CRIMINAL LAW
Sloane Bessey
In Matter of Mark V., 501 P.3d 228 (Alaska 2021), the supreme court held that that for a less restrictive analysis in a commitment proceeding only options available at the time need to be considered and not all of the factors supporting a finding that a patient lacks competence to consent to the administration of medication are required for a court to make such a finding. (Id. at 236). Mark V. has had a history of severe mental illness, and he has repeatedly been committed to the Alaska Psychiatric Institute (API) since he stabbed his parents during a psychotic episode. (Id. at 229–30). In September 2019, a psychiatric advanced nurse practitioner at API, Gerald Martone, petitioned for a 180-day commitment order, and he testified that Mark needed to take his medication to control the symptoms of his disorder. (Id. at 230). The court found that Mark was not ready to be discharged and that there was no feasible less restrictive alternative at the time. (Id. at 230–32). In May 2020, Martone petitioned the court again because Mark was refusing to take medication, and the court found that Mark was unable to give or withhold informed consent at the time and gave Martone authorization to administer the medication involuntarily. (Id. at 232–34). Mark is appealing both the commitment order and the orders authorizing the administration of medication involuntarily. (Id. at 234). The court found that the trial court had not improperly shifted the burden to Mark to show that there was no less restrictive alternative to confinement, and that its findings regarding the lack of a less restrictive alternative were accurate. (Id. at 234–35). The court also found that Mark’s continued institutionalization did not violate federal antidiscrimination laws, because even if the court had considered ADA requirements in its analysis, the court only had to consider options available to it at that time, which it did. (Id. at 236). The court found that the lower court testimony supported a finding that Mark met at least one of the factors supporting a lack of competence to consent to the administration of medication because he lacked the ability to rationally participate in his treatment, but the court reminded the lower court to include specific findings in its future orders. (Id.at 237–38). The supreme court affirmed both the confinement order and the medication order, holding that for a less restrictive analysis in a commitment proceeding only options available at the time need to be considered and not all of the factors supporting a finding that a patient lacks competence to consent to the administration of medication are required for a court to make such a finding. (Id. at 236).