decided: January 26, 1978.
IN RE CHRISTOPHER J. F. GROSS, APPELLANT
Michael L. Rosenfield, Pittsburgh, David Ferleger, Philadelphia, for appellant.
John Edward Wall, Wilbur McCoy Otto, Stewart M. Flam, John M. Duff, Wm. C. O'Toole, Pittsburgh, for appellee.
Jones, C. J., and Eagen, O'Brien, Roberts, Pomeroy, Nix and Manderino, JJ. Jones, former C. J., did not participate in the decision of this case.
[ 476 Pa. Page 205]
This is an appeal from a decree of the Orphans' Court Division of the Court of Common Pleas of Allegheny County dismissing appellant's exceptions to an earlier decree denying appellant's petition for injunctive relief.*fn1 The lower court's dismissal of exceptions was based upon its holding that the legal issue upon which appellant based his prayer for injunctive relief had been rendered moot. Because we also conclude that the issue is moot, for the reasons set forth herein, we affirm the decree.
The material facts, as found in the record and stipulation of facts by counsel for the parties, are as follow: On or about March 24, 1974, appellant, then age 18, was involuntarily committed to Western Psychiatric Institute and Clinic (W.P.I.C.), appellee, pursuant to the then applicable involuntary civil commitment provisions of Section 406 of the Mental Health and Mental Retardation Act of 1966 (Mental
[ 476 Pa. Page 206]
Health Act).*fn2 Act of October 20, 1966, Special Sess. No. 3, P.L. 96, art. IV, § 406, 50 P.S. § 4406 (1969). Appellant remained in treatment at W.P.I.C. until June 19, 1974, at which time he was released.*fn3 On February 28, 1975, appellant, then age 19, was again involuntarily committed to W.P.I.C. under the provisions of Section 406 of the Mental Health Act.
On both occasions appellant was diagnosed as suffering from an acute paranoid schizophrenic psychosis. During his periods of treatment as an inpatient at W.P.I.C., appellant was administered an anti-psychotic, psychotropic tranquilizer called trilafon and a second medication, cogentin, designed to mitigate certain side-effects of the trilafon. On numerous occasions appellant indicated to W.P.I.C. staff
[ 476 Pa. Page 207]
members that he did not wish to take the medication. On these occasions appellant was informed by W.P.I.C. staff members that the physicians in charge of his treatment had the authority to compel him to take the medication and that if he did not take the medication orally, the usual method of administration, it would be administered via intramuscular injection. According to the stipulation of facts, only once was appellant given the medication by injection. Appellant later complained of blurred vision, inability to read without magnifying glasses, dryness of the mouth, and tremors, all of which appellant attributed to the medication.*fn4 The parties agreed that the use of the medications in question was, in the judgment of the W.P.I.C. physicians, the best medically indicated treatment and the most generally accepted method of treatment, although not the only acceptable method.
On May 1, 1975, appellant, while still an inpatient at W.P.I.C., filed a petition for injunctive relief in the Orphans' Court Division of the Court of Common Pleas of Allegheny County seeking to restrain W.P.I.C. from administering medication against his will. The petition was denied on the same date, but the court granted appellant leave to amend the petition, which he did on the following day, alleging in the amended petition that Section 417 of the Mental Health Act,*fn5 upon which W.P.I.C. relies for its authority to administer
[ 476 Pa. Page 208]
the medication, was unconstitutional. In a decree nisi dated May 2, 1975, the lower court dismissed appellant's amended petition for injunctive relief.*fn6 Appellant, on May 2, 1975, filed exceptions to this dismissal. On May 28, 1975, appellant was released from W.P.I.C.*fn7 After oral argument on June 2, 1975, the lower court en banc, in an opinion dated August 25, 1975, dismissed appellant's exceptions, holding that appellant's release from W.P.I.C. rendered the underlying issue moot. On appeal to this Court, appellant, in addition to contending that the questions presented are not moot, claims that Section 417 is overly broad and thus violative of due process and further asserts that involuntarily committed mental patients have a common law right to refuse treatments, which right cannot, in the absence of judicially declared incompetence, be negated by the state. Since we find, for the reasons set forth below, that the appeal is moot, we need not address the merits of appellant's latter claims.
