Background
Ryan (a pseudonym) faced charges in three Brown County, Wisconsin criminal cases: unauthorized use of a vehicle, second-degree sexual assault of a child under 16, and disorderly conduct/resisting an officer/felony bail jumping. His competency was raised multiple times beginning in December 2023. A jury convicted him on the sexual assault charge in May 2025, and before sentencing—with the other two cases still pending—his competency was again placed in question. In August 2025, the circuit court found him incompetent to proceed but likely to become competent within twelve months and committed him. He was transferred to an inpatient hospital in December 2025.
The Department of Health Services (DHS) moved on January 9, 2026, for an order authorizing involuntary administration of antipsychotic medication, principally risperidone, to restore Ryan’s competency. Treating psychiatrists documented that Ryan had previously responded to risperidone but had since refused medication for months, denied having schizophrenia, denied any prior treatment, and was unable to apply his partial understanding of the drug’s risks and benefits to his own condition. Ryan contested the motion, and the circuit court held an evidentiary hearing on January 16, 2026, at which Dr. Molly Kadlec testified.
The circuit court granted the DHS’s motion and issued written involuntary medication orders in all three cases, checking boxes reflecting that the federal Sell v. United States factors had been satisfied. However, neither the court’s oral ruling nor its written orders addressed the separate requirements of Wis. Stat. § 971.14(3)(dm)—the Wisconsin statute governing a defendant’s competency to refuse medication—or made any findings that Ryan lacked that competency.
The Court’s Holding
The Wisconsin Court of Appeals reversed the involuntary medication orders in all three consolidated cases. The court held that before a circuit court may order involuntary medication under Wis. Stat. § 971.14, it must make explicit findings—supported by clear and convincing evidence—that (1) the advantages, disadvantages, and alternatives of the proposed medication were explained to the defendant, and (2) the defendant is either incapable of expressing an understanding of those matters or is substantially incapable of applying that understanding to his own mental illness in order to make an informed treatment decision. Because the circuit court never referenced § 971.14(3)(dm), never discussed Ryan’s competency to refuse medication, and made no findings on those elements, the orders could not stand.
The court rejected the State’s forfeiture argument, concluding that Ryan’s challenges were properly framed as sufficiency-of-the-evidence claims (which cannot be forfeited under Wisconsin procedural rules) and that the burden to satisfy the statutory and constitutional requirements for an involuntary medication order rests on the State, not the defense. The court also distinguished its earlier decision in State v. D.E.C., which involved a defendant raising new factual material on appeal rather than purely legal arguments about unmet statutory burdens.
The court further declined to affirm the orders on the ground that the evidentiary record might have supported the missing findings. It found no statutory or other basis to substitute its own fact-finding for the circuit court’s absent determination, and treated the State’s failure to respond to Ryan’s substantive arguments on this point as a concession. The case was remanded with the orders reversed.
Key Takeaways
- A Wisconsin circuit court ordering involuntary medication under Wis. Stat. § 971.14 must make explicit findings under § 971.14(3)(dm) that the defendant’s competency to refuse medication has been addressed; satisfying the federal Sell factors alone is insufficient.
- The burden to ensure all statutory and constitutional prerequisites for an involuntary medication order are met falls on the State, not the defendant; the defense is not required to prompt the court to make required findings.
- A sufficiency-of-the-evidence challenge to an involuntary medication order cannot be forfeited under Wisconsin law, even if the defendant did not raise the specific argument below.
- An appellate court will not supply missing circuit court findings on competency to refuse medication, even when the underlying record might support them—the trial court must make those findings in the first instance.
Why It Matters
This decision underscores that Wisconsin’s involuntary medication framework imposes a dual and independent obligation on circuit courts: they must satisfy both the federal Sell constitutional criteria and the separate state statutory requirements of § 971.14(3)(dm). Courts cannot treat compliance with one framework as a proxy for the other, and checking the Sell boxes in a written order will not rescue an involuntary medication order that is silent on the defendant’s competency to refuse treatment.
For criminal defense attorneys, the ruling clarifies that challenges to the adequacy of a circuit court’s § 971.14(3)(dm) findings are preserved regardless of whether counsel explicitly raised them at the hearing, and that the State—not the defense—is responsible for ensuring the record contains the necessary factual and legal determinations. Prosecutors and DHS counsel seeking involuntary medication orders should ensure the circuit court affirmatively addresses and finds each statutory element on the record.