APPEAL from a judgment of the Superior Court of Kings County. Timothy S. Buckley, Judge. (Super. Ct. No. 06P0143).
The opinion of the court was delivered by: Wiseman, Acting P.J.
CERTIFIED FOR PUBLICATION
In this case we resolve a conflict in statutory language relating to mental capacity to give or refuse consent to medical treatment. Harrison Burton, a state prison inmate, argues that, although he embarked on a hunger strike based on delusional beliefs, the Probate Code gave him the right to continue the hunger strike because his mental condition did not impair his understanding of its potential fatal consequences. He expresses his view this way in his opening brief: "The [Probate Code] does not grant the authority to a court to take away an individual's right to make health care decisions for . stupid or, even, delusional reasons." (Italics added.)
The trial court ruled that the delusional beliefs meant Burton's decision was not based on a rational thought process and that under the code he therefore lacked the mental capacity to refuse the nourishment (and medicine) prison doctors sought to compel him to take. The court granted the doctors' petition to authorize prison administrators to consent to treatment on Burton's behalf. We agree with the trial court.
FACTUAL AND PROCEDURAL HISTORIES
As a result of the latest in a series of hunger strikes, Burton was admitted to a prison infirmary in August 2007. He refused to eat but consented to drink juice.
A prison psychiatrist explained that Burton engaged in the hunger strike for delusional reasons:
"He believes that he is on a hunger strike as a kind of martyr for the other inmates who are being tortured by female correctional officers who go into the tower and take off their clothes and then proceed to insert objects into their vaginas in view of the other inmates so as to torture them. [¶] He also believes . that his food is contaminated; that officers are spitting into his food or, in other words, in other ways poisoning his food. [¶] . [¶] And that his hunger strike, if he succumbs that he will then be able to-that there will be the possibility of pursuing legal action so as to improve the condition of the other inmates."
Burton's fear of poisoning also extended to his medicine; he would take tablets but not capsules, which might have been tampered with. Another prison physician stated that Burton heard voices that told him not to abandon the hunger strike. These were the same voices that told Burton to commit the crime for which he was incarcerated. Burton's delusions were fixed, meaning that he believed in them continuously, not intermittently.
The delusions resulted from paranoid schizophrenia. Burton's other symptoms included visual and auditory hallucinations.
Burton has hepatitis C, which worsened as the hunger strike went on and degraded his immune system. He had lost a substantial amount of weight since beginning the hunger strike. If he continued to take only juice, he would eventually experience kidney and liver failure and, ultimately, death.
Both doctors believed Burton understood the consequences of the hunger strike. They filed the petition in spite of this because they concluded that Burton's delusions meant his refusal to take nourishment was not the result of a rational thought process. The psychiatrist testified:
"Mr. Burton has-is a very, very intelligent man, and he has a comprehensive understanding of the effects of a hunger strike on his medical condition, including the possibility of death.
"The Petition is not based on his understanding of the consequences of his action. The Petition is based on the motivation behind his action, which is psychotic."
The psychiatrist agreed when the court asked him if his position was "that the fact that a person understands the consequences in and of itself does not make him or ...