[ 476 Pa. Page 209]
An accurate description of those circumstances which raise the issue of mootness is provided by Professor Gunther, who writes:
The cases presenting mootness problems involve litigants who clearly had standing to sue at the outset of the litigation. The problems arise from events occurring after the lawsuit has gotten under way -- changes in the facts or in the law -- which allegedly deprive the litigant of the necessary stake in the outcome. The mootness doctrine requires that "an actual controversy must be extant at all stages of review, not merely at the time the complaint is filed." G. Gunther, Constitutional Law 1578 (9th ed. 1975).
It is well established in this jurisdiction that this Court will not decide moot questions. Wortex Mills v. Textile Workers, 369 Pa. 359, 85 A.2d 851 (1952). As explained above, a legal question can become moot on appeal as a result of an intervening change in the facts of the case. For example, in Meyer v. Strouse, 422 Pa. 136, 221 A.2d 191 (1966) involving an action in quo warrantor, the appellant appealed from the lower court's judgment which ordered his ouster from the office of tax collector. When the appeal reached this Court, the appellant's term of office had already expired, and this Court held that the intervening expiration of the appellant's term of office rendered the appeal moot. Id. See Schuster v. Gilberton Coal Co., 412 Pa. 353, 194 A.2d 346 (1963) (an intervening, superseding contract and separate pending litigation thereunder rendered appeal under original contract moot); Ridley Park Shopping Center v. Sun Ray Drug Co., 407 Pa. 230, 180 A.2d 1 (1962) (declaratory judgment action to establish appellant's right to possession of property made moot an appeal due to appellant's intervening conveyance of subject property).
Similarly, an issue can become moot due to an intervening change in the applicable law. In Conti v. Pa. Dept. of Labor & Industry, 405 Pa. 309, 175 A.2d 56 (1961), this Court held an appeal to be moot where the question involved the
[ 476 Pa. Page 210]
validity of a minimum wage order executed by the Secretary of Labor and Industry based upon the then existing statutory authority and thereafter, during the pendency of the action, the General Assembly enacted the Minimum Wage Act of 1961, P.L. 1313. In holding that the appeal was moot, this Court stated:
Since the entry of the lower court's order the Pennsylvania Legislature in the 1961 session, enacted 'The Minimum Wage Act of 1961,' P.L. 1313, to supplement the provisions of the Act of 1937, supra, which initially established the regulation of minimum wages in Pennsylvania. Section 5(a) of the Act of 1961 (effective January 1, 1962), provides for the payment of a minimum wage of $1.00 per hour to every employee in any occupation except 'as may otherwise be prescribed.' Admittedly, none of the occupations dealt with in the instant action are exempt. Hence, the question basically raised by this appeal is moot. It is now impossible to grant relief by deciding the issue involved since no actual controversy exists. It has long been the rule in Pennsylvania that this Court will not decide moot questions. We will do so only in rare instances where exceptional circumstances exist or where questions of great public importance are involved: Id. at 310-11, 175 A.2d at 57 (Citations omitted).
See Salisbury Twp. v. Sun Oil Co., 406 Pa. 604, 179 A.2d 195 (1962) (challenge to ordinance held moot on appeal due to expiration of ordinance); N. Pa. Pwr. Co. v. Pa. P.U.C., 333 Pa. 265, 5 A.2d 133 (1939) (constitutional challenge to statute held moot on appeal due to intervening amendment enacted by legislature), overruled on other grounds, York v. Pa. P.U.C., 449 Pa. 136, 295 A.2d 825 (1972).
This Court is even more reluctant to decide moot questions which raise constitutional issues. Wortex Mills v. Textile Workers, supra. In Wortex Mills this Court was asked to decide, as a constitutional matter, whether peaceful, organizational labor union picketing was legal; in Wortex Mills the strike which caused the picketing had ended by the time
[ 476 Pa. Page 211]
the appeal reached this Court. In declining to reach the constitutional question, this Court observed:
"'Constitutional questions are not to be dealt with abstractly.'"
