NO. 12-05-00424-CV
IN THE COURT OF APPEALS
TWELFTH COURT OF APPEALS DISTRICT
TYLER, TEXAS
THE STATE OF TEXAS § APPEAL FROM THE
FOR THE BEST INTEREST § COUNTY COURT AT LAW
AND PROTECTION OF D.D. § CHEROKEE COUNTY, TEXAS
MEMORANDUM OPINION
D.D. appeals from an order to administer psychoactive medication. After a hearing without a jury, the trial court entered an order authorizing the Texas Department of Mental Health and Mental Retardation to administer psychoactive medication to D.D. In two issues, D.D. asserts the trial court erred in admitting certain evidence and the evidence is legally and factually insufficient to support the order. We affirm.
Background
On July 5, 2005, the trial court entered an order for extended mental health services. On December 20, 2005, an application for court ordered authorization for the administration of psychoactive medication was filed. The application was prepared by a physician, Dr. Satyajeet Lahiri. Dr. Lahiri diagnosed D.D. as suffering from schizoaffective disorder. The doctor indicated that he believes D.D. lacks the capacity to make a decision regarding administration of psychoactive medication because she is acutely psychotic with persecutory delusions of being harmed. After hearing Dr. Lahiri’s testimony, the court entered an order to administer psychoactive medication.
Admissibility of Application
In her first issue, D.D. asserts the trial court committed reversible error by admitting the application for court ordered medication. She contends the evidence shows she voluntarily took the medication and, therefore, the application falsely states that she verbally refused to take the medication. She argues that a false application should not support the order to administer medication.
In order to preserve error for appellate review, a party must present to the trial court a timely request, objection, or motion, state the specific grounds therefor, and obtain a ruling. Clark v. Trailways, Inc., 774 S.W.2d 644, 647 (Tex. 1989). By failing to object to evidence offered at trial, a party waives any complaint about the admissibility of the evidence. See id. When the application was offered into evidence at the hearing, counsel for D.D. stated that he had no objection to the application. D.D. has waived this complaint. We overrule her first issue.
Psychoactive Medication
In her second issue, D.D. asserts the evidence is neither legally nor factually sufficient to support the order to administer psychoactive medication. She contends that the State did not prove by clear and convincing evidence that she lacks the capacity to make a decision regarding the administration of psychoactive medicine. She argues that the record does not show that she did not have the ability to understand the nature and consequences of taking medication.
Applicable Law
In a legal sufficiency review where the burden of proof is clear and convincing evidence, the reviewing court must consider all of the evidence in the light most favorable to the finding to determine whether a reasonable trier of fact could have formed a firm belief or conviction that its finding was true. In re J.F.C., 96 S.W.3d 256, 266 (Tex. 2002). The reviewing court must assume that the factfinder resolved disputed facts in favor of its finding if a reasonable factfinder could do so. Id. A court should disregard all evidence that a reasonable factfinder could have disbelieved or found to have been incredible. Id.
In addressing a factual sufficiency of the evidence challenge, we must consider all the evidence in the record, both that in support of and contrary to the trial court’s findings. In re C.H., 89 S.W.3d 17, 27-29 (Tex. 2002). This court must give due consideration to evidence that the factfinder could reasonably have found to be clear and convincing. Id. at 25. We must determine whether the evidence is such that a factfinder could reasonably form a firm belief or conviction about the truth of the State’s allegations. Id. We must consider whether disputed evidence is such that a reasonable trier of fact could not have reconciled that disputed evidence in favor of its finding. In re J.F.C., 96 S.W.3d at 266. Appellate courts retain deference for the constitutional roles of the factfinder. In re C.H., 89 S.W.3d at 26. The trier of fact is the exclusive judge of the credibility of the witnesses and the weight to be given to their testimony. See id. at 27; In re J.J.O., 131 S.W.2d 618, 632 (Tex. App.–Fort Worth 2004, no pet.).
