCS
5/3-806(b) (West 1996).
The Supreme Court of Illinois has addressed the stan-
dard for evaluating facial attacks on procedural due process
grounds since the decision in Barbara H.. East St. Louis Federa-
tion of Teachers Local 1220 v. East St. Louis School District No.
189 Financial Oversight Panel, 178 Ill. 2d 399, 687 N.E.2d 1050
(1997). In East St. Louis Federation, the court rejected an
argument that a statute was facially unconstitutional because it
failed to provide members of a local school board with a hearing
before they could be dismissed by a government panel, even though
the due process clause guaranteed them the right to a hearing.
The court reasoned that, even though the statute did not require
a hearing, the statute survived a facial attack because it did
not bar the panel from conducting a hearing and, therefore, could
operate constitutionally as to some school board members. East
St. Louis Federation, 178 Ill. 2d at 421, 687 N.E.2d at 1063.
Given East St. Louis Federation, it is difficult to
raise a succesful facial attack on a statute on procedural due
process grounds. As long as a statute allows a government body
to provide adequate protection for a constitutionally protected
interest, it need not specifically mandate such protections in
every case. Further, reviewing courts are to presume statutes
are constitutional and will construe them so as to uphold them
when it is reasonably possible to do so. Wilson v. Department of
Revenue, 169 Ill. 2d 306, 310, 662 N.E.2d 415, 417 (1996).
Deciding whether a statutory procedure comports with
procedural due process involves a three-part analysis: first, we
ask whether there exists a liberty or property interest that has
been interfered with by the state; second, we examine the risk of
an erroneous deprivation of such an interest through procedures
already in place, while considering the value of additional safe-
guards; and third, we examine the effect the administrative and
monetary burdens of additional procedures would have on the
state's interest. Mathews v. Eldridge, 424 U.S. 319, 335, 47 L.
Ed. 2d 18, 33, 96 S. Ct. 893, 903 (1976); East St. Louis Federa-
tion, 178 Ill. 2d at 415-16, 687 N.E.2d at 1060.
It has long been recognized that procedural due process
guarantees a respondent the right to be present at his hearing in
order to protect his liberty interest. See Specht v. Patterson,
386 U.S. 605, 610, 18 L. Ed. 2d 326, 330, 87 S. Ct. 1209, 1212
(1967). However, respondents may waive their constitutional
rights. People v. Johnson, 75 Ill. 2d 180, 187, 387 N.E.2d 688,
691 (1979). A waiver of constitutional rights must be not only a
voluntary act, but also a knowing, intelligent act done with suf-
ficient awareness of the relevant circumstances and likely conse-
quences. Johnson, 75 Ill. 2d at 187, 387 N.E.2d at 691, quoting
Brady v. United States, 397 U.S. 742, 748, 25 L. Ed. 2d 747, 756,
90 S. Ct. 1463, 1469 (1970).
The risk of an erroneous deprivation of a respondent's
right to be present is not high. It is true that a party to a
commitment proceeding may have mental difficulties that affect
his ability to waive his constitutional rights. However, parties
are presumed competent until proved otherwise. See People ex
rel. Drury v. Catholic Home Bureau, 34 Ill. 2d 84, 95, 213 N.E.2d
507, 512-13 (1966). This is true even if, as here, the respon-
dent has been involuntarily committed in the past but the com-
mitment order has expired. See Drury, 34 Ill. 2d at 95, 213
N.E.2d at 512-13.
We must examine the risk of erroneous deprivation in
the context of the procedural safeguards already existing in the
statute. Mathews, 424 U.S. at 541, 84 L.Ed. 2d at 503, 105 S.
Ct. at 1492; East St. Louis Federation, 178 Ill. 2d at 419, 687
N.E.2d at 1061. The Code provides several safeguards to ensure a
respondent's refusal to attend is voluntary. The court must pro-
vide the respondent personal notice of his legal status and his
right to counsel and a hearing. 405 ILCS 5/3-205 (West 1996).
Both the respondent and his attorney must be given notice of the
time and place of the hearing. 405 ILCS 5/3-706 (West 1996).
The statutory right to counsel has been interpreted by this court
to include a right to effective assistance of counsel analogous
to the right to counsel guaranteed by the sixth amendment in
criminal proceedings. In re Carmody, 274 Ill. App. 3d 46, 54-55,
653 N.E.2d 977, 983-84 (1995). In this facial attack, we must
assume these protections have been provided and, accordingly, the
attorney is acting in good faith, has informed his client of the
consequences of his decision, and is making a truthful statement
at the request of his client.
Next we examine the specific procedure Perona seeks.
Perona would require the court to question the respondent regard-
ing his desire not to attend or otherwise assure itself by per-
sonal observation of the respondent that he is competent to make
this decision. The extra costs--to both respondents and the
State--of this procedure are high in comparison to any additional
protection this would provide. This would effectively require
any respondent to be present before he can waive his right to be
present. The competent respondent's right to refuse to attend at
all would be eliminated.