Id. at 370, 85 A.2d at 857, quoting, Bandini Petroleum Co. v. Superior Ct., 284 U.S. 8, 22, 52 S.Ct. 103, 108, 76 L.Ed. 136 (1931). The United States Supreme Court has described such judicial reluctance as "the exercise of judicial restraint from unnecessary decision of constitutional issues." Kremens v. Bartley, 431 U.S. 119, 136, 97 S.Ct. 1709, 1719, 52 L.Ed.2d 184 (1977), quoting, Regional Rail Reorganization Act Cases, 419 U.S. 102, 138, 95 S.Ct. 335, 356, 42 L.Ed.2d 320 (1974).
The instant appeal presents a situation involving an intervening change in the factual posture of the case as well as an intervening change in the applicable law. Appellant is no longer an inpatient at W.P.I.C. and, therefore, is no longer being administered medication by W.P.I.C. against his will. Appellant is now being treated by his own physician. In short, there was nothing for the lower court to enjoin, nor can this Court now order the injunctive relief sought below.*fn8 See Allen v. Birmingham Twp., 430 Pa. 595, 244 A.2d 661 (1968) (appeal from denial of injunction to prevent excavation of land held moot where excavation had already been completed); Strassburger v. Philadelphia Record Co., 335 Pa. 485, 6 A.2d 922 (1939) (appeal from denial of injunction to prevent annual shareholder meeting held moot where meeting had already been held according to by-laws).
Of equal or greater significance than the altered factual posture of the instant appeal is the fact that three months after oral argument the legislature passed the Mental
[ 476 Pa. Page 212]
Health Procedures Act (Procedures Act).*fn9 Act of July 9, 1976, P.L. 817, No. 143, § 101 et seq., 50 P.S. Section 7101 et seq. (Supp.1977-78); see note 2, supra. Appellant's contention, in summary, is that Section 417 of the Mental Health Act*fn10 confers unfettered discretion upon the directors of mental health facilities as to treatment and, therefore, violates appellant's alleged constitutional and common law right to refuse treatment. It is true that the Procedures Act did not repeal Section 417 of the Mental Health Act. See 50 P.S. § 7502(a) (Supp.1977-78). However, since both acts govern the treatment of the mentally disabled, they are in pari materia and must be construed together, if possible, as one statute. Statutory Construction Act of December 6, 1972, P.L. 1339, No. 290, Section 3, 1 Pa.C.S.A. § 1932 (Supp.1977-78). Whether Section 417 did confer unbridled discretion upon directors of mental health facilities prior to the enactment of the Procedures Act is a question we need not decide, because as the law stands now it is clear that the discretion previously conferred under Section 417 has been significantly restricted by the Procedures Act.*fn11
The entire text of the Procedures Act shows an enlightened legislative endeavor to strike a balance between the state's valid interest in imposing and providing mental health treatment and the individual patient's rights. The legislative policy of the Procedures Act is set forth in Section 102:
It is the policy of the Commonwealth of Pennsylvania to seek to assure the availability of adequate treatment to
[ 476 Pa. Page 213]
persons who are mentally ill, and it is the purpose of this act to establish procedures whereby this policy can be effected. Treatment on a voluntary basis shall be preferred to involuntary treatment; and in every case, the least restrictions consistent with adequate treatment shall be employed. Persons who are mentally retarded, senile, alcoholic, or drug dependent shall receive mental health treatment only if they are also diagnosed as mentally ill, but these conditions of themselves shall not be deemed to constitute mental illness. 50 P.S. § 7102 (Supp.1977-78).
Section 104 of the Act defines "adequate treatment" as follows:
Adequate treatment means a course of treatment designed and administered to alleviate a person's pain and distress and to maximize the probability of his recovery from mental illness. It shall be provided to all persons in treatment who are subject to this act. It may include inpatient treatment, partial hospitalization, or outpatient treatment. Adequate inpatient treatment shall include such accommodations, diet, heat, light, sanitary facilities, clothing, recreation, education and medical care as are necessary to maintain decent, safe and healthful living conditions.
Treatment shall include diagnosis, evaluation, therapy, or rehabilitation needed to alleviate pain and distress and to facilitate the recovery of a person from mental illness and shall also include care and other services that supplement treatment and aid or promote such recovery. Id. § 7104.
