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People ex rel. Marquardt

Court of Appeals of Colorado, Second Division

April 24, 2014

The People of the State of Colorado, Petitioner-Appellee, In the Interest of Larry Wayne Marquardt, Respondent-Appellant

          Pueblo County District Court No. 14MH8. Honorable William D. Alexander, Judge.

         Gregory J. Styduhar, County Attorney, David A. Roth, Special Assistant County Attorney, Pueblo, Colorado, for Petitioner-Appellee.

         The Law Firm of John L. Rice, John L. Rice, Pueblo, Colorado, for Respondent-Appellant.

         Opinion by JUDGE ASHBY. Richman, J., concurs. Casebolt, J., concurs in part and dissents in part.

          OPINION

         ASHBY, JUDGE.

          [¶1] Respondent, Larry Wayne Marquardt, appeals from the trial court's order authorizing the involuntary administration to him of antipsychotic medication. We reverse.

         I. Background

          [¶2] Mr. Marquardt was committed to the Colorado Mental Health Institute at Pueblo (CMHIP) after having been found not guilty by reason of insanity in a criminal case. He has been diagnosed with schizoaffective disorder, bipolar type, with prominent paranoia.

          [¶3] Since arriving at CMHIP, Mr. Marquardt has been voluntarily taking ten milligrams of Saphris, an antipsychotic medication, once a day. The People petitioned the court to slowly increase the dosage to 20 milligrams per day because he refused to take any dosage above 10 milligrams per day, and his psychiatrist felt that the medication was not effective at that dosage.

          [¶4] After a hearing, at which both the psychiatrist and Mr. Marquardt testified, the court ordered that the dosage of this medication could be increased over his objection.

          [¶5] Mr. Marquardt appeals.

         II. Discussion

          [¶6] Mr. Marquardt contends that the trial court erred in applying the elements established in People v. Medina, 705 P.2d 961 (Colo. 1985) to the facts of this case.

          [¶7] As a matter of first impression, we must first decide whether Medina is applicable to a nonemergency request to increase antipsychotic medication dosage over a patient's objection. We conclude that it is. We also agree with Mr. Marquardt that the trial court applied an incorrect legal standard in deciding that the evidence presented supported a finding under Medina that an increased dose of his antipsychotic medication is necessary to prevent a significant and likely long-term deterioration in his mental condition.

          [¶8] In Medina, the supreme court found that a patient has a right under both common law and Colorado's statutory scheme relating to involuntary commitment to refuse unwanted treatment that could result in serious and permanent disabilities. Id. at 971. The court noted that the common law had long protected a person's right to personal autonomy and bodily integrity. This protection was founded upon the principle that the individual is best suited to weigh the risks and benefits of treatment and to decide what the best course of treatment is for him or her. Id. at 968.

          [¶9] However, the Medina court held that an involuntarily committed patient's right to autonomy and bodily integrity is not absolute. There are legitimate state interests in providing care to the patient ...


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