PRESIDING JUSTICE MYERSCOUGH delivered the opinion ofthe court:

In November 2002, the State named respondent, StevenP., in a petition for involuntary administration of drugs and theuse of electroconvulsive therapy (ECT) due to his mental condition. Following a hearing, the trial court granted the petitionauthorizing ECT and involuntary administration of medication.

On appeal, respondent argues (1) the State failed toprove by clear and convincing evidence that less-restrictiveservices other than ECT were inappropriate to treat his condition, and (2) he was not advised in writing of the side effects,benefits, and alternatives to the proposed treatment. We affirm.

I. BACKGROUND

In November 2002, the State named respondent in apetition for administration of authorized involuntary treatmentbased on his suffering from a serious mental illness, namely,bipolar affective disorder with psychotic symptoms and manicstate. Because of his illness, respondent exhibited deterioration of his ability to function, remained delusional, and wasunable to weigh the risks and benefits of treatment, and hisintermittent use of medication had not improved his symptoms. Inthe petition, Dr. Hayng-Sung Yang found respondent to be in needof involuntary treatment because the benefits of treatmentoutweighed the harm, he lacked the capacity to make a reasoneddecision about treatment, and other, less-restrictive serviceswere explored and found inappropriate. Dr. Yang indicated theadministration of ECT and psychotropic medication were essentialfor the safe and effective administration of treatment.

The trial court conducted a hearing on the petition. Dr. Yang testified he has been a psychiatrist since 1974. Hestated respondent came under his care at the Provena CovenantMedical Center psychiatric unit about three weeks prior to thehearing. During his care, Dr. Yang found respondent to be"religiously delusional," believing himself to be in perfecthealth. Respondent thinks he is depressed while "showing [a]rather elated, excited, [and] irritable mood." Dr. Yang diagnosed respondent with manic depression, a manic condition withpsychotic symptoms. Respondent did not show much improvementbecause he did not regularly take his medication. Dr. Yangopined respondent's mental illness rendered him incapable ofrationally weighing the risks and benefits involved in thetreatment options available to him.

Dr. Yang recommended ECT, which he stated is used whena patient is extremely depressed, suicidal, or suffering from amanic condition. Dr. Yang stated respondent had no other alternative because he refused to take oral medication, such asDepakote, lithium, and Tegretol, to improve his manic condition. He also sought court authority to administer a number of drugs,including Zyprexia (a mood stabilizer), lithium carbonate,Depakote, Haldol Decanoate, and Cogentin (to alleviate the sideeffects of Haldol).

Respondent testified he no longer needed Depakote orlithium, but instead he needed to go home and have "more homecooking." He stated he was forced to take pills every day andsuffered from screaming, throwing up, and shaking in the night. Respondent indicated the lithium "makes [his] mind unclear." Further, he had ECT about five years ago and it "helped [him]somewhat."

The State sought authority to administer for 90 daysECT for a maximum of 12 times, Zyprexia, lithium carbonate,Depakote, Cogentin, Haldol Decanoate, general anesthesia, restraints, and blood tests. The trial court found by clear andconvincing evidence that respondent has a serious mental illness,exhibiting a deterioration of his ability to function thatexisted for a period of time marked by the continuing presence ofthe symptoms. The court also found the benefits of the treatmentoutweighed the harm and other, less-restrictive services wereexplored and found inappropriate. The court then authorized theadministration of ECT and the various medications. Following theappointment of the Guardianship and Advocacy Commission asrespondent's counsel, this appeal followed.

II. ANALYSIS

Respondent argues the State failed to prove by clearand convincing evidence that he lacked the capacity to make areasoned decision about his treatment because he was not advisedin writing of the side effects, risks, benefits, and alternativesto the proposed treatment as required by law. We disagree eventhough the State concedes this issue.

To administer authorized involuntary treatment, theState must prove by clear and convincing evidence that, interalia, the recipient lacks the capacity to make a reasoned decision about the treatment. In re Edward S., 298 Ill. App. 3d 162,166, 698 N.E.2d 186, 188 (1998). When reviewing the sufficiencyof the evidence, the trial court's decision will be reversed onlyif it is against the manifest weight of the evidence. In reRichard C., 329 Ill. App. 3d 1090, 1094, 769 N.E.2d 1071, 1075(2002). "A judgment is against the manifest weight of theevidence when the opposite conclusion is clearly evident, plain,and indisputable." In re Cathy M., 326 Ill. App. 3d 335, 341,760 N.E.2d 579, 585 (2001).

Section 2-107.1(a)(4)(E) of the Mental Health andDevelopmental Disabilities Code (Code) provides the State mustprove the respondent lacked the capacity to make a reasoneddecision about the treatment. 405 ILCS 5/2-107.1(a)(4)(E) (West2000). A necessary predicate to making this informed decision isthat the respondent must be informed of the risks and benefits ofthe medication and treatment. Cathy M., 326 Ill. App. 3d at 341,760 N.E.2d at 585. To that end, the Code states:

"If the services include the administration of authorized involuntary treatment, thephysician or the physician's designee shalladvise the recipient, in writing, of the sideeffects, risks, and benefits of the treatment, as well as alternatives to the proposedtreatment, to the extent such advice is consistent with the recipient's ability tounderstand the information communicated." 405 ILCS 5/2-102(a-5) (West 2000).

