JUSTICE APPLETON delivered the opinion of the court:

On or about June 17, 2001, defendant, Eldon Millard, aninmate at Pontiac Correctional Center (Pontiac), declared ahunger strike to protest his transfer from East Moline Correctional Center (East Moline). The Illinois Department of Corrections (Department) filed a complaint for injunctive reliefseeking authority to use reasonable and necessary force toadminister medical treatment and nutrition to defendant.

On September 10, 2001, after hearing evidence andargument of counsel, the trial court entered an order authorizingthe Department to force-feed defendant through the use of intravenous injections, a nasogastric tube, or a jejunostomy tube. OnSeptember 27, 2001, the trial court entered an amended order alsoauthorizing the Department to force-feed defendant through thesurgical implantation of a percutaneous endoscopic gastrostomy(PEG) tube. Defendant appeals, arguing his right to refusenourishment outweighs the Department's interests in preservinglife, preventing suicide, and maintaining the orderly prisonadministration. We affirm.

I. BACKGROUND

We review the testimony only to the extent necessary toput defendant's argument in context. According to the testimony,defendant began serving a three-year sentence for stalking onMarch 17, 1999. In October 2000, defendant was given one year'smandatory supervised release. In December 2000, he violated theterms of his release and was returned to prison to serve theremainder of his original sentence. Upon his return, defendantwas placed in East Moline, a minimum-security facility. There,he was housed in the health-care unit due to his numerous healthproblems, including obesity, coronary artery disease, hypertension, asthma, degenerative arthritis, and obstructive sleepapnea.

In January 2001, defendant was transferred to Pontiacfor medical reasons. Defendant had a tracheostomy tube, which,according to the manufacturer's recommendation, was scheduled tobe replaced. A surgeon in Joliet, Illinois, was trained toperform such replacements, and Pontiac was closer to the scheduled surgery site than East Moline. At Pontiac, defendant wasalso housed in the health-care unit; however, Pontiac is amaximum-security facility where inmates have considerably fewerprivileges. Within a few weeks of his transfer to Pontiac,defendant became obstinate, insulting, and threatening. Herefused all medical care. He was evaluated twice by a psychiatrist, who determined that defendant was competent to refusemedical treatment.

In February and March 2001, defendant was disciplinedfor refusing orders and for engaging in threatening and intimidating behavior. Defendant was placed in segregation within thehealth-care unit and lost his good-time credit, giving him a newdischarge date of February 16, 2002.

Beginning approximately June 17, 2001, defendant begana hunger strike (1) protesting his transfer to Pontiac, (2)objecting to having his tracheostomy tube replaced while in theDepartment's custody, and (3) claiming he was being wrongfullydetained beyond his discharge date. He vowed to continue hishunger strike until he (1) was sent back to East Moline, (2) wasreleased from prison, or (3) died.

On July 13, 2001, the Department filed an emergencymotion for a temporary restraining order and preliminary injunction requesting authority to use reasonable and necessary forceto monitor defendant's health and, if necessary, to administerlife-essential nutrition. The trial court entered a temporaryorder requiring defendant submit to one blood draw, one electrocardiogram, and a check of his vital signs. The Department wasnot granted any further authorization.

On July 17, 2001, the trial court heard testimony andargument on the Department's motion for preliminary injunctionand subsequently entered an order authorizing the Department tomonitor defendant's health condition and, if necessary, toadminister nutrition through intravenous and nasogastric tubes. On September 6, 2001, the Department filed a complaint forpermanent injunctive relief and the trial court conducted anevidentiary hearing. After two days of testimony, the trialcourt entered an order finding the Department's interests inpreserving life, preventing suicide, and maintaining the orderlyadministration of its correctional institutions outweigheddefendant's right to privacy. The trial court authorized theDepartment to monitor defendant's health and to administernutrition intravenously or through the use of nasogastric orjejunostomy tubes. Defendant appealed, docket No. 4-01-0857.

On September 21, 2001, the Department requested thetrial court amend its order to include the use of a PEG tube, aless-invasive approach, to administer nutrition to defendant. The trial court heard testimony from the Department's physician,who explained the procedure and benefits of the PEG tube. OnSeptember 27, 2001, the trial court amended its order to includethe use of a PEG tube. Defendant appealed, docket No. 4-01-0953. We consolidated the appeals.