More important, requiring attendance at any point would
encourage--if not require--caregivers to physically force an
unwilling respondent to attend. This would create a high risk of
physical injury to the respondent and his caregivers, increase
the cost of care, and infringe even further on the respondent's
personal liberty. If the petition or representations of the
respondent's counsel indicate these costs are warranted, the
court clearly has the authority to require the respondent's at-
tendance. See 405 ILCS 5/3-706 (West 1996). We cannot conclude
due process requires the respondent's presence in every case
before a waiver is valid.
In In re Denby, 273 Ill. App. 3d 287, 290-91, 653
N.E.2d 73, 75-76 (1995), this court held that, absent specific
conduct at a hearing demonstrating confusion or delusional
thought processes, a court could allow a respondent to waive his
right to counsel at recommitment hearing without first question-
ing him as to his capacity. This case is even more favorable to
the state since it does not involve a pro se litigant entitled to
special protection under the law. See In re Click, 196 Ill. App.
3d 413, 423, 554 N.E.2d 494, 500 (1990); Caruth v. Pinkney, 683
F.2d 1044 (7th Cir. 1982).
Alternatively, Perona would require input from a medi-
cal professional as to a respondent's ability to waive his
rights. The Code allows the court to appoint a physician to
examine the respondent and make a detailed report of his condi-
tion. See 405 ILCS 5/3-803 (West 1996). However, requiring a
report on the issue of capacity to waive the right to be present
in every case would also cause great expense in exchange for lit-
tle gain. Again, respondents are presumed competent, and a
respondent's attorney may inform the court if he believes his
client did not understand the notice or make an informed deci-
sion.
The due process right to be present at a commitment
proceeding has been referred to as closely related to the sixth
amendment right to be present at a criminal trial. See Bell, 384
F. Supp. at 1094. Under the sixth amendment, a defendant's re-
fusal to attend is enough to constitute a valid waiver of the
right to be present, without any additional showing the refusal
was knowing and intelligent. See Taylor v. United States, 414
U.S. 17, 18-19, 38 L. Ed. 2d 174, 177, 94 S. Ct. 194, 194 (1973);
People v. Owens, 102 Ill. 2d 145, 156-57, 464 N.E.2d 252, 258
(1984).
We find no basis in this case for creating a higher
standard for waiver of the due process right to be present at a
hearing than for waiver of the sixth amendment right to be pres-
ent at trial. A civil commitment is nonpunitive and lasts only
so long as is necessary to address a respondent's problems.
Because this is a lesser intrusion on the liberty of the respon-
dent than a criminal conviction, it triggers lesser procedural
due process rights. United States v. Baker, 45 F.3d 837, 844
(4th Cir. 1995). Any argument that the respondent's mental prob-
lems giving rise to the commitment proceeding may affect his
ability to make an informed, rational choice is negated by the
presumption of competence and the court's power to allow addi-
tional inquiry depending on the nature of the petition.
Perona argues the sixth amendment cases are distin-
guishable because he was never given an admonishment that the
hearing would go forward in his absence even if he chose not to
attend. Though such an admonishment is required by statute in
criminal proceedings (725 ILCS 5/113-4(e) (West 1996); People v.
Garner, 147 Ill. 2d 467, 483, 590 N.E.2d 470, 477 (1992)), it is
not required as a constitutional matter (Taylor, 414 U.S. at 19-
20, 38 L. Ed. 2d at 177-78, 94 S. Ct. at 195-96).
We stress that we are not holding additional assurances
of a voluntary waiver of the right to be present are never re-
quired by due process. We only hold that the Code provides suf-
ficient safeguards that the provisions allowing for waiver by
refusal to attend are not facially unconstitutional.
C. The Medication Order
Perona also challenges the trial court order subjecting
him to involuntary psychotropic medication under section 2-107.1
of the Code. 405 ILCS 5/2-107.1 (West 1996). Perona first ar-
gues an order under section 2-107.1 of the Code was premature
because there was no showing that he in fact refused to accept
treatment. Section 2-107.1 applies only when it is necessary to
administer psychotropic medication to an adult against his will.
405 ILCS 4/2-107.1(a) (West 1996). However, Attaluri's uncon-
tested testimony was that Perona refused to take his medication
in the past and again the morning of the hearing, after the prior
medication order had expired.
Perona next argues the evidence was insufficient to
support the trial court's judgment. Section 2-107.1 provides, in
pertinent part:
"Psychotropic medication shall not be
administered to the recipient unless it has
been determined by clear and convincing evi-
dence that all of the following factors are
present:
(A) That the recipient has a
serious mental illness or develop-
mental disability.
(B) That because of said men-
tal illness or developmental dis-
ability, the recipient exhibits
deterioration of his ability to
function, suffering, or threatening
or disruptive behavior.
(C) That the illness or dis-
ability has existed for a period
marked by the continuing presence
of the symptoms set forth in item
(B) of this subdivision *** or the
repeated episodic occurrence of
these symptoms.