Of particular relevance is the Procedures Act's requirement that an individualized treatment plan be formulated for each person being treated under the Act. Id. § 7106. This treatment plan and the manner of its formulation are described in Section 107:
Individualized treatment plan means a plan of treatment formulated for a particular person in a program appropriate to his specific needs. To the extent possible, the plan shall be made with the cooperation, understanding
[ 476 Pa. Page 214]
and consent of the person in treatment, and shall impose the least restrictive alternative consistent with affording the person adequate treatment for his condition. Id. § 7107.
Thus, not only does the Procedures Act mandate that the treatment plan impose the least restrictive alternative consistent with adequate treatment, it also seeks the cooperation, understanding, and consent of the patient.*fn12 Although Section 417 of the Mental Health Act was not repealed by the Procedures Act, it can hardly be disputed that the Procedures Act significantly circumscribes the discretion vested in mental health facility directors by Section 417. What is even more obvious is that by requiring patient participation, Section 107 of the Procedures Act strikes directly at the heart of appellant's constitutional and common law attack on Section 417 of the Mental Health Act. In short, Section 107 of the Procedures Act addresses itself to those very rights that appellant sought to establish in the court below. Appellant's release from treatment at W.P.I.C. coupled with the subsequent enactment of the Procedures Act has rendered this appeal moot.
[ 476 Pa. Page 215]
Appellant next contends that even if his case is moot, this Court should nonetheless reach the merits of his claim, because it presents a question of great public importance, thus coming within one of the well-organized exceptions to the mootness doctrine. Meyer v. Strouse, supra (dicta); Schuster v. Gilberton Coal Co., supra (dicta); Ridley Park Page 215} Shopping Center v. Sun Ray Drug Co., supra (dicta); Conti v. Dept. of Labor & Industry, supra (dicta); Wortex Mills v. Textile Workers, supra (dicta); Janet D. v. Carros, 240 Pa. Super. 291, 362 A.2d 1060 (1976); Commonwealth ex rel Finken v. Roop, 234 Pa. Super. 155, 339 A.2d 764 (1975), cert. denied, 424 U.S. 960, 96 S.Ct. 1452, 47 L.Ed.2d 728 (1976). It is conceded that the questions raised by appellant concerning the rights of involuntarily committed mental patients are of public importance. However, as the case law cited above indicates, the appellate courts of this jurisdiction have infrequently invoked the great public importance exception to the mootness doctrine. In Wortex Mills this Court was confronted with a significant question involving the interface between constitutional law and labor law and still declined to resolve the issue, because it was moot. Wortex Mills v. Textile Workers, supra. What is controlling in the instant case is that the legislature obviously recognized the significance of questions involving rights of mental patients and, therefore, enacted the Procedures Act subsequent to the time that this appeal was taken. As noted before, the Procedures Act deals squarely with the issues appellant raises. In view of the new comprehensive statutory scheme, there is no longer a need to assess the validity of the former scheme.*fn13 Thus, we hold that the instant appeal does not fall within the great public importance exception to the mootness doctrine.
[ 476 Pa. Page 216]
Finally, appellant contends that notwithstanding the mootness of his claim this Court should reach its merits, because the question presented is capable of replication yet escaping judicial review, and, thus, is encompassed by another exception to the mootness doctrine. This Court has in the past reviewed moot questions which are necessarily recurring ones.*fn14 Devlin v. Osser, 434 Pa. 408, 411, 254 A.2d 303, 304 (1969); Miller v. Lutheran Ass'n., 331 Pa. 241, 200 A. 646 (1938) (question involved possible recurrence of trespass to land); Werner v. King, 310 Pa. 120, 164 A. 918 (1933) (question concerned duty that public official had to perform every year). Appellant attempts to bring his case within the scope of this exception by arguing in essence that he could be recommitted, involuntarily treated, and then released again before an appeal from a denial of injunctive relief could reach this Court. While this argument would be impressive if the basis of our holding of mootness rested solely upon the fact of appellant's discharge from W.P.I.C., it is not persuasive where mootness has been determined because of a change in the law, particularly where this change attempts to address the objections raised by appellant.*fn15 Thus, we conclude that the instant appeal does not present a necessarily recurring question.
[ 476 Pa. Page 217]
Each party pay own costs.