Filed March 14, 2007 – Opinion by Judge Lynne Battaglia
Anthony Kelly was adjudged incompetent to stand trial in the Circuit Court for Montgomery County because his delusional disorder prevented him from understanding the adversarial nature of the proceedings against him, and precluded him from assisting in his criminal defense. He was committed to a state health institution for treatment, where the Department of Health and Mental Hygiene sought to forcibly medicate him. The Department convened a Clinical Review Panel that approved the forcible medication and that decision was upheld by an ALJ. The Circuit Court for Baltimore City reversed. On appeal, the Court of Appeals affirmed, holding that Section 10-708 (g) of the Health-General Article of the Maryland Code (1982, 2005 Repl. Vol.) requires the State to prove that an individual, because of his mental illness, is dangerous to himself or others within a state institution before it can forcibly administer medication. Finding nothing in the record to show that Kelly was, because of his mental illness, dangerous to himself or others within the state institution, the Court determined that he could not be forcibly medicated pursuant to Section 10-70 8 (b)(2) and (g).
In a concurring opinion, Judge Alan Wilner raised a concern that the Court had addressed a broader question that the one presented in the case. Judge Wilner would have courts look at the nature and purpose of the prescribed medication when psychiatrists in a State hospital to which a criminal defendant has been committed believe it is necessary to forcibly medicate the defendant. Where the State could demonstrate that the purpose of the medication was not just to suppress but also to treat and ameliorate the symptoms that caused the patient to be committed in the first place, Judge Wilner would put the focus on whether (1) without the medication, those symptoms will not be treated or ameliorated and the patient will therefore remain ineligible for release, and (2) with the medication, the patient will likely become eligible for release. Judge Wilner would put the burden on the State to show both that the prescribed medication is for that broader purpose and that, alone or in conjunction with other medications or therapies, it has a reasonable chance of achieving that objective without undue side effects. Judge Glenn Harrell joined in the concurrence.
The opinion is available in PDF.
Showing posts with label insane delusion. Show all posts
Showing posts with label insane delusion. Show all posts
Wednesday, March 14, 2007
Friday, January 5, 2007
Dougherty v. Rubenstein (Ct. of Special Appeals)
Filed January 4, 2007 — Opinion by Judge Deborah Eyler.
The "insane delusion rule" was created in Britain nearly two centuries ago, in 1826, devised to cover a gap between "idiots and persons of non-sane memory", who are without testamentary capacity, and a person "who knew the natural objects of his or her bounty, the nature and extent of his or her property, and could make a 'rational' plan for disposition, but who nonetheless was as crazy as a March hare", who could enter into a valid will.
In the seminal British case, Dew v. Clark, a father became unalterably convinced that his very young daughter was gross, wicked, depraved, vile, deceitful, and violent, a "child of the devil". He subsequently entered into a will disinheriting his daughter, then died three years later, after having been declared in chancery as being of unsound mind. In the caveat proceeding, the evidence showed that the daughter was known by all for her good disposition, and that the father had boasted about his good treatment of the daughter when the opposite was actually true. The father's behavior was otherwise usual, except for his warped thinking about the daughter, which "did and could only proceed from, and be founded in, insanity." The Dew court found that the father's "partial insanity" or "monomania" (insanity about a particular subject) had caused him to disinherit his daughter, and thus held the father to have been without testamentary capacity when he made his will, and set it aside. The "insane delusion rule" created in Dew was subsequently adopted in Maryland in the 1848 case of Townsend v. Townsend, but applied only rarely, in seven subsequent cases, the latest in 1973.
In this case, the insane delusion rule was invoked in an effort to set aside the 1998 will of James J. Dougherty, III ("James") by his son, James J. Dougherty, IV ("Jay"). The will had disinherited Jay, and, he claimed, was a product of an insane delusion that Jay had stolen his father's money. After his father's death in 2004, Jay sought to be appointed PR of the estate, and to not have the will admitted into probate. The Orphan's Court held evidenciary hearings in 2005. The testimony revealed a rocky relationship between James and Jay, beginning with James' divorce from Jay's mother. They reconciled four years later, and were close for seven more years. In 1990, James executed a will, leaving his estate to Jay.
In the 1990's, James' health deteriorated, due largely to alcohol abuse and prescription narcotics. In 1997, James suffered a minor stroke, and was diagnosed with congestive heart failure and an enlarged heart due to the alcohol abuse. During the hospitalization, James was often disoriented and confused, and had trouble expressing himself or understanding what was being said to him. He was transferred to the hospital's psychiatric unit, where he was diagnosed with dementia, a "lifelong" and "permanent" condition.