(D) That the benefits of the
psychotropic medication will out-
weigh the harm.
(E) That the recipient lacks
the capacity to make a reasoned
decision about the medication.
(F) That other less restric-
tive services have been explored
and found inappropriate." 405 ILCS
5/2-107.1(a)(4) (West 1996).
Even though this section requires proof "by clear and convincing
evidence," great deference is given to the trier of fact, and re-
versal is only warranted when its decision is manifestly errone-
ous. In re Brazelton, 245 Ill. App. 3d 1028, 1033, 615 N.E.2d
406, 408 (1993).
We find no manifest error here. The testimony of a
single, uncontested expert witness, in conjunction with the
recipient's own behavior in court, is sufficient to meet the
State's burden of proof. See Brazelton, 245 Ill. App. 3d at
1033, 615 N.E.2d at 409. Attaluri's testimony that Perona had a
serious mental illness related to all of the factors listed in
section 2-107.1. She testified nonmedical services such as coun-
seling had been attempted, but were unsuccessful.
The trial court could reasonably conclude Perona's
ability to function had deteriorated and that he was exhibiting
disruptive behavior. Perona's inability to remain both present
and clothed demonstrated this and Attaluri's testimony estab-
lished this conduct was recurring. While Perona's conduct may
not subject him to risk while inside Zeller, it can still be
considered in determining his overall ability to function. See
Brazelton, 245 Ill. App. 3d at 1033, 615 N.E.2d at 409 (when
assessing ability to function, court could consider prehospital-
ization incident in which recipient responded to delusions while
driving by almost driving off a bridge). Moreover, Attaluri
testified Perona was depressed and had stopped eating regularly
as well, demonstrating that his illness had begun to inhibit his
functioning within the hospital.
Attaluri testified the benefits of the medication out-
weighed the harm. For medical testimony to be clear and convinc-
ing, it is sufficient if the expert indicates the basis of his
diagnosis by having directly observed the recipient on several
occasions. In re Schaap, 274 Ill. App. 3d 497, 502, 654 N.E.2d
1084, 1087 (1995). A State expert's opinion need not include
factual support. In re Jeffers, 239 Ill. App. 3d 29, 36-37, 606
N.E.2d 727, 732 (1992), aff'd after remand, 272 Ill. App. 3d 44,
47, 650 N.E.2d 242, 245 (1995). Perona attempts to undercut
Attaluri's testimony, arguing he had been taking the medication
for 10 days prior to the petition and yet his condition did not
improve. However, Attaluri also testified the medication did not
take effect immediately and Perona's behavior had improved after
prior extended use of Olanzapine.
Perona argues he was to be subjected to drugs different
from those he was subjected to in the past. It is not necessary
for a respondent to have tried a particular regimen of medicine
before in order for his doctor to make a valid determination its
benefits would outweigh the harm it imposed. See Schaap, 274
Ill. App. 3d at 499, 654 N.E.2d at 1085. The expert's opinion
alone is prima facie proof the benefits of a medication plan
outweigh the harm. Jeffers, 239 Ill. App. 3d at 36-37, 606
N.E.2d at 732. However, an order allowing psychotropic drugs
cannot be based on a new regimen so poorly defined that the ex-
pert could not have meaningfully weighed the benefits and harm
involved. See In re Kness, 277 Ill. App. 3d 711, 720-21, 661
N.E.2d 394, 399-400 (1996).
In this case, the trial court properly relied on
Attaluri's opinion. The regimen was not entirely new. Perona
had been on different neuroleptic drugs before, including
Olanzapine, which Attaluri wanted to continue. Perona had been
on antidepressants before. The only aspect of Attaluri's pro-
posed regimen that was entirely new was a second drug, either
Prolixin or Haldol. While Attaluri did not specify which drug
would be used, she did narrow it down to those two, both neuro-
leptic drugs, and Perona presented no evidence they had different
side effects. Attaluri testified that two neuroleptic drugs were
used together on rare occasions because they were more effective
together. There was no evidence of any potential negative inter-
action effects between the medications in the new regimen.
Attaluri testified Perona lacked the capacity to make a
reasoned decision regarding administration of psychotropic medi-
cation. The record supports a finding that Perona did not under-
stand the benefits of treatment. Attaluri testified Perona no
longer acknowledged he had a mental illness, did not believe his
hallucinations or unhealthy eating habits were a problem, and
refused to talk about them. See Kness, 277 Ill. App. 3d at 719,
661 N.E.2d at 399 (recipient lacked ability to make reasoned
decisions about medication, partially because he did not acknowl-
edge he was suffering from mental illness). Perona did not pres-
ent any rational explanation for his refusal to take the medica-
tions. Cf. In re Israel, 278 Ill. App. 3d 24, 39, 664 N.E.2d
1032, 1041 (1996).
III. CONCLUSION
For all of the reasons stated, we affirm.
Affirmed.
GREEN and STEIGMANN, JJ., concur.
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