In the Matter of the Civil Commitment of: Nicholas D. Webster.

This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2018).

STATE OF MINNESOTA
IN COURT OF APPEALS
A20-0128

In the Matter of the Civil Commitment of: Nicholas D. Webster.

Filed June 15, 2020
Affirmed
Connolly, Judge

Scott County District Court
File No. 70-PR-19-21686

James P. Conway, Jaspers, Moriarty & Wetherille, P.A., Shakopee, Minnesota (for
appellant)

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

Susan Dredge, Bloomington, Minnesota (guardian ad litem)

Considered and decided by Connolly, Presiding Judge; Larkin, Judge; and
Rodenberg, Judge.

U N P U B L I S H E D O P I N I O N
CONNOLLY, Judge
On this appeal from the district court’ s civil commitment of appellant and
authorization of the involuntary administration of neuroleptic medication to him, appellant
argues that the district court erred by dec lining to appoint a substitute decision -maker.

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Because the district court’s failure to appoint a substitute decision -maker was harmless
error, we affirm.
FACTS
On December 27, 2019, Scott County filed a petition for judicial commitment of
appellant Nicholas D. Webster. Appellant was 18 years old at the time and is currently 19
years old. The petition arose after appellant used a cannabis vaping device with
concentrated THC on a daily basis for approximately five to six months while he was
attending college. Appellant was hospitalized for one month in November and December
2019 “for management of delusional psychosis.” Shortly after he was released from t he
hospital, he left his parent s’ house, where he resided, without proper winter clothing. He
reportedly believed that his parents had been replaced by actors who had kidnapped him to
be on an internet streaming show. The police found appellant and transferred him to the
hospital.
The county also filed a petition to authorize treatment with neuroleptic medication,
based on the recommendations of doctors at the hospital. Neuroleptic medication is
designed to relieve the psychotic symptoms of mental il lnesses. The county noted that
appellant had clearly refused the treatment.
The district court he ld a commitment hearing on January 8, 2020. At the hearing,
the court -appointed examiner recommended that appellant be civilly committed and
receive neuroleptic medication. Appellant’s guardian ad litem also recommended that the
court authorize the recommended treatment of appellant. The district court heard testimony

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that appellant had refused to take neuroleptic medication since December 31, 2019, even
though it had been offered to him every day.
Appellant’s mother testified at the hearing. She requested to be appellant’s
substitute decision-maker, so that she would be authorized to make decisions for appellant
regarding what medication to take. Appellant’s mother did not want the hospital to
administer two specific neuroleptic drugs because she believed that they had been
ineffective. Appellant’s counsel later reiterated this concern to the district court. He had
no objection to the forcible administration of four neuroleptic drugs but requeste d that the
court exclude the two drugs that appellant’s mother had mentioned. He also asked that the
district court appoint appellant’s mother as a substitute decision-maker. Appellant did not
testify at the hearing.
The district court issued orders on January 10, 2020, granting the county’s petitions.
First, it determined that appellant was “mentally ill and chemically dependent with a
diagnostic impression of Schizophrenia [and] Cannabis Use Disorder.” Accordingly, it
committed him to the treatment facility for an initial period of six months.
Second, the district court authorized treatment with neuroleptic medication. It
concluded that neuroleptic medication was necessary to treat the symptoms of appellant’s
mental illness, that appellant had not su fficiently responded to less intrusive forms of
treatment, and that appellant’s “need for treatment with neuroleptic medication has been
clearly shown to greatly outweigh the intrusiveness and possible side effects of the
treatment.” The district court fo und that appellant had consistently refused to take
neuroleptic medication since December 31, 2019. It then determined that appellant lacked

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the capacit y to decide whether to take the medication and concluded that a reasonable
person would consent to the administration of the medication.
As such, the district court authorized the treatment facility to administer neuroleptic
medication to appellant without his consent. The district court authorized the use of six
different neuroleptic dru gs, including the two drugs to which appellant’s mo ther and
counsel had objected . The court’s order did not address the appointment of a substitute
decision-maker.
On January 14, 2020, a ppellant requested that the district court amend its order to
appoint a substitute deci sion-maker, arguing that such an appointment was mandatory by
statute. The county opposed appellant’s request. The district court denied appellant’s
request, stating that it was “not convinced that appointing a substitute decision maker is
mandatory in this case.” This appeal follows.
D E C I S I O N
Appellant contends that the Minnesota Civil Commitment Act required the district
court to appoint a substitute decision -maker under these circumstances. 1 “[T]his court
reviews de novo questions of statutory construction and the application of statutory criteria
to the facts found.” In re Civil Commitment of Kropp, 895 N.W.2d 647, 650 (Minn. App.
2017), review denied (June 20, 2017). When interpreting a sta tute, appellate courts

1 At oral argument, the county suggested that appellant had waived this argument because
he did not present it to the district court. But appellant’s counsel requested that the district
court appoint a substitute decision-maker at the co mmitment hearing and repeated that
request in a letter to the district court after the district court issued its orders. This issue is
therefore properly before this court.

