In the Matter of the Civil Commitment of:

STATE OF MINNESOTA
IN COURT OF APPEALS
A19-1484

In the Matter of the Civil Commitment of:

Lindsay Evan Breault.

Filed March 9, 2020
Affirmed
Jesson, Judge

Scott County District Court
File No. 70-PR-19-13489

James P. Conway, Nicole A. Raebel, Jasper s, Moriarty & Wether ille, P.A., Shakopee,
Minnesota (for appellant Lindsay Evan Breault)

Ronald Hocevar, Scott County Attorney, Todd P. Zettler, Jody Kieser Kisting, Assistant
County Attorneys, Shakopee, Minnesota (for respondent Scott County)

Considered and decided by Jesson, Presiding Judge; Ross, Judge; and
Smith, John, Judge.

S Y L L A B U S
A patient’s recent, inconsistent complia nce with taking pres cribed neuroleptic
medication as treatment for a mental illness provides a district court with a sufficient basis
to conclude that the patient “refuses to consent to treatment with neuroleptic medications”
under Minnesota Statutes section 253B.092, subdivision 8(a) (2018).

 Retired judge of the Minnesota Court of A ppeals, serving by appoi ntment pursuant to
Minn. Const. art. VI, § 10.

2
O P I N I O N
JESSON, Judge
Civil commitment patient Lindsay Evan Br eault challenges a district court order
authorizing medical staff to involuntarily administer neuroleptic medication to her. Breault
argues that Minnesota Statutes section 253B.092, subdivision 8 (2018) requires the district
court to find that a patient is currently refusing medication before it can authorize
involuntary administration. Alternatively, Breault contends that the district court’s finding
that a reasonable person in her position would consent to treatment with neuroleptic
medication is not supported by the record. B ecause we conclude that the district court
correctly applied the law and because the record supports its findings, we affirm.
FACTS
Appellant Lindsay Evan Breault has a histor y of mental illness, which led to civil
commitment on two prior occasions.1 Breault’s current commitment began in August 2019
when police responded to a call that Breault threatened to ha rm her child with a rubber
mallet. Upon arrival at her residence, po lice observed Breault “speaking nonsensically”
and describing hallucinations. Following this encounter, Breault was admitted to the
hospital.
At the hospital, Breault was “delusional” and “acutely psychotic and paranoid.”
Based on her symptoms, doctors provisionally diagnosed her with paranoid schizophrenia

1 Breault’s previous civil commitments occurred in Scott County in 2012 and 2013.

3
and recommended neuroleptic medication to treat her condition.2 But Breault refused the
medication.
Roughly one week after her admission to the hospital, a petition was filed seeking
Breault’s civil commitment. Simultaneously, respondent Scott County sought a court order
authorizing the involuntary administration of the prescribed neuroleptic medication. About
two weeks later, the district c ourt held a hearing on the petiti on. At the hearing, which
Breault did not attend, the court heard testimony from the physician tasked with examining
Breault.3 His testimony focused on three topics: Breault’s compliance with taking the
prescribed neuroleptic medication, her past experiences with neuroleptic drugs, and the
benefits and risks of the medication.
Beginning with Breault’s medication compliance, the physician explained that when
he drafted his report, Breault was not taking me dication. However, he stated that he had
since learned that in the three days before the hearing, which was held on August 22, 2019,
Breault was taking the prescribed medication. But the physician also indicated that he was
unsure of Breault’s exact level of compliance, testifying,“[w]ell, I know that she refused
medications when she initially came in. I don’t know what her compliance has been since
August 15.”

2 Certain terms—including “n euroleptic,” “major tranqu ilizer,” “psychotropic” and
“antipsychotic”—are used interc hangeably to describe a class of drugs that result in
sedation of the nervous system. Jarvis v. Levine, 418 N.W.2d 139, 140 n.1 (Minn. 1988).
Because the applicable statute uses “neuroleptic” to refer to this class of drugs, we use that
term throughout this opinion. See Minn. Stat. § 253B.092 (2018).
3 At the beginning of his testimony, the doctor explained that he tried to interview Breault,
but she refused to meet with him. As a re sult, he relied on written records to make his
recommendation.