Based upon the doctors' advice, Jay decided to place James in a nursing or boarding home in 1998. James was, by all accounts, miserable in the home, and sought help from his visitors to get out. Conditions in the home were by all accounts rather grim, and James correctly blamed Jay for placing him there, and refused to have nothing to do with him. When Jay was away, James' sister (the "Rubenstein" who was later James' PR and a party to this case) removed him from the home and returned him to his house. Upon Jay's return, he returned his father's financial records to him, whereupon James lashed out at him, accusing him of stealing his money and saying that, for him, Jay did not exist.
In subsequent weeks and months, James appointed his sister his attorney in fact, and his heart condition was cared for by a doctor for whom the sister worked. He had a new will drafted, which disinherited his son, over the cautions of his attorney, He lived alone until his death in 2004, largely self-sufficient and in general appearing competent to care for himself. Although there was never any evidence that Jay had actually stolen anything from him, James maintained that he had, and that he had for that reason cut him out of his will. He also complained that Jay had placed him in the home, intending the stay to be permanent.
After the hearings, the Orphans Court judge found that, while a patient in the hospital in 1997 and early 1998, he was clearly without capacity to make a will, although he rejected the diagnosis of permanent and progressive dementia, based on James' subsequent improvement. Based on that improvement, other than the possible issue of an insane delusion, James was found competent to have made the 1998 will. The judge found that James' belief that his son had stolen from him was in fact a delusion, but was unable to conclude that the delusion was the product of a mental disease, and so admitted the will to probate.
On appeal, Jay argued that the judge had applied an incorrect standard to the determination, by requiring a separate determination that the delusion was caused by a mental illness.
In addressing the issue, the Court of Special Appeals (the "Court") noted that, to be valid, a will must be executed by a testator who is of age and legally competent. To rebut the presumption of competence, one must prove either permanent insanity or that the testator was of unsound mind when the will was made. An "insane delusion" or "monomania" is an unsoundness of mind that will invalidate the will if the delusion produced the disposition made in the will. The delusion must be "insane" and the will must be the product of the insane delusion, however. An insane delusion is "a belief in things impossible, or a belief in things possible, but so improbable under the surrounding circumstances, that no man of sound mind could give them credence." Mere eccentricity, peculiar beliefs or aversion to one relative or another are not, standing alone, insane delusions, nor is an insane delusion a general condition, but rather is directed toward some specific object, a person or thing.
The Court them carefully reviewed in detail the three prior Maryland cases where an insane delusion had been found or upheld, finding common features: all were negative false beliefs about the character of a close relative, unconnected to any reality or true experience but only existing in the testator's mind. The obect of the hostility had not only not done the specific acts charged, but in fact had done nothing that could account for the testator's hostility, leaving insanity as the only explanation for the delusion.
Turning to the case at hand, the Court was not convinced the judge had added an additional element by seeking an underlying mental disease, but was merely using "mental disease" as an alternative to "insanity," correctly formulating that more than a mere delusion is needed, namely an "insane delusion." The Court also upheld the judge's determination that the testator's delusion found in this case was not "insane" within the meaning of the rule. The Court distinguished the earlier cases, in which there was no alternate explanation for the delusion other than insanity. Here, the delusion arose while James was a resident, not by choice, of the home, a condition for which James accurately blamed Jay, and arose as an outgrowth of James' stubborn conviction that Jay had "done something wrong" by "imprisoning" him at the home. Although false, the Court found that James' conviction, though it led him to disinherit his son, was not "an inexplicable delusion that only could have come into being as a product of an insane mind," and upheld the judge's conclusion as a reasonable interpretation.
The full opinion is available in WordPerfect and PDF.
The "insane delusion rule" was created in Britain nearly two centuries ago, in 1826, devised to cover a gap between "idiots and persons of non-sane memory", who are without testamentary capacity, and a person "who knew the natural objects of his or her bounty, the nature and extent of his or her property, and could make a 'rational' plan for disposition, but who nonetheless was as crazy as a March hare", who could enter into a valid will.
In the seminal British case, Dew v. Clark, a father became unalterably convinced that his very young daughter was gross, wicked, depraved, vile, deceitful, and violent, a "child of the devil". He subsequently entered into a will disinheriting his daughter, then died three years later, after having been declared in chancery as being of unsound mind. In the caveat proceeding, the evidence showed that the daughter was known by all for her good disposition, and that the father had boasted about his good treatment of the daughter when the opposite was actually true. The father's behavior was otherwise usual, except for his warped thinking about the daughter, which "did and could only proceed from, and be founded in, insanity." The Dew court found that the father's "partial insanity" or "monomania" (insanity about a particular subject) had caused him to disinherit his daughter, and thus held the father to have been without testamentary capacity when he made his will, and set it aside. The "insane delusion rule" created in Dew was subsequently adopted in Maryland in the 1848 case of Townsend v. Townsend, but applied only rarely, in seven subsequent cases, the latest in 1973.