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“construe a statute as a whole and interpret its language to give effect to all of its
provisions.” State v. Riggs , 865 N.W.2d 679, 683 (Minn. 2015). Furthermore, “various
provisions of the same statute must be interpreted in the light of each other.” Id. (quotation
omitted).
Appellant points to Minn. Stat. § 253B.092, subd. 6(a) (2018). That provision
provides:
Upon request of any person, and upon a showing that
administration of neuroleptic medications may be
recommended and tha t the person may lack capacity to make
decisions regarding the administration of neuroleptic
medication, the court shall appoint a substitute decision-maker
with authority to consent to the administration of neuroleptic
medication as provided in this section.
Minn. Stat. § 253B.092, subd. 6(a). Appellant argues that all the circumstances listed in
the statute were present here —treatment by neuroleptic medication was recommended,
appellant lacked the capacity to make decisions, and he requested a substitute decision-
maker. Since those circumstances were present, he maintains that the statute required the
district court to appoint a substitute decision-maker.
In response, the county argues that subdivision 6(a) does not apply here. Instead, it
contends that the statute “only requires the appointment of a Substitute Decision Maker
when the Substitute Decision Maker has the authority to consent to treatment under
Subdivision 6,” and “a Substitute Decision Maker does not have authority to consent to
treatment under Subdivision 6 when the patient refuses to take the medication.” The county
notes that because appellant refused to consent to treatment, a substitute decision -maker
could not override that decision. The county maintains that Minn. Stat. § 253B.092, subd.

6
8 (2018), articulates t he proper procedure here . That provision addresses situations in
which the patient refuses to consent to neuroleptic medication. It provides that, if the
patient refuses the medication, then “neuroleptic medications may not be administered
without a court order.” Minn. Stat. § 253B.092, subd. 8(a).
Appellant is correct that the requirements of Minn. Stat. § 253B.092, subd. 6(a), for
appointing a substitute decision-maker were satisfied here. The court-appointed examiner
and guardian ad litem recommended neuroleptic medication, the examiner opined that
appellant lacked the capacity to make decisions regarding the administration of the
medication, and appellant’s mother and counsel requested a substitute decision-maker. We
have held that Minn. Stat. § 253B.092, subd. 6(a), is mandatory, so the district court must
appoint a substitute decision -maker when those circumstances are present . In re Civil
Commitment of Raboin, 704 N.W.2d 767 , 772-73 (Minn. App. 2005). However, there is
an important distinction between this case and Raboin—here, appellant had already refused
to take ne uroleptic medication when he requested a substitute decision -maker, whereas
there is no indication that the patient in Raboin had made such a refusal. See id. at 768.
It is undisputed that appellant had refused neurol eptic medication since
December 31, 2019. That refus al changes the application of the statute. Generally, a
substitute decision-maker has the authority to consent to the administrati on of neuroleptic
medication. Minn. Stat. § 253B.092, subd. 6(a). But medication may be administered “[i]f
the substitute decision-maker gives informed consent to the treatment and the person does
not refuse.” Id., subd. 6(b) (2018) (emphasis added). “ If the substitute decision -maker
refuses or withdraws consent or the person refuses the medication, neuroleptic medication

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may not be administered to the person without a court order or in an emergency.” Id.
(emphasis added). Because of appellant’s refusal to take the medication, even if the district
court had appointed appellant’s mother as a substitute decision -maker, neuroleptic
medication could not have been administered unless there was a court order or an
emergency. Indeed, that was the entire purpose of the court order—to override appellant’s
refusal to consent to neuroleptic medication.
The appointment of appellant’s mother as a substitute decision-maker would change
nothing in this case. Appellant’s mother would not be able to consent to the administration
of neuroleptic medication, since appellant already refused to take the medication. Nor
would she be able to refuse particular neuroleptic drugs on appellant’s behalf (wh ich was
her primary reason for wanting to be substitute decision-maker) because the district court
has already authorized the administration of the two drugs that appellant’s mother objected
to.
Therefore, we conclude that the district court’s failure to appoint a substitute
decision-maker was harmless error. See Minn. R. Civ. P. 61 (providing that the court at
every stage of the proceeding must disregard any error that does not affect substantial
rights); cf. In re Muntner , 470 N.W.2d 717, 719 (Minn. App. 1991) (holding that patient
must show that he was prejudic ed by the absence of his guardian ad litem at hearing on
administration of neuroleptic medication to justify reversal of the district court’s order ),
review denied (Minn. Aug. 2, 1991). Although Minn. Stat. § 253B.092, subd. 6(a), requires
the district court to appoint a substitute decision-maker under the circumstances that were
present here, the district court’s failure to do so had no impact on the proceedings.

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Additionally, appellant contends that the district court’s failure to appoint a
substitute decision-maker violated his right to substantive due process. Specifically, he
asserts that treatment with neuroleptic medication infringes on his state constitutional rights
to privacy and bodily autonomy. Appellant argues that the district court’s actions were
subject to strict scrutiny and did not satisfy strict scrutiny because they were not narrowly
tailored. According to him, the appointment of a substitute decision -maker is a “less
restrictive alternative” to “an order for forced treatment against the will of the patient,” so
the district court infringed upon his “right to be subjected only to the least restrictive
method to meet his needs” when it failed to appoint a substitute decision-maker.
We cannot discern how appointing a substitute dec ision-maker would have been a
less restrictive alternative to the hearing that appellant received. When a patient refuses
neuroleptic medication, as appellant did here, a court order is the only method for
administering the medication, regardless of what the substitute decision -maker decides.
See Minn. Stat. § 253B.092, subd. 6(b). The district court held a hearing on the matter and
then issued an order. Judicial review, such as occurred here, has long been considered the
primary way to vindicate patien ts’ substantive -due-process rights to privacy and bodily
autonomy. See Price v. Sheppard , 239 N.W.2d 905, 913 (Minn. 1976) (holding that
hospitals must obtain a court order before administering intrusive forms of treatment
against patients who are incompe tent or refuse consent); see also Jarvis v. Levine , 418
N.W.2d 139, 148 (Minn. 1988) (holding that the administration of neuroleptic medication
is an intrusive treatment, so hospitals must follow the procedures from Price when
administering it against incompetent patients who refuse consent).

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Because appellant received full judicial review in the district court before the
neuroleptic medication was administered, the district court did not violate his substantive-
due-process rights.
Affirmed.