In Cathy M., the evidence showed respondent was givenno written or oral advice about the medications' side effects. The treating psychiatrist so testified. The doctor never spokewith respondent about the side effects because she walked awaywhen he spoke to her. For that reason, the court found writtennotice was required to provide the minimal amount of noticerequired under the Code.

"In this cause, *** the written informationshould have been given to respondent precisely because respondent refused to discussthe matter with Dr. Anwar when she left thediscussion before Dr. Anwar could adviserespondent about the medications' risks andbenefits. By giving respondent the writteninformation, she would have been afforded theminimal amount of notice that was requiredunder the Code." Cathy M., 326 Ill. App. 3dat 343, 760 N.E.2d at 586.

In contrast, in In re Barry B., 295 Ill. App. 3d 1080,1086, 693 N.E.2d 882, 885 (1998), the respondent refused tolisten to the doctor when the doctor told respondent about histreatment options. So, therefore, through the respondent's ownactions, the side effects were not discussed meaningfully. Butsee In re John R., 339 Ill. App. 3d 778, 792 N.E.2d 350 (2003). In our case, the record is silent on written and oral attempts tonotify Steven P. of side effects. However, Steven P. was clearlypresent at the hearing and heard the doctor's testimony. He alsotestified and had previously taken most of these medications andreceived ECT treatment and been helped by both. In this hearing,respondent was adequately notified of the treatment requested.

No evidence was presented as to prior notification. Absent any objection, we assume the doctor complied with thestatute and did what he was required to do. Any absence ofwritten advice should have been raised in the trial court, whereit could have been addressed, and if there were a problem, itcould have been cured.

Respondent has forfeited the notification issue byfailing to raise it at the hearing or in a posttrial motion. People v. Bull, 185 Ill. 2d 179, 207, 705 N.E.2d 824, 838 (1998);People v. Enoch, 122 Ill. 2d 176, 185-86, 522 N.E.2d 1124, 1129(1988). Moreover, the evidence was clear and convincing thatrespondent could not make a rational choice whether to seektreatment for his mental illness or to weigh the risks andbenefits of the treatment options.

"Q. [MR. FLETCHER (Assistant State'sAttorney)]: In your expert opinion is Mr.Prye capable of making an informed and rational choice about whether to seek medicaltreatment for his mental illness?

A. [DR. HAYNG-SUNG YANG]: No.

Q. In your expert opinion is he capableof rationally weighing the risks and benefitsinvolved in the treatment options availableto him?

A. No.

Q. And that's because of mental illness?

A. Yes.

Q. Okay. You indicated that [respondent] in the past has not been willing toreceive treatment for his mental illness. Doyou now have any reason to believe he wouldbe cooperative now?

A. Last [sic] December he has not shownany cooperation for the treatment, what Ibelieve that will work for him, and the lastthree years he has been in and out of thepsychiatric hospital. I was told that he wasnot cooperating with treatment, even beforehe became my patient."

Therefore, the State has shown by clear and convincing evidencethat respondent's emotional state prevented him from being ableto understand the risks and benefits of medication.

Recently, in In re Christopher P., No. 5-02-0198, slipop. at 7 (July 29, 2003), _ Ill. App. 3d, _ , _ N.E.2d _ , theFifth District recognized the error of its previous decisions,which held the risk-benefit information must always be in writingbefore forced medication may be authorized, and concluded:

"[A] circuit court must determine, based uponcompetent medical testimony, whether thepatient has the ability to understand therisks and benefits of treatment or if thepatient has pathological perceptions or beliefs that prevent him from understanding theinformation. If the patient lacks this ability, there is no requirement, by statute,that he be given written advisements of theseoptions, advantages, and disadvantages."Christopher P., slip op. at 8, __ Ill. App.3d at __, __ N.E.2d at __ .

However, in Christopher P., the court found the State had failedto show by clear and convincing evidence that respondent lackedthe capacity to understand the risks and benefits of the medication.

Under these circumstances, the advice to respondentabout the involuntary treatment did not have to be in writing. The language in the statute actually contemplates this situationwhere respondent cannot comprehend written advice--"shall advise*** to the extent such advice is consistent with the recipient'sability to understand the information communicated." 405 ILCS5/2-102(a-5) (West 2000). Moreover, the options available weremade clear to respondent in the hearing, and, therefore, anyerror was harmless.

Finally, the State did clearly and convincingly proveless-restrictive services were inappropriate. Psychotropicmedications, a less-restrictive treatment, were not available andappropriate here. Dr. Yang, respondent, and respondent's counselconcede that respondent refused to take the psychotropic medications, and respondent had not improved during his hospital stay.