4
The physician then turned to Breault’s past experiences with neuroleptic
medication. Based on his review of available medical records, he testified that there was
no indication that Breault suffered negative side effects from neuroleptic medication. But
the physician informed the court that he did not have Breault’s records from past
hospitalizations. And while th e physician knew Breault was previously hospitalized, he
admitted that he did not know if she was pr escribed neuroleptic medication. But he
assumed doctors prescribed neuroleptic medi cation for Breault in the past based on her
documented medical condition.
Finally, the physician addressed the benefits and risks associated with the prescribed
medication, Invega. He testified that the drug has relatively few side effects. Although the
drug can cause weight gain and tardive dyskinesia,4 the physician explained that there was
no evidence Breault suffered from that condition. Further, the physician noted that taking
the drug could make less-invasive forms of tr eatment appropriate in the future. In the
physician’s professional opinion, Breault could remain in a psychotic state for a
prolonged—if not indefinite—time period if she did not take the medication. He therefore
opined that the benefits of taking the prescribed drug outweighed the risk of harm.
Along with the physician’s te stimony, the district court took judicial notice of the
reports authored by the civil commitment examiner and the guardian ad litem. Both reports
recommended civil commitment and a court orde r authorizing involuntary administration
of Breault’s medication. Each report focuse d on Breault’s inconsistent compliance with

4 Tardive dyskinesia is a neurological condition characterized by involuntary movements.
Jarvis, 418 N.W.2d at 146.

5
taking the prescribed medication, noting that during the hospitalization, Breault’s behavior
ranged from adamant refusal of medication to compliance.
After the hearing, the district court foun d by clear and convincing evidence that
Breault has a mental illness and committed her as mentally ill. Additionally, finding that
Breault lacked capacity to make decisions regarding treatment with neuroleptic medication,
the court issued an order authorizing its i nvoluntary administration. Breault appeals,
contesting only the court’s auth orization of involuntary ad ministration of neuroleptic
medication.
ISSUES
I. Is this appeal moot because Breault a sserts that she will vol untarily take the
prescribed medication?

II. Before authorizing the involuntary admi nistration of neuroleptic medication under
Minnesota Statutes section 253B.092, subdivision 8, must the district court find that
a patient is currently refusing those medications at the time of the hearing?

III. Does the record support the district court’s finding that a reasonable person in
Breault’s position would consent to treatment with neuroleptic medication?

ANALYSIS
Before civilly committing an individual based on mental illness, a court must first
find that clear and convincing evidence proves that the patient is mentally ill. Minn.
Stat. § 253B.09, subd. 1(a) (2018). If the patient is mentally ill and no suitable alternative
to judicial commitment exists, the court “sha ll commit the patient to the least restrictive

6
treatment program or alternative programs which can meet the patient’s treatment needs.”5
Id.
The court’s involvement does not end upon a patient’s commitment.6 Often, doctors
recommend neuroleptic medication as a form of treatment for patients committed as
mentally ill. That medication can have seri ous negative side effects including tardive
dyskinesia and metabolic syndrome. S t e v e n K . E r i c k s o n e t a l . , Legal Fallacies of
Antipsychotic Drugs, 35 J. Am. Acad. Psychiatry Law 235, 238 (2007); see also Jarvis ,
418 N.W.2d at 146 (describing tardive dyski nesia). But neuroleptic medication often
improves cognitive functioni ng—including memory, atte ntion, and executive
functioning—in many individuals with certain types of mental illness. Erickson, supra, at
242. And essentially, these medications may reduce psychotic symptoms, such as
hallucinations, delusions, and thought disorganization. See id.
Although patients are presumed to have capacity to make decisions about treatment
with neuroleptic medication, when a patient e ither lacks capacity or refuses to consent,
medical staff often seek judicial determina tions related to the administration of that
medication. See Minn. Stat. § 253B.092, subds. 5, 8. Minnesota law provides the path for
doing so. It begins with the premise that court approval is necessary before medication can
be administered involuntarily in nonemergency situations. Id., subds. 3, 8(a). Determining

5 While this process can entail commitment to a state facility, less restrictive programs may
also be available in the community. See generally Minn. Stat. § 253B.097 (2018).
6 In addition to decisions re garding the involuntary administration of medication, courts
remain involved in the civil commitment pr ocess by reviewing 60 and 90-day treatment
reports and deciding requests to extend a period of commitment or discharge a patient from
commitment. See Minn. Stat. §§ 253B.12-.13, .17 (2018).