The court may enter an order authorizing the administration of psychoactive medication if it finds by clear and convincing evidence that the patient is under an order for temporary or extended mental health services, the patient lacks the capacity to make a decision regarding the administration of the proposed medication, and treatment with the proposed medication is in the best interest of the patient. Tex. Health & Safety Code Ann. § 574.106(a) (Vernon Supp. 2005). In determining that there is a need for psychoactive medication, the court is required to consider the following:
(1) the patient’s expressed preferences regarding treatment with psychoactive medication;
(2) the patient’s religious beliefs;
(3) the risks and benefits, from the perspective of the patient, of taking psychoactive medication;
(4) the consequences to the patient if the psychoactive medication is not administered;
(5) the prognosis for the patient if the patient is treated with psychoactive medication;
(6) alternatives to treatment with psychoactive medication; and
(7) less intrusive treatments likely to secure the patient’s agreement to take the psychoactive medication.
Tex. Health & Safety Code Ann. § 574.106(b) (Vernon Supp. 2005).
Discussion
Dr. Lahiri testified that D.D. was, at the time of the hearing, under an order for extended mental health services. The doctor testified that D.D. suffers from schizoaffective disorder. He said D.D. has refused to accept medications voluntarily and lacks the capacity to make an informed decision regarding administration of psychoactive medication. The requested medications are in the proper course of treatment and are in D.D.’s best interests, the benefits outweigh the risks, and her hospital stay would be shortened if medications are used.
On cross examination, Dr. Lahiri said that D.D. is taking her medication, but she does not have the capacity to consent. He explained that the issue of court ordered medication was overlooked at the commitment hearing. He filed the application when the issue was brought to his attention. The doctor testified that D.D. refuses to sign a consent to take the medication, but she does take the medication.
On redirect, the doctor testified that she does not have the capacity to accept medication. On further cross examination, he explained that D.D. is not capable of understanding the side effects, risks, or benefits of the medications because her psychosis is so acute. She gets angry and does not engage in rational conversation. Therefore, if a patient does not have the capacity to give consent, the physicians do not give medications. If a patient has the capacity to consent, they give the medication if the patient agrees to it.
Considering all the evidence in the light most favorable to the findings, we conclude a reasonable trier of fact could have formed a firm belief or conviction that D.D. lacked the capacity to make a decision regarding administration of the proposed medication. See In re J.F.C., 96 S.W.3d at 266. This evidence satisfies the statutory requirement for clear and convincing evidence in support of the order for administration of psychoactive medication. See Tex. Health & Safety Code Ann. § 574.106(a). The evidence is legally sufficient to support the trial court’s order. See J.F.C., 96 S.W.3d at 266.
In addressing D.D.’s factual sufficiency complaint, we consider all the evidence, giving due consideration to evidence the factfinder could reasonably have found to be clear and convincing. In re C.H., 89 S.W.3d at 25. D.D. presented no testimony at the hearing. Although D.D. did not refuse medication given to her, the doctor believed that D.D. was not competent to make a decision about whether to take or refuse medication. The mere fact that a patient will take medications offered does not indicate that patient has the capacity to make a decision regarding the administration of medication. In light of the entire record, the evidence that the trial court could not have credited in favor of its findings is not so significant that the trial court could not reasonably form a firm belief or conviction that D.D. lacks the capacity to make a decision regarding the administration of the proposed medication and that treatment with the proposed medication is in his best interest. See id. Thus, the evidence is factually sufficient to support the trial court’s findings. See Tex. Health & Safety Code Ann. § 574.106(a). Because we hold the evidence is both legally and factually sufficient to support the trial court’s order, we overrule D.D.’s second issue.
Conclusion
D.D. waived any complaint about the admissibility of the application for court ordered medication. The evidence is legally and factually sufficient to support the trial court’s order for the administration of psychoactive medication.
We affirm the trial court’s order.
SAM GRIFFITH
Justice
Opinion delivered July 31, 2006.
Panel consisted of Worthen, C.J. and Griffith, J.
(PUBLISH)