Indefinite Civil Commitment for HIV+ Schizophrenic Man

The Court of Appeals of Minnesota has upheld the indeterminate civil commitment to a secure facility of David Kendall Renz, a mentally ill HIV-positive man who has tested positive for syphilis, gonorrhea and chlamydia, sexually transmitted diseases, and who has admitted that he had engaged in sex without informing his partners about his HIV status. The court reached this ruling despite the lack of any identified victim who has actually been infected by Renz. The October 28 opinion for the court by Judge Renee L. Worke does not indicate the gender of Renz’s sexual partners.  In the Matter of the Civil Commitment of David Kendall Renz, 2008 WL 4706962.

Under Minnesota law, there is a significant difference between being civilly committed as "mentally ill" and being civilly committed as "mentally ill and dangerous," as was the case with Renz. Civil commitment for mental illness is limited to 12 months, and the individual is sent to the "least restrictive treatment program" available. A person who is committed as "mentally ill and dangerous" is sent to a secure facility and the commitment may be indefinite, meaning that it will only end upon a determination that the individual no longer presents a danger to others.

Renz had previously been civilly committed as mentally ill, from May 1998 through June 1999, from October 2000 through October 2001, from March 2003 until July 2003, and then from April 2005 until October 2006, but, as the trial court noted, his behavior regarding treatment for HIV had been inconsistent. His treating psychiatrist testified that he was "schizophrenic," did not understand the nature of HIV infection, and was casual about taking medications, evidently believing that he had cured himself because he was asymptomatic. He had admitted to his doctors that he was engaging in unprotected sex. As a result of these admissions, he was tested for venereal diseases, and when he tested positive, doctors and law enforcement officials drew the obviously conclusion that his admissions were true, since at least two of the diseases he had contracted are only spread through intimate unprotected sexual contact.

Having found that Renz was engaging in sexual activity that can transmit HIV, the court decided that he was dangerous, even thought no identified victim has been located. The trial court found that there was "clear and convincing evidence" that he "deliberately engaged in unprotected sexual activity with others even though he has been diagnosed with HIV and, thus, has ‘engaged in an overt act causing or attempting to cause serious physical harm to another’ regardless of intent or the outcome of the action." When questioned, Renz freely admitted that he had engaged in unprotected sex, "at times without disclosing his HIV diagnosis to his sexual partners."

Renz was not prosecuted, even though his conduct might be characterized as criminal were he not mentally ill, but rather subjected to civil commitment. The court drew an analogy between his conduct and the act of "a mentally ill person who fires a shotgun at another or drives a vehicle into a crowd of people at 100 m.p.h." A court-appointed medical examiner, having interviewed Renz, testified that it was "pretty clear" that Renz has unprotected sex, because he said that "it would be impossible to use protection all the time." This doctor also opined that Renz did not appreciate the need for consistently taking his HIV medication because he believed he had cured himself.

Renz’s own treating physician concurred, testifying that he had treated Renz for sexually transmitted diseases, from which he drew the conclusion that Renz was engaging in unprotected sex. Another court-appointed doctor testified that if Renz were released back into the community, he would likely be "sexually active in a way that puts him at higher exposure for engaging in reckless sexual behavior, in part due to his psychiatric state." This doctor testified that Renz had admitted to him having had five or six sexual partners in the previous year. Renz’s psychiatrist testified that he did not seem to understand HIV infection and how it is transmitted. He also testified, somewhat confusingly, that Renz had told him that he told his sexual partners that he has the infection and if they do not care then he does not use protection, but evaluating the accuracy of statements is difficult due to Renz’s schizophrenia.

The court of appeals concluded that in light of all this medical testimony, the trial court "did not err" in concluding that Renz met the requirement for civil commitment as "mentally ill and dangerous." The lack of an identified victim was not a bar to the determination, in light of the obvious inferences about Renz’s conduct to be drawn from his admissions and his venereal infections.

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