In this case, the insane delusion rule was invoked in an effort to set aside the 1998 will of James J. Dougherty, III ("James") by his son, James J. Dougherty, IV ("Jay"). The will had disinherited Jay, and, he claimed, was a product of an insane delusion that Jay had stolen his father's money. After his father's death in 2004, Jay sought to be appointed PR of the estate, and to not have the will admitted into probate. The Orphan's Court held evidenciary hearings in 2005. The testimony revealed a rocky relationship between James and Jay, beginning with James' divorce from Jay's mother. They reconciled four years later, and were close for seven more years. In 1990, James executed a will, leaving his estate to Jay.
In the 1990's, James' health deteriorated, due largely to alcohol abuse and prescription narcotics. In 1997, James suffered a minor stroke, and was diagnosed with congestive heart failure and an enlarged heart due to the alcohol abuse. During the hospitalization, James was often disoriented and confused, and had trouble expressing himself or understanding what was being said to him. He was transferred to the hospital's psychiatric unit, where he was diagnosed with dementia, a "lifelong" and "permanent" condition.
Based upon the doctors' advice, Jay decided to place James in a nursing or boarding home in 1998. James was, by all accounts, miserable in the home, and sought help from his visitors to get out. Conditions in the home were by all accounts rather grim, and James correctly blamed Jay for placing him there, and refused to have nothing to do with him. When Jay was away, James' sister (the "Rubenstein" who was later James' PR and a party to this case) removed him from the home and returned him to his house. Upon Jay's return, he returned his father's financial records to him, whereupon James lashed out at him, accusing him of stealing his money and saying that, for him, Jay did not exist.
In subsequent weeks and months, James appointed his sister his attorney in fact, and his heart condition was cared for by a doctor for whom the sister worked. He had a new will drafted, which disinherited his son, over the cautions of his attorney, He lived alone until his death in 2004, largely self-sufficient and in general appearing competent to care for himself. Although there was never any evidence that Jay had actually stolen anything from him, James maintained that he had, and that he had for that reason cut him out of his will. He also complained that Jay had placed him in the home, intending the stay to be permanent.
After the hearings, the Orphans Court judge found that, while a patient in the hospital in 1997 and early 1998, he was clearly without capacity to make a will, although he rejected the diagnosis of permanent and progressive dementia, based on James' subsequent improvement. Based on that improvement, other than the possible issue of an insane delusion, James was found competent to have made the 1998 will. The judge found that James' belief that his son had stolen from him was in fact a delusion, but was unable to conclude that the delusion was the product of a mental disease, and so admitted the will to probate.
On appeal, Jay argued that the judge had applied an incorrect standard to the determination, by requiring a separate determination that the delusion was caused by a mental illness.
In addressing the issue, the Court of Special Appeals (the "Court") noted that, to be valid, a will must be executed by a testator who is of age and legally competent. To rebut the presumption of competence, one must prove either permanent insanity or that the testator was of unsound mind when the will was made. An "insane delusion" or "monomania" is an unsoundness of mind that will invalidate the will if the delusion produced the disposition made in the will. The delusion must be "insane" and the will must be the product of the insane delusion, however. An insane delusion is "a belief in things impossible, or a belief in things possible, but so improbable under the surrounding circumstances, that no man of sound mind could give them credence." Mere eccentricity, peculiar beliefs or aversion to one relative or another are not, standing alone, insane delusions, nor is an insane delusion a general condition, but rather is directed toward some specific object, a person or thing.
The Court them carefully reviewed in detail the three prior Maryland cases where an insane delusion had been found or upheld, finding common features: all were negative false beliefs about the character of a close relative, unconnected to any reality or true experience but only existing in the testator's mind. The obect of the hostility had not only not done the specific acts charged, but in fact had done nothing that could account for the testator's hostility, leaving insanity as the only explanation for the delusion.
Turning to the case at hand, the Court was not convinced the judge had added an additional element by seeking an underlying mental disease, but was merely using "mental disease" as an alternative to "insanity," correctly formulating that more than a mere delusion is needed, namely an "insane delusion." The Court also upheld the judge's determination that the testator's delusion found in this case was not "insane" within the meaning of the rule. The Court distinguished the earlier cases, in which there was no alternate explanation for the delusion other than insanity. Here, the delusion arose while James was a resident, not by choice, of the home, a condition for which James accurately blamed Jay, and arose as an outgrowth of James' stubborn conviction that Jay had "done something wrong" by "imprisoning" him at the home. Although false, the Court found that James' conviction, though it led him to disinherit his son, was not "an inexplicable delusion that only could have come into being as a product of an insane mind," and upheld the judge's conclusion as a reasonable interpretation.
The full opinion is available in WordPerfect and PDF.
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