7
whether a patient has capacity to make decisi ons about neuroleptic medication is the first
step in the court process. Id., subd. 5. If a court finds that the patient has capacity, the
patient’s wishes must be followed. Id., subds. 4, 8(d). If the patient lacks capacity, the
court evaluates whether the patient expresse d what they would do regarding neuroleptic
medication “when the person had the cap acity to make a reasoned decision.” Id.,
subd. 7(b). Again, if clearly expre ssed, the patient’s wishes control. Id. But if the court
does not have evidence of the wishes of a patient without capacity, it must evaluate what a
reasonable person would do, considering the four factors detailed in the statute. Id.,
subd. 7(c)(1)-(4). In cases wh ere the court concludes that a patient lacks capacity and
determines that a reasonable person would consent to treatmen t with neuroleptic
medication, it may authorize the involuntary administration of the prescribed drug.
Id., subd. 8(e).
With this backdrop in mind, we turn to Breault’s case. First, we address
respondent’s argument that this appeal is moot. Having concluded that it is not, we
evaluate Breault’s arguments. We begin by interpreting Minnesota Statutes section
253B.092, subdivision 8, concluding that a pa tient’s recent, inconsistent compliance in
taking prescribed neuroleptic medication is a sufficient basis to determine that the patient
“refuses to consent to treatme nt with neuroleptic medications .” Then, we evaluate the
district court’s findings regarding whether a reasonable person in Breault’s position would
consent to treatment with neuroleptic medica tion. Because the district court did not
erroneously apply the law and because its findings of fact are supported by the record, we
affirm.

8
I. A patient’s assurance of voluntary co mpliance with a prescribed neuroleptic
medication regimen does not render moot a challenge to an order authorizing
involuntary administration of that medication.

Before we turn to Breault’ s arguments, we must addre ss the threshold question of
whether this appeal is moot, as respondent contends. 7 According to respondent, Breault
conceded that she lacked cap acity to make medication decisions and indicated that she
would voluntarily take neuroleptic medicati on. Because the district court’s order
authorized the involuntary administration of medication that Breault alleged she would
take voluntarily, respondent argues that no actu al controversy exists, making this appeal
moot.
An appeal is moot “when a decision on the merits is no longer necessary or an award
of effective relief is no longer possible.” Dean v. City of Winona , 868 N.W.2d 1, 5
(Minn. 2015). Mootness is not “a mechanical rule” but rather a “flexible discretionary
doctrine.” Id. at 4 (quotation omitted). We consider de novo whether an appeal is moot.
Verhein v. Piper, 917 N.W.2d 96, 100 (Minn. App. 2018).
We begin our analysis by observing a fundamental truth: a difference exists between
voluntarily choosing to take psychiatric me dication and having that same medication
forced upon you by the gove rnment. Indeed, we have re cognized that “[i]nvoluntary
medication of mentally ill people presents an issue of the highest concern in a civilized

7 Respondent first raised this issue during oral arguments to this court. Despite the failure
to brief this issue, we nonetheless address it because “[a]s a constitutional prerequisite to
the exercise of jurisdiction, we must consider the mootness question even if ignored by the
parties.” In re Schmidt, 443 N.W.2d 824, 826 (Minn. 1989).