II. ANALYSIS

During the pendency of this appeal, defendant wasreleased from prison. As of his release, it was no longer theDepartment's responsibility to provide medical care or nutritionto defendant, thereby rendering his claim moot. When events haveoccurred that make it impossible for the reviewing court torender effectual relief, a case is rendered moot. Marion Hospital Corp. v. Illinois Health Facilities Planning Board, 201 Ill.2d 465, 471, 777 N.E.2d 924, 927 (2002).

Despite the mootness of defendant's appeal, bothparties ask that we retain jurisdiction and decide the legalissues presented pursuant to the public interest exception to themootness doctrine. The criteria to invoke the public interestexception are (1) the public nature of the question, (2) thedesirability of an authoritative determination for the purpose ofguiding public officers, and (3) the likelihood that the questionwill generally recur. Johnson v. Edgar, 176 Ill. 2d 499, 513,680 N.E.2d 1372, 1378 (1997).

We agree with the parties that the issue in this casefalls within the public interest exception. The issue of whetherthe Department must force-feed a starving inmate against his willor allow the inmate to starve to death while committed to theDepartment is a matter of public importance. Further, this is acase of first impression in Illinois and the Department is inneed of guidance. Finally, the issue of the Department's roleduring an inmate's hunger strike is likely to recur. Thus, wewill decide the case on the merits and remove the uncertainty ofthe Department's role in similar situations.

This is a matter of weighing the Department's interest against defendant's or other inmates' constitutional rights. Constitutional questions, like other questions of law, arereviewed de novo. Quantum Pipeline Co. v. Illinois CommerceComm'n, 304 Ill. App. 3d 310, 314, 709 N.E.2d 950, 953 (1999).

In reviewing the trial court's force-feeding order ofSeptember 27, 2001, we, like the majority of courts that haveconsidered the question, hold that such an order does not violatea hunger-striking prisoner's constitutional rights. See, e.g.,In re Soliman, 134 F. Supp. 2d 1238 (N.D. Ala. 2001); In reGrand Jury Subpoena John Doe, 150 F.3d 170 (2d Cir. 1998); Stateex rel. Schuetzle v. Vogel, 537 N.W.2d 358 (N.D. 1995); Commonwealth v. Kallinger, 134 Pa. Commw. 415, 580 A.2d 887 (1990); Inre Caulk, 125 N.H. 226, 480 A.2d 93 (1984); State ex rel. Whitev. Narick, 170 W. Va. 195, 292 S.E.2d 54 (1982); In re Von Holden, 87 A.D.2d 66, 450 N.Y.S.2d 623 (1982).

Finding that the difficulties of prison administrationwarrant special consideration, the United States Supreme Courtarticulated a standard of review for prisoners' constitutionalclaims that is responsive both to the "'policy of judicialrestraint regarding prisoner complaints and [to] the need toprotect constitutional rights.'" Turner v. Safley, 482 U.S. 78,85, 96 L. Ed. 2d 64, 76, 107 S. Ct. 2254, 2259, (1987), Procunierv. Martinez, 416 U.S. 396, 406, 40 L. Ed. 2d 224, 236, 94 S. Ct.1800, 1808 (1974). When a prison regulation impinges on aninmate's constitutional right, the regulation is valid if it isreasonably related to legitimate penological interests. Turner,482 U.S. at 89, 96 L. Ed. 2d at 79, 107 S. Ct. at 2261. Thisdiffers from the strict standards of scrutiny applicable to theconstitutional rights of persons in a free society.

Defendant does not assert that his hunger strike is anexpression of his first amendment right to free speech and/orreligion. It would appear defendant's main purpose in refusingnutrients was to manipulate the system. Defendant claims thatforcing him to take in nutrients is a violation of his right toprivacy.

In Soliman, the court addressed the Immigration andNaturalization Service's authority to force-feed a hunger-striking detainee who alleged his right to privacy in objecting to theforced-feeding. The Soliman court stated:

"'Although the United States Constitutiondoes not specifically mention a right toprivacy, the Supreme Court has recently recognized it as an independent constitutionalright. The Court has grounded the right onat least three sources: common[-]law rights,emanations from specific constitutional provisions, and the general requirements of'liberty' underlying the Constitution.'" Soliman, 134 F. Supp. at 1254, quoting S.Bennett, The Privacy & Procedural Due ProcessRights of Hunger Striking Prisoners, 58N.Y.U. L. Rev. 1157, 1165 (1983).

Although forced-feeding may violate an inmate's rightto privacy, that right is outweighed by the Department's interests in the administration of our penal system. We agree withseveral state-court decisions that upheld the right to force-feedhunger-striking prisoners.

For example, in White, a convicted murderer began ahunger strike to protest the conditions at the prison. The WestVirginia Supreme Court recognized that the federal constitutionhas been interpreted to secure the right to privacy over one'sbody and that competent patients have been allowed to refusemedical treatment. The court held, nevertheless, that:

"West Virginia's interest in preservinglife is superior to White's personal privacy(severely modified by his incarceration) andfreedom of expression right. Our researchindicates that although only one appellatecourt has dealt with death resulting fromhunger strikes, they are common in prisonsthroughout the country. Their main aim is togain attention from prison officials andoccasionally from the public, to manipulatethe system. We cannot condemn fasting--Ghandi [sic] taught us about its force--as away to secure change. But prison officialsmust do their best to preserve White's life." White, 170 W. Va. at 199, 292 S.E.2d at 58.

In Caulk, the New Hampshire Supreme Court determinedthat a prison inmate had no constitutional right to starvehimself to death even though the decision to do so was madeknowingly and voluntarily. After noting that the inmate enjoyeda constitutional right to privacy, the court concluded that thestate interest in the maintenance of institutional security wasimplicated:

"In addition to necessitating specialtreatment for himself, the defendant's actions have the potential of causing morewidespread institutional problems. If thedefendant is successful in evading theprison's control over his behavior, this mayjeopardize prison discipline and tax prisonresources. [Citation.] We agree with the[s]tate that prison officials will lose muchof their ability to enforce institutionalorder if any inmate can shield himself fromthe administration's control and authority byannouncing that he is on a starvation diet. Prisoners are not permitted to live in accordance with their own desires, nor may they bepermitted to die on their own terms withoutadversely and impermissibly affecting the[s]tate's legitimate authority over inmates." Caulk, 125 N.H. at 231, 480 A.2d at 96.

In Caulk, the court concluded that the state's interests in preserving life, preventing suicide, and maintaining aneffective criminal justice system outweighed the prisoner's rightto privacy. Caulk, 125 N.H. at 232, 480 A.2d at 97. Similarlyin Kallinger, the court determined that an inmate did not havethe right to starve himself to death.

"The Commonwealth has an overwhelminginterest in maintaining prison security,order[,] and discipline. ***

Prison officials are given a wide rangeof discretion in the promulgation and enforcement of rules to govern the prison community in order to maintain security, orderand discipline. [Citations.] ***

* * *

In the present case, the uncontradictedtestimony shows that if Kallinger would bepermitted to die, other patients at Farview[State Hospital] would almost certainly copythe same tactic, manipulating the system toget a change of conditions, possibly resulting in their death. [Citation.] Allowing aprisoner to die will cause other patients tobecome angry and lose faith in the system andmake treatment more difficult; it may evenspawn rioting at Farview or from prisoners atHuntingdon or other state institutions.[Citation.] It is clear that allowing aprisoner to starve to death while in statecustody would have an unpredictable negativeeffect on the security and order within theprison system." Kallinger, 134 Pa. Commw. at421-22, 580 A.2d at 890-91.

The court also implicated the integrity of the medicalprofession and found that it must be factored into the balancingequation. The court concluded:

"The Commonwealth of Pennsylvania has anoverwhelming interest in the orderly administration of its prison system. The Commonwealth must maintain prison security, order[,] and discipline. It must also fulfillits duty to provide proper medical care tothe inmates, thus preserving life and preventing suicide. These vital interests,along with the need to preserve the integrityof the physicians and psychiatrists workingwithin the penal system, clearly outweigh anydiminished right to privacy held byKallinger." Kallinger, 134 Pa. Commw. at426, 580 A.2d at 893.

In contrast to the above cases is the Georgia case ofZant v. Prevatte, 248 Ga. 832, 286 S.E.2d 715 (1982). In Zant,the inmate decided to engage in a hunger strike to get theattention of the prison officials. The lower court determinedthat the state had no right to interfere with the inmate's hungerstrike:

"The [s]tate has no right to monitor thisman's physical condition against his will;neither does it have the right to feed him toprevent his death from starvation if that ishis wish.

***

*** The [s]tate can incarcerate one whohas violated the law and, in certain circumstances, even take his life. But it has noright to destroy a person's will by frustrating his attempt to die if necessary to make apoint." Zant, 248 Ga. at 834, 286 S.E.2d at716-17.

The Georgia Supreme Court affirmed the lower court'sdecision disallowing state interference, stating:

"Prevatte is not mentally incompetent, nordoes he have dependents who rely on him for ameans of livelihood. The issue of religiousfreedom is not present. Under these circumstances, we hold that Prevatte, by virtue ofhis right of privacy, can refuse to allowintrusions on his person, even though calculated to preserve his life. The [s]tate hasnot shown such a compelling interest in preserving Prevatte's life, as would overridehis right to refuse medical treatment." Zant, 248 Ga. at 834, 286 S.E.2d at 717.

We do not agree with Zant. The Georgia court failed toconsider compelling penological objectives such as the preservation of life, prevention of suicide, and the enforcement ofprison security, order, and discipline. We not only acknowledgethose interests of the Department, but hold that they are superior to the constitutional rights asserted by defendant in thiscase.

Defendant was not on a hunger strike as a means ofdemonstrating on behalf of some political cause or religiousbelief. His "cause," as is most commonly the case in hungerstrike situations in prison, was to manipulate the system, togain the attention of prison officials with the hope of makinghis confinement easier. We do not condone such manipulativebehavior in our prison system. At the same time, however, werespect an individual's right to privacy and the right to controlone's own body. See Thor v. Superior Court, 5 Cal. 4th 725, 734-38, 855 P.2d 375, 380-83, 21 Cal. Rptr. 2d 357, 362-65 (1993) (aperson's interest in personal autonomy and self-determination isa fundamentally commanding one, with well-established legal andphilosophical underpinnings). While in the Department's custody,however, an inmate's right to privacy must be balanced againstthe Department's interest in maintaining an orderly and disciplined institution. Because the Department's interest in prisonadministration is the controlling factor here, we hold that theDepartment may force-feed a hunger-striking inmate, whose onlypurpose is to attempt to manipulate the system so as to avoiddisruptive or otherwise detrimental effects to the orderlyadministration of our prison system.

III. CONCLUSION

For the reasons stated, we affirm the trial court'sorder authorizing the Department to monitor defendant's healthand, if necessary, forcefully administer life-sustaining nutrition.

Affirmed.

COOK, J., concurs.

KNECHT, J., dissents.

JUSTICE KNECHT, dissenting:

I respectfully dissent. I agree with the holdings inZant v. Prevatte 248 Ga. 832, 286 S.E.2d 715, and Thor v. Superior Court, 5 Cal. 4th 725, 855 P.2d 375, 21 Cal. Rptr. 2d 357. Eldon Millard is competent to refuse medical treatment or medication. He does not wish to commit suicide, but he is willing todie. His hunger strike is a protest against prison conditionsand his transfer to Pontiac. His protest does not extend toprison conditions in general, nor does he seek to enlist otherinmates in a cause.

The State presented no evidence showing his conduct haddisrupted the prison or raised security issues. No evidence waspresented other inmates sympathize with him or are themselvesprepared to go on a hunger strike in response to his conduct. Noanecdotal evidence was presented as to what has occurred in otherinstitutions after a hunger strike or a death by hunger strike soeven an inference could be drawn as to what might occur.

The Department simply asserts we need to forcibly feedMillard to keep him alive. We need to do so with a nasogastrictube, and then--because this is a temporary solution--we need tosurgically insert a tube into his stomach. To maintain anorderly and disciplined institution, we want to do these thingsagainst his expressed wishes.

I agree an inmate's right to privacy must be balancedagainst the Department's interest in maintaining order, security,and discipline. What is missing in this record is any evidencethat Millard's conduct has had, or will have, any effect onorder, security, or discipline. There is no balancing to bedone. Millard has carefully expressed his will. We need notlike him or the reasons for his hunger strike, but if the government wants to ram a tub down his throat or cut a hole in hisabdomen, it should be required to demonstrate a compelling reasonfor doing so.

Millard cannot travel or work where he pleases. Hecannot take a walk or enjoy unlimited access to earth and sky. He forfeited liberty when he was convicted of a crime. He doesnot deserve unfettered freedom--but the right to refuse medicaltreatment continues to reside with him. I believe this rightencompasses refusing nourishment. The right to die--if hechooses to do so quietly and without disruption--is a civilliberty he retains. It is a liberty that belongs to him. If thegovernment wishes to take that liberty from him, it must explainand persuade. It cannot just speculate that something bad mayhappen.