III. CONCLUSION

For the reasons stated, we affirm the trial court'sjudgment.

Affirmed.

COOK, J., concurs.

TURNER, J., dissents.

JUSTICE TURNER, dissenting:

I respectfully dissent. The State concedes the trialcourt's order must be vacated, and the State's concession is forgood reason. If the respondent is not informed in writing of therisks and benefits of the medication and treatment, the court'sorder for the involuntary administration of medication or therapymust be reversed. See Cathy M., 326 Ill. App. 3d at 342, 760N.E.2d at 585; Edward S., 298 Ill. App. 3d at 166, 698 N.E.2d at188.

In the case sub judice, Dr. Yang did not indicate heinformed respondent either orally or in writing as to the benefits and risks of drug therapy or ETC. A review of the recordsupports the State's concession that it failed to prove respondent was informed of the risks and benefits of the proposedtreatment as required by the Code. Thus, the trial court erredin ordering respondent to be subjected to the involuntary administration of ECT and medication. I would, therefore, accept theState's concession and reverse the trial court's judgment.

In support of its conclusion that strict compliancewith the statute was not necessary, the majority cites only abrief segment of Dr. Yang's testimony. Slip op. at 7-8. WhenDr. Yang was asked if respondent was "'capable of rationallyweighing the risks and benefits involved in the treatment optionsavailable to him,'" the doctor opined "'No.'" Slip op. at 7. This is hardly surprising inasmuch as the doctor initiated thepetition. Neither the question posed to the doctor, nor thedoctor's response, addresses the ultimate issue of whether thedoctor advised respondent in writing (or otherwise) of the sideeffects, risks, and benefits of the treatment, as well as alternatives. Nonetheless, the majority concludes that under thecircumstances of this case, "the advice to respondent about theinvoluntary treatment did not have to be in writing. The language in the statute actually contemplates this situation whererespondent cannot comprehend written advice ***." Slip op. at 9. This generous interpretation of the statutory language ignoresthe important liberty interests of respondent and any similarlysituated recipients involved in mental health cases. See In reJill R., 336 Ill. App. 3d 956, 963, 785 N.E.2d 46, 52 (2003)(recognizing "a compelling need for strict compliance withstatutory requirements in mental health cases because commitmentis involuntary and liberty interests are involved"); In reLanter, 216 Ill. App. 3d 972, 974, 576 N.E.2d 1219, 1220 (1991).

Under the majority opinion, the same physician whotreats the recipient may petition for involuntary treatment,testify to the allegations set forth in the petition, and ignorethe mandatory language of the statute by opining that the recipient would not have understood the advice anyway. This rendersthe statutory mandate utterly meaningless and should not becountenanced by this court, particularly in instances like thecase now before us. Here, respondent, a former law professor atthe University of Illinois, was capable of articulating andexpressing his thoughts and anxieties. His testimony, thoughrambling, demonstrates he was lucid, and more important, notincapable of comprehending the written advice required by thestatute. Under these facts, I conclude there is no reason todeviate from the statutory requirement to advise respondent ofthe risks and benefits of the proposed treatment.

In Jill R., 336 Ill. App. 3d at 964, 785 N.E.2d at 52,the respondent argued on appeal that the State failed to proveshe lacked the capacity to make a reasoned decision about medication, alleging the State failed to present sufficient proof shewas informed of the risks and benefits of the medication inwriting. This court disagreed, noting the respondent received awritten statement advising her of the benefits and side effectsof the medication. Jill R., 336 Ill. App. 3d at 964, 785 N.E.2dat 52. Further, the multidisciplinary treatment plan contained asigned statement that the benefits and potential side effects ofmedications had been discussed with the respondent and providedin writing, along with informing her of the right to refusemedication. Jill R., 336 Ill. App. 3d at 964, 785 N.E.2d at 52. Here, the State offered nothing to show respondent was informedeither in writing or orally of the risks and benefits of theproposed treatment as required by the Code.

Although I would reverse the trial court, I acknowledgethe record as a whole appears to justify the trial court'sultimate determination to allow the administration of the recommended treatment. The trial court no doubt considered thevoluntary testimony of respondent and rendered a judgment itdeemed would best serve respondent. However, bad facts make badlaw, and the majority, in my opinion, today establishes ill-advised precedent, which obviates a logical and commonsensestatutory requirement that recipients should be advised of thebenefits and detriments of the treatment proposed to be administered to them.

As a final matter, I strongly disagree with the majority's dicta that it will presume the doctor complied with thestatute absent evidence to the contrary. Slip op. at 6. "Thatthe statutory procedures may have been followed offers littlecertainty that respondent's liberty interests have, in fact, beensafeguarded." (Emphasis in original.) In re Luttrell, 261 Ill.App. 3d 221, 229, 633 N.E.2d 74, 80 (1994). Moreover, such apresumption cannot be inferred from the statutory language, and Ifind no authority to support the majority's position.