9
society. In recognition, the Minnesota cour ts and the legislature have surrounded this
personal intrusion into one’s liberty with a series of safeguards culminating in strict judicial
review.” In re Peterson , 446 N.W.2d 669, 673 (Minn. App. 1989), review denied
(Minn. Dec. 1, 1989).
This strict judicial revi ew began in 1976. In Price v. Sheppard , the Minnesota
Supreme Court recognized that intrusive fo rms of psychiatric treatment implicate an
individual’s right to privacy. 239 N.W.2d 905, 910-11 (Minn. 1976). As a result, the
supreme court adopted procedures to prot ect an unconsenting patient’s rights when
intrusive psychiatric treatment is contemplated. Id. at 912-13.
Roughly twelve years later, in Jarvis, the supreme court considered whether
neuroleptic medications cons tituted an invasive form of treatment warranting the
protections outlined in Price. 418 N.W.2d at 144, 146-47. In deciding this question, the
supreme court held that the right to privacy guaranteed by Minnesota’s constitution “begins
with protecting the integrity of one’s own body and includes the right not to have it altered
or invaded without consent.” Id. at 148. Consequently, the supreme court determined that
the involuntary administration of neuroleptic medication amounts to an intrusive form of
psychiatric treatment requiring the protections outlined in Price. Id. After Jarvis, in 1989,
the legislature added a provision to the Mi nnesota Commitment Act detailing a judicial
procedure for authorizing the involuntary administration of neuroleptic medication. See In
re Civil Commitment of Raboin , 704 N.W.2d 767, 770 (Minn. App. 2005) (citing 1989
Minn. Laws ch. 282, art. 2, § 100). And late r, in 1997, the legislature inserted Minnesota
Statutes section 253B.092, replacing previous provisions in the act. Id. at 770 n.2.

10
With this caselaw in mind, we return to Breault’s case. Regardless of Breault’s
assurance that she is taking or is willing to voluntarily take the prescribed medication, she
is still subject to a court orde r. That court order authorizes medical staff to administer
medication to her “orally or intramuscularly” for the duration of her commitment. And if
based on an incorrect reading of the law or an incomplete factual re cord, that order is a
serious infringement on Breault’s bodily autono my as protected by he r right to privacy.
The fundamental nature of Breault’s right to privacy—based on her personal autonomy—
is precisely why courts are entrusted with the authority to carefu lly consider whether
involuntary administration of neuroleptic medication is warranted. See Jarvis, 418 N.W.2d
at 147-48. That Breault may be voluntarily accepting the same medication authorized by
the court order does not diminish her interest in protecting her right to privacy by avoiding
an invasive treatment mandated by the government.
Here, an actual controversy exists: whether the district court properly authorized the
involuntary administration of neuroleptic medication. And we are able to grant effective
relief by reversing the district court’s order, if warranted. Accordingly, this appeal is not
moot. See Dean, 868 N.W.2d at 5.

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II. A district court is not required to fi nd that a patient is refusing neuroleptic
medication at the precise time of the hearing before authorizing the
involuntary administration of those medications under Minnesota Statutes
section 253B.092, subdivision 8.

Breault first argues that the district court erroneously interpreted Minnesota Statutes
section 253B.092, subdivision 8, which governs the procedure for authorizing involuntary
administration of neuroleptic medication. A ccording to Breault, the statute is ambiguous
about what level of patient refusal is necessary to trigger the court’s authority to order the
involuntary administration of medication. Breault proposes that we construe the statute as
requiring the district court to find that an individual is currently refusing medication before
it may authorize involuntary administration of medication. To address Breault’s argument
we must interpret the relevant statute, a qu estion of law which we consider de novo.
Lee v. Lee, 775 N.W.2d 631, 637 (Minn. 2009).
The purpose of statutory interpretation is to determine the legislature’s intent. Minn.
Stat. § 645.16 (2018). The “best guide” to th e legislature’s intent is a statute’s plain
language. Rodriguez v. State Farm Mut. Auto. Ins. Co. , 931 N.W.2d 632, 634
(Minn. 2019). When ex amining the plain language of a st atute, we construe “words and
phrases according to rules of grammar a nd according to their common and approved
usage.” Id. (quotation omitted). “In addition, the meaning of a word is informed by how
it is used in the context of a statute.” State v. Rogers , 925 N.W.2d 1, 3 (Minn. 2019).
Accordingly, “[w]e consider a statute as a whole” in order to “harmonize and give effect
to all its parts.” Id. (quotation omitted). If a statute’ s plain language is clear and
unambiguous, then the legislature’s intent is clear, and we apply the plain language. Id.

12
We now turn to the statute in question, Minnesota Statutes section 253B.092,
subdivision 8(a). That subdivision, entitled “Procedure when patient refuses medication,”
provides that “[i]f the substitute decision-maker or the patient refuses to consent to
treatment with neuroleptic medications . . . neuroleptic medications may not be
administered without a court order.” Minn. Stat. § 253B.092, subd. 8(a) (emphasis added).
We must first determine whether the plai n language of the phrase “the patient refuses to
consent to treatment with neuroleptic medications ” is ambiguous. Am. Family Ins.
Grp. v. Schroedl, 616 N.W.2d 273, 277 (Minn. 2000). We conclude that it is not.
We begin with the word “refuses.” Because the statute uses the present-tense form
of the verb “refuse,” it is clear that the statute contemplates recent refusal. 8 The next
question, then, is what must the patient refu se. And the statute provides the answer: “to
consent to treatment with neuroleptic medications.” Read ing this phrase as a whole, we
conclude that the verb “refuses ” must be interpreted in the c ontext of refusing treatment.
Accordingly, we shift our focus to the meaning of “treatment.”
The statute does not define treatment, so we turn to its dictionary definition to
discern its plain meaning. See In re Restorff, 932 N.W.2d 12, 19 (Minn. 2019) (explaining
that courts often use dictionary definitions to determine a statute’s plain meaning).
“Treatment” is commonly unders tood to mean “[t]he use of an agent, procedure, or
regimen, such as a drug, surgery, or exercise, in an attempt to cure or mitigate a disease,
condition, or injury.” The American Heritage Dictionary 1850 (5th ed. 2011). This

8 For instance, a patient who has never—or rarely—expressed an unwillingness to comply
with prescribed neuroleptic medication would not be subject to this statutory subdivision.

13
definition of treatment is broader than a patie nt’s decision to accept or refuse medication
at a singular point in time. Indeed, treatme nt may—and often does—require engaging in
ongoing behavior like following a medication regimen. Consistent with this understanding
of treatment, we read the statute as permitting a district court to consider the totality of the
recent circumstances surrounding a patient’s compliance with tr eatment involving a
neuroleptic medication regimen. And when a patient refuses to follow a neuroleptic
medication regimen as prescribed, it may be appropriate for a district court to authorize the
involuntary administration of that medication.
Further, our reading of the statute is th at the phrase “consent to treatment with
neuroleptic medications” is necessarily broader than a different phrase the legislature could
have chosen. By requiring that a patient refuse “to consent to treatment with neuroleptic
medications” rather than requiring that a patient refuse “to take neuroleptic medications,”
the statute encompasses broader conduct than refusal to take neuroleptic medication at a
given moment. Consenting to treatment with a particular medication may often include
complying with a medication regimen, which may require regular, consistent, or daily use
of medication. Under our interpretation of the statute, a patient’s inconsistent compliance
with a medication regimen provides the district court with a basis to conclude that he or
she “refuses to consent to treatment with neuroleptic medications.”
Applying the plain meaning of the statute to Breault’s case, it is evident that Breault
did not consistently comply with the neuroleptic medicati on treatment prescribed by her
doctor. The record reflects a variety of behavior during Breault’s hospitalization, ranging
from adamant refusal of medication to reluctant acceptance of it. But even acknowledging

14
this range of behavior, the record is clear that Breault refused medication on several
occasions in the weeks preceding the hearing. Recognizing these varying levels of
medication compliance, the district court fo und that Breault was “currently refusing
administration of neuroleptic medication” or “not consiste ntly accepting such treatment
and cannot be relied upon to accept such treatment.” Because this finding is supported by
the record and falls within the conduct contempl ated by the statute, we affirm the district
court’s order.9
Still, Breault argues that because the statute uses the word “refuses,” which is in the
present tense, the district c ourt must find that a patient is currently refusing medication
before authorizing involuntary administration. We reject Breault’s proposed interpretation
for two reasons. First, despite being written in the present tense, th e statute does not use
the words “current” or “currently” to modify a patient’s refusal. Because the statute omits
those words, we cannot read them into “an unambiguous statute under the guise of statutory
interpretation.” 328 Barry Ave., LLC v. Nolan Props. Grp., LLC , 871 N.W.2d 745, 750
(Minn. 2015).
Second, even if we agreed that the statute is ambi guous, we would consider a
number of statutorily identified factors to determine the legislature’s intent. Minn.
Stat. § 645.16. One such factor is “the c onsequences of a particular interpretation.” Id.
We observe that, practically speaking, Breault’ s proposed interpretation is not workable.

9 Our interpretation of the statute is consis tent with unpublished opinions from this court
affirming orders authorizi ng the involuntary administrati on of neuroleptic medication
where a patient may have been taking medication voluntarily at the time of the hearing.

15
If we interpret the statute to require a findin g of current refusal at the time of a court
hearing, a patient could simply refuse medication until the hearing, accept medication the
day of the hearing in order to avoid a court order, and then resume refusal upon return to
the hospital. This “revolving door” to the courthouse is not what the legislature intended.
See Minn. Stat. § 645.17 (2018) (explaining that “the legislature does not intend a result
that is absurd, impossible of execution, or unreasonable”). Accordingly, because it is
contrary to the plain language of the statute and the legislature’s intent, we decline to adopt
Breault’s proposed reading of the statute.
III. The record supports the district court’s finding that a reasonable person in
Breault’s position would consent to treatment with neuroleptic medication.

In addition to her statutory argument, Breault also contends that clear and
convincing evidence does not support the district court’s finding that a reasonable person
in her position would consent to treatment w ith neuroleptic medication. Specifically,
Breault argues that the district court did not have sufficient info rmation to make a
determination on three of the four statutorily identified reasonableness factors.10 See Minn.
Stat. § 253B.092, subd. 7(c)(1)-(4). Becau se the decision whether to authorize the
involuntary administration of neuroleptic me dication implicates the fundamental liberty
interests of privacy and bod ily autonomy, “persons seeki ng to administer neuroleptic
medications must prove by clear and convi ncing evidence that such medication is

10 Breault concedes that there was sufficient information regarding the second factor: the
medical risks, benefits, and alternatives to the proposed treatment.

16
necessary.”11 Peterson, 446 N.W.2d at 672; see also Jarvis, 418 N.W.2d at 146-48. We
review the district court’s factual findings fo r clear error, considering “the record in the
light most favorable to the findings of fact.” In re Civil Commitment of Spicer ,
853 N.W.2d 803, 807 (Minn. App. 2014).
When a patient lacks capacity to make decisions about neuroleptic medication—a
point Breault concedes—and evidence of the patient’s wishes is lacking, the district court
must consider four factors to determine “what a reasonable pe rson would do.” Minn.
Stat. § 253B.092, subd. 7(c). Those four factors are:
(1) the person’s family, comm unity, moral, religious, and
social values;
(2) the medical risks, benef its, and alternatives to the
proposed treatment;
(3) past efficacy and any exte nuating circumstances of past
use of neuroleptic medications; and
(4) any other relevant factors.

11 At oral argument, respondent suggested that the applicable burden of proof is a
preponderance of the evidence, pointing to Minnesota Statutes section 253B.092,
subdivision 6(d). That subdivision details pr ocedures relevant to determining a patient’s
capacity to make informed deci sions about neuroleptic medication. But neither
subdivision 7, which describes the reason ableness factors, nor subdivision 8, which
discusses involuntary administration, co ntain a burden-of-proof requirement. See Minn.
Stat. § 253B.092, subds. 7-8. While this bur den-of-proof issue has been raised but not
decided in a recent unpublished decision, see In re Sharp , No. A19-0875, 2019 WL
5543962, at *3 n.1 (Minn. App. Oct. 28, 2019), review denied (Minn. Dec. 31, 2019), the
weight of our caselaw—both published and unpublished—applies the clear-and-
convincing-evidence burden of proof. See In re Thulin, 660 N.W.2d 140, 145 (Minn. App.
2003); In re Martin, 527 N.W.2d 170, 172 (Minn. App. 1995); In re Muntner, 470 N.W.2d
717, 719 (Minn. App. 1991), review denied (Minn. Aug. 2, 1991); In re Civil Commitment
of Russell, No. A18-0833, 2018 WL 6595910, at *4 (Minn. App. Dec. 17, 2018), In re
Tefera, No. A10-1770, 2011 WL 781353, at *2 (Minn. App. Mar. 8, 2011), review denied
(Minn. May 17, 2011).

17
Id. After considering these f actors, the district court may authorize treatment with
neuroleptic medication if a reasonable person in the patient’s position would consent to the
treatment. Id., subd. 8(e).
Here, nothing in the record indicates that Breault clearly stated her wishes regarding
neuroleptic medication when she was able to make a reasoned decision. Accordingly, the
district court considered the four statutory factors. The district court found that Breault’s
“mental illness has not sufficientl y responded to efforts in th e use of other less intrusive
forms of treatment” and that it was anticipated “with reasonable medical certainty” that she
would respond favorably to treatment with neuroleptic medication. As a result, the district
court found that “[t]aking into consideration [Breault’s] known family, community, moral,
religious, and social values, the medical risks, benefits, and alternatives to such treatment,
the past efficacy and any extenuating circumstances of past use of neuroleptic medication,
and all other relevant factors, a reasonable person would cons ent to the administration of
neuroleptic medication.” This finding is not clearly erroneous.
Beginning with the first factor—involving a person’s family, religious, community,
and moral values—the record does not contain specific information about Breault’s values.
But we observe that this is largely attributable to Breault’s lack of participation—whether
due to an inability to engage in the court’s evaluation proce ss or a desire not to do so—
including her unwillingness to speak with any of the court-appointed medical examiners.
Further, Breault herself contends in her arguments to this court that she is either taking the
medication or willing to take it voluntarily. This proposition undercuts any argument that

18
Breault may have a moral opposition to neurolep tic medication. Accordingly, this factor
does not weigh against the district court’s finding.
Turning to the next contested factor—past treatment with neuroleptic medication—
the Jarvis examiner testified that he presumed Br eault had been prescribed medication in
the past, but that his statement was a presumption. But he also testified that, in the records
he was able to review, he did not see any ev idence of a negative reaction to neuroleptic
medication. This absence of any informat ion indicating a prior negative response to
neuroleptic medication again supports the district court’s finding that a reasonable person
would consent to treatment with neuroleptic medication.
Regarding the final factor—any other relevant factors—the district court’s order did
not identify what other relevant factors it specifically considered. But the record contains
other factors that support the district court’s finding. Those factors include the examiner’s
testimony that Breault’s mental illness had not responded to other less-intrusive treatment
options and his opinion that Br eault would respond favorably to neuroleptic medication
with few, if any, negative side effects. Ag ain, this factor supports the district court’s
conclusion.
Still, Breault argues that the district court did not have enough information to make
a finding on each factor and to narrowly tailor its order to her case. But we do not read the
statute as requiring the district court to make a specific finding on each of the four identified
factors. Rather, the statute states that the district court’s “decision must be based on what
a reasonable person would do, taking into consideration” the four factors outlined in the
statute. Minn. Stat. § 253B.092, subd. 7(c) (e mphasis added). We read this language as

19
requiring a district court to consider the to tality of the circumstances, including the four
specific factors, and then ultimately find what a reasonable person would do. Here, the
district court did just that. And after c onsidering each factor, it determined that a
reasonable person would consent to treatment with neuroleptic medication. Because that
finding is not clearly erroneous, we affirm.12
D E C I S I O N
In sum, we conclude that a patient’s re cent, inconsistent co mpliance with taking
prescribed neuroleptic medication as treatment for a mental illness provides a district court
with a sufficient basis to conclude that the pa tient “refuses to consent to treatment with
neuroleptic medications” under Minnesota Stat utes section 253B.092 , subdivision 8(a).
Here, the district court determined that, at best, Breault inconsistently accepted neuroleptic
medication. And the district court’s finding that a reasonable person in Breault’s position
would consent to neuroleptic medication is not clearly erroneous. Accordingly, the district
court properly authorized the involuntary administration of neuroleptic medication.
Affirmed.

12 We note that in cases where the patient par ticipates in the proceedings, we expect the
district court to make more robust findings. But in cases like this one where the patient
does not or cannot cooperate with examiners, testify, provide any information to the court,
and participate in the proceeding in any way, the district court does not err by relying on
the information presented to it, if that information is sufficient